When you were younger, did you ever imagine needing a Ph.D. to understand how to pay for your prescription drugs in later life? That is about where we have arrived with the passage of the so-called “Medicare Prescription Drug, Improvement and Modernization Act of 2003.”

A recent headline “Medicare Law Befuddles Elders” aptly describes the mental condition of most among us who have paid any attention to the recent restructuring of Medicare. Except for blasting AARP for selling out our interests, I have suffered enough befuddlement myself to discourage me from writing much about the subject till now.

The very name of the new legislation rankles me. Improvement? Modernization? Both words are politically charged and hide the antisocial philosophy that lies behind the changes in Medicare. They also disguise the fact that the 700-page legislation favors drug companies at the expense of consumers.

I still hope for changes in the new law, if not ideally its complete repeal. And yet, facing reality, I believe that older Americans should take advantage of whatever help we can get now to pay for our medications. The cost of many drugs lies increasingly out of reach for so many of us that we cannot afford to pass up help.

Though the full legislation does not kick in till 2006, this is the month when Medicare Drug Discount Cards have become available, their appearance signaling the first opportunity, due in June, for some elders to save money on medication purchases.

Getting word about the new cards to older people is crucial, says CMS (Centers for Medicare and Medicaid Services), the federal agency responsible for implementing the changes. Otherwise, its administrators fear, almost three million eligible beneficiaries will fail to register and thus forfeit access to a $600 annual subsidy, plus other possible savings.

This is why more than 100 national organizations have banded together to spread the word. They include AARP, the National Council on the Aging, and Catholic Charities USA. This coalition believes that “Few low-income beneficiaries are likely to know that they should not only consider enrolling in a Medicare discount card but also continue to take advantage of existing public and private prescription savings programs.”

In a slide show, the coalition shows how the difference for some could amount to far more than the basic credit of $600 that comes with the card for many low-income people. They show a 68-year-old Louisiana woman saving $1,320 and an Idaho man $5,058, largely through taking advantage of discount programs given by the drug manufacturers.

Compared to the rules set for 2006, those for the cards seem relatively simple. However, even here most older people will need some explanation of the system before making wise choices. And, after grasping how it works, we will require further help to discern which card will serve us best.

Those considering the cards will have to ask questions: How convenient are the pharmacies where the particular card can be used? does the card cover the drugs they need? does it offer the best price for these drugs?

Fortunately, those who already belong to Massachusetts’ Prescription Advantage program do not need to sign up for the discount cards.

I recommend taking counsel from the SHINE Program, run by the state Department of Elder Affairs. SHINE operates in the Councils on Aging in Massachusetts cities and towns, with cooperation from the state home care agencies in each part of the Commonwealth. Through this program, professionals and volunteers trained in financial and other issues provide information and counseling to older people who request it, free of charge. You can reach this source of help by calling 1 800 AGE-INFO.

If you use the Internet, you can find details about the drug discount card by tapping into the Medicare web site www.Medicare.gov. Otherwise you can call a toll-free number: 1 800 MEDICARE.

AARP also has helpful information at www.aarp.org, and, by telephone, at 1 888-OUR-AARP. The latter organization also offers callers a well designed booklet (with a title in small caps): “medicare changes that could affect you.”

Again, if you have Internet access,  I strongly recommend reading what the Families USA Foundation offers at www.familiesusa.org.  It describes the discount drug card program as “very flawed” and gives reasons why it does not serve the best interests of consumers. But it also offers guidelines for choosing the discount cards.

I hope that the new program will serve elders well but fear otherwise. How can we expect much good to come from a law that prohibits the federal government from bargaining with the drug companies for lower prices?  And how can users of the discount cards be confident of savings when the companies and other agencies that sponsor these cards are allowed to make indefinitely large profits by raising prices with only one week’s notice?

All of this is further argument for getting help in finding your way through this maze of laws and rules. Again I recommend asking the SHINE counselors for assistance as the best resource.

Richard Griffin