Millions of seniors who qualify for Medicare have just a few weeks remaining to choose a prescription plan, and health advocates are urging seniors to take careful stock of their needs and choices so they get the coverage – and medicines – they need in 2009.

Beneficiaries have until Dec. 31 – but shouldn't delay, senior advocates say – to wade through the often complicated open-enrollment process for Medicare's so-called "Part D" program, the federal prescription drug plan for seniors.

"There have been significant changes, and people should not feel complacent about their current plans," said Margaret Reilly, a regional program manager for the Health Insurance Counseling and Advocacy Program. The program is a free service to help Medicare beneficiaries understand their choices.

"We're getting flooded with calls from people who don't know what to do," said Reilly, who called the annual year-end ritual "daunting."

More than 500,000 Medicare beneficiaries live in the nine-county Central Valley region.

"I want to suggest that seniors do a little homework," she said. "I know it's been a while since they did homework, but this requires some homework."

She recommends that seniors not wait until the deadline to enroll in a plan, so paperwork can be processed in time for coverage at the start of the new year. She also suggests going online to speed up the enrollment process.

Virtually every plan will have some kind of change, many of them significant – including premium hikes, revisions to drug coverage and customer service.

Start by assessing your needs, Reilly said.

Consult your doctor and pharmacist. List the drugs you need – and the dosage – to figure out which plan will provide the right coverage.

Plans change and people change, according to senior advocates.

"Seniors should review their plans to make sure they match up with their needs for drugs and their costs, because the cost and coverage of pharmaceuticals change every year," said Elizabeth Abbott, project director for Health Access California and a former regional administrator of the Centers for Medicare and Medicaid Services, which administers the Medicare program.

"Even if they are satisfied, they need to confirm that it meets their health needs."

Low-income seniors need to be especially careful, according to the National Senior Citizens Law Center, which last month warned that as many as 2 million low-income seniors nationwide, including more than 200,000 Californians, face potential disruption to their Medicare prescription plans next year and thousands could lose subsidies under the program's coverage formulas.

In recent weeks, drug insurance programs have been wooing seniors to choose their plans. In California, seniors have 51 plans from which to choose, five fewer than they had this year.

"This requires a sophisticated shopper," said Gary Passmore, a spokesman for the Congress of California Seniors, a coalition of more than 500,000 seniors.

The least expensive plan has a monthly premium of $18, while the most expensive is $129 a month, he said.

"That tells you there are enormous differences – in deductibles, co-pays and coverage," Passmore said.

"I don't want to scare people, but if they need help, they should get it. There are so many plans available that they should take the opportunity during open enrollment to see if there is a better plan that best suits their needs."

Call The Bee's Bobby Caina Calvan, (916) 321-1067.