PROVIDENCE -- They paced and slumped in various stages of confusion. They stared slackjawed at the documents before them.

The residents at Parenti Villa, a Providence high-rise, had just endured a lecture on "Medicare Part D," the federal government's new prescription drug program for the elderly and those with disabilities.

"I'm making myself sick over this thing," said Jennie Joseph, 71, who sat in the community room, which was decorated with hangings of smiling pumpkins and happy ghosts.

Richard Dupuis, 64, fiercely stirred his coffee.

"They're making it so complicated, I don't understand none of it," he fumed.

The most chipper person in the fluorescent-lit room, it seemed, was Michael Tabishesky, 82, with a tuft of gray hair standing tall. So, what did he think of the presentation?

"I couldn't hear a thing they said, to tell you the truth," he bellowed.

STARTING Jan. 1, 2006, the government, for the first time, will offer Americans with disabilities, and those 65 or older, prescription-drug insurance under Medicare.

Enrollment for the 173,000 Medicare beneficiaries in Rhode Island begins Tuesday and goes through May of next year. Many people are excited about the new plan. It's an opportunity for many people to have steady access to prescription drugs at an affordable price. In Rhode Island, monthly premiums will range from $7.32 per month to $65.58.

But signing up for Medicare Part D is complex. It's like getting a present that you have to assemble yourself.

The program looks and works nothing like traditional Medicare. It is privatized -- available only through private insurers.

In Rhode Island, people must choose from among 18 competing companies, which are offering a total of 44 plans.

That's no easy task: Each plan covers different drugs at different prices and is accepted at different pharmacies.

There are penalties for signing up at the wrong time. And the plans have hangups -- lots of lingo such as "however," and "there is one caveat."

To add to the chaos, the insurance companies are currently blitzing people with promotional literature.

The federal government, for its part, has supplied 43 million households nationally with "Medicare & You," a thick booklet that ultimately sends readers to the Internet for answers.

DOROTHY St. Germain is one of many Rhode Island seniors experiencing option overload.

"If they would just shorten it up and give me the facts," said St. Germain, 80, a widow who lives at the Village at Waterman Lake, an assisted living community in Smithfield.

"They explain so many different options that your brain is going from one way to the other and you're saying, 'Gee, I don't know what to do,' " she said.

Lewis Prescott, 78, of Lincoln, is more irritated than confused, though he is also confused -- and he's an astute retired CEO.

He believes the ones making out best are insurance companies, which "are going to be diving into this as fast as they can because it's a big moneymaker."

"I'm wound up," he said.

But nonetheless, he thought it prudent to see whether he and his wife should enroll in Medicare Part D.

The couple does not pay for supplemental coverage and consider themselves self-insured. Prescott needs scant prescriptions; his wife's needs are considerable. They buy her more expensive medications from Canada.

Doing the math, he determined that his wife might benefit from the plan but that he probably didn't need it -- not yet anyway.

BUT THE "Medicare & You" opus kept urging him to sign up now, whether he needed it now or not.

In fact, under the program, he could pay higher penalties by not signing up in the six-month enrollment period that begins Tuesday and ends in May. He's baffled.

"I don't know why any senior citizen who doesn't need something should buy it just to avoid being penalized," he said. "It's coercion."

As he read along in "Medicare & You," he became more befuddled. "It just keeps you going from section to section with arrows. By page 50 you've learned absolutely nothing."

At that juncture, the book sent him to the Internet. The book introduces a new character, elderly "Mary." Mary and her daughter go onto www.medicare.gov to decide on a plan.

"I don't have a daughter, and it's too late to get one," Prescott said.

Prescott followed the trail to the Internet.

"The road led to oblivion," he said. "There's no way that Mary's daughter would help her to decide what plan to get."

RECENTLY, HOWEVER, the Medicare Web site began offering more concrete information. People can type medications into the "Medicare Prescription Drug Plan Finder" and multiple plans come up.

Deane Beebe, a spokeswoman for the Medicare Rights Center, a nonprofit advocacy organization in New York, tried it out at home on Tuesday night. She sought out the cheapest plan.

But something curious happened, she said. There was an asterisk next to the drugs on her chosen plan.

That meant there would be limitations on access to the drug. The drug might be available only in certain quantities, for instance.

The asterisk directed her to "call the plan." She obeyed.

"I was left on hold for 40 minutes," she said. "They explained they were experiencing heavy call volume."

She accidentally hung up, and never did reach a human being. She doesn't know how long she might have lingered on hold.

"This is not just incomprehensible for older and disabled Americans," she said. "It's incomprehensible for everyone."

PHARMACISTS and state officials in Rhode Island are trying to help.

At CVS on Chalkstone Avenue in Providence, there's a Neon yellow and red banner: "Attention seniors: Aviso para personas de la tercera edad: Medicare Prescription Insurance is here!"

Brooks Pharmacy has made Wednesday Medicare Day. Come in, chat, watch a video, and maybe get a freebie, which on a recent day in Cranston was hand sanitizer.

Though some pharmacists say they can offer only general advice, many people really want someone to crunch the numbers and tell them what to do.

"It's hard for us to even understand," said Daniel Lefkowitz, a University of Rhode Island pharmacy student who was working an information booth at Brooks one day.

A team from the Rhode Island Department of Elderly Affairs is offering seminars and posting Senior Health Insurance Program counselors at 22 meal sites and senior centers. For information, call the department at (401) 462-4000.

Larry Grimaldi, spokesman for the department, said, "Once you understand it, it is a relatively simple program. The difficulty comes in the wide variety of choices that they have."

BUT NOTHING is simple, as was demonstrated at the meeting at Parenti Villa.

For example, at one point, Rep. Steven M. Costantino, a Providence Democrat, asked for a show of hands -- Who had Medicare? Who had Medicaid?"

"Which is which?" asked a middle-aged man in combat fatigues.

There were more questions. "Yes! Hello!," shouted a white-haired man over in the corner.

He was about to turn 65 and had recently received a letter from Medicare. "They're taking $78.20 out of my coming check on the third." What was that all about?

Costantino thought the man might be "dual eligible."

Larry Grimaldi, spokesman for the Department of Elderly Affairs, jumped up to help with the question.

Costantino backed off, muttering to himself. "It's so complicated. It's unbelievable."

Grimaldi explained that the man's new deduction in his paycheck had nothing to do with prescription drugs and the Medicare Part D program.

No, the deduction was Medicare Part B. That's a different program, for medical insurance.

"Not Medicare?" the man asked softly, holding his chin in his hand.

"Medicare Part B," Grimaldi repeated.

Grimaldi paced, his shiny, black tassled loafers clicking on the worn red and blue tile. He enunciated slowly as if teaching the alphabet to an English as a Second Language class.

"A. B. C. D."

"I want you to understand," he said kindly, "these are separate pieces."

Anna Pinto, an elegant woman with a bevy of jingling bracelets and a green quilt neatly folded over her walker, put down her magnifying glass and spoke up.

"Do you have to get the Part D?"

BROWSE recent Journal coverage of the upcoming changes in Medicare, as well as reports from Journal MoneyLine columnist Neil Downing, at:

http://projo.com/extra/2005/medicare/