Seniors will be allowed to choose from an array of programs offered by the selected insurance companies rather than a single Medicare drug plan. Insurers will begin marketing their offerings Oct. 1, with enrollments to begin Nov. 15. Coverage will kick in Jan. 1.

The Bush administration named 10 insurers to provide a prescription drug program to an estimated 30 million senior citizens as part of the largest expansion in Medicare's 40-year history.

While insurers are prohibited from detailing their programs until Oct. 1, several emphasized that convenience and simplicity will be key components.

Minnetonka, Minn.-based UnitedHealth Group Inc. plans low-cost programs based on which drugs are covered; Unicare partner Wellpoint, based in Indianapolis, is setting up low-cost programs based on beneficiaries' income levels.

Cigna Corp.'s plans will include flat copay systems, while Pacificare Health Systems Inc. in Los Angeles is contracting with 30,000 brokers nationwide to sell its prescription plan in hopes that local sales reps will stand out from the rest of the crowd.

Array of Programs

The expansion culminated a long battle for federally subsidized prescription drugs. Rather than a single Medicare drug plan, seniors will be allowed to choose from an array of programs offered by the selected insurance companies. Insurers will begin marketing their offerings Oct. 1, with enrollments to begin Nov. 15. Coverage will kick in Jan. 1.

"There were no real surprises today in who was selected," said Susan Rawlings, Wellpoint's president of senior services. "The surprises will be after Oct. 1, how products are designed, the relative value of the product to the customer and how we find the right path to new customers and new prospective customers."

The companies approved to offer stand-alone drug coverage nationwide are: Aetna Life Insurance Co., Coventry Health and Life Insurance Co., Connecticut General Life Insurance Co., Medco, Memberhealth Inc., Pacificare Life and Health Insurance Co., Silverscript Insurance Co., Unicare, UnitedHealth Group Inc., and Wellcare Health Plans.

While the choices are intended to benefit senior citizens and inject market-driven competition, insurers fear confusion will reign.

"I do think there's a concern there will be an overwhelming set of choices," Rawlings said.

Nearly $400 Billion over 10 Years

The Centers for Medicare & Medicaid Services plan to launch a Web site Oct. 13 offering details on formulas that will allow beneficiaries to select drugs and review benefits, costs and premiums.

Seniors without access to the Internet may call a toll-free number and have information mailed to them.

"It will be important to get the full picture," said Tricia Neuman, vice president of the Kaiser Family Foundation, a health policy organization. "We now know the number of organizations. From a consumer point of view, they may want to know the number of plans."

Terri Swanson, vice president of Cigna Senior Care, said the company will offer "simple, affordable solutions" that include flat copay systems allowing beneficiaries to easily understand what they will pay.

Pacificare has contracted with 30,000 brokers nationwide to sell its prescription plan, said spokesman Tyler Mason.

"We may not know North Carolina, especially with a name like Pacificare," he said. "They could be what cuts through the consumer confusion. Our whole distribution strategy is predicated on working with brokers."

Neuman said she found it "striking that there are so many businesses that have stepped up to the plate and are apparently eager to enroll people in Medicare."

Initial estimates project that Medicare Part D, part of the greatest expansion in Medicare's 40-year history, will cost nearly $400 billion over 10 years.

Goldman Sachs & Co. said in July that the prescription drug program will generate as much as $10 billion in revenue and $250 million in earnings next year for nine large insurance companies that they follow.