It's open-enrollment time for seniors who want to take advantage of Medicare's drug benefit, which kicked in at the beginning of 2006.

About 44 million elderly and disabled beneficiaries can enroll in a private drug plan approved and heavily subsidized by the federal government. But the government subsidy next year, $53.97 a month for the typical enrollee, only covers part of the costs. All but the poorest participants also pay monthly premiums and co-payments, a share of cost when filling each prescription.

Participants don't have to stick with the same company, though. Beginning Saturday through Dec. 31, they can choose prescription drug coverage from dozens upon dozens of insurance plans operating in their state. The enrollment period ends Dec. 31.

Here are some questions and answers about the program:

Q: What is Medicare Part D?

A: In 2003, Congress passed a law that for the first time gave a prescription drug benefit to all seniors. Before the law was implemented in 2006, Medicare did not pay for outpatient drugs.

Q: Do I have to buy it?

A: No. But if you don't have prescription drug coverage and put off buying a plan, the price will be higher when you do.

Q: How do I select a plan?

A: It's best to go to the www.medicare.gov website, where you can type the name of your medications into a Web program. It will tell you how much you would pay under each prescription drug plan.

If you don't have a computer, call 800-633-4227 or go to the Medicare Answers Prescription Savings centers for one-on-one counseling. Call 561-688-1211 or 772-467-0008.

Q: What's new with Medicare Part D for 2009?

A: In Florida, the number of stand-alone Medicare prescription drug plans for 2009 has decreased to 53 from 58. Virtually all the plans have changed costs and benefits compared with the 2008 plans.

Q: When can I sign up for Medicare Part D?

A: Enrollment begins Saturday and ends Dec. 31. After that, you have to wait until the end of 2009.

Q: What's the doughnut hole?

A: When Congress created the prescription drug program, it tried to save money by creating a gap in coverage -- a hole.

In 2009, the gap begins after you -- and the drug plan -- spend $2,700 on prescription drugs.

Coverage does not resume until you have spent $4,350 in out-of-pocket drug costs, including the cost of premiums and deductibles. At that point, prescription drug coverage resumes and you pay 5 percent of the cost of your drugs.

Some plans do provide limited coverage of brands and generics in the gap.

Q: If I like my Part D plan, what should I do?

A: Virtually all the plans are changing their costs and benefits for 2009. So even if you are satisfied, it pays to shop.

Q: Is it best to buy a plan if I can get cheap drugs from Canadian pharmacies?

A: Drugs may be cheaper in Canada, but that's not insurance, and there's no guarantee prices in Canada won't go up.

Q: I don't use any medicines now or buy only cheap generics, so why should I pay for a drug plan?

A: It takes only one illness to run up thousands of dollars in drug bills. If you wait to buy a drug policy, the price goes up 1 percent a month for each month you could have bought coverage -- but didn't.

Q: What if I have prescription drug coverage through an employer or the Department of Veterans Affairs?

A: Then you won't be penalized if one day you decide to buy from a Medicare Part D plan.

And though you are probably in good shape, it does pay to check whether you would save money buying from a Medicare prescription drug plan.

Q: I spend part of the year in Florida and part of the year up north; what should I do?

A: Most of the plans offer national coverage, but it's best to check with the specific plan.

Q: I already get drug coverage through a Medicare HMO and am happy. Do I have to change?

A: You are covered, so you won't face a penalty if you later decide to switch to Medicare Part D. Drug coverage is often cheapest through Medicare HMOs because they typically don't charge a monthly premium.

But be warned that Medicare HMOs, like Medicare Part D, change costs and benefits each year.

Q: Can I be assured the drugs I use will not be dropped from the plan in future years?

A: Plans cannot discontinue or reduce coverage for a drug you are already taking.

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