Seniors and disabled Americans enrolled in Medicare's new prescription-drug program face more coverage disruptions in two weeks, state officials, doctors and pharmacists warn.

A special 90-day transition period, set by Medicare to prevent beneficiaries from losing any drug coverage, ends April 1. Private insurance plans can then stop covering drugs they don't usually pay for. Most of the 36 states that stepped in on an emergency basis to help low-income beneficiaries also will stop paying.

State insurance counselors and health care advocates say the result could be a repeat of problems first encountered in January, when the program began. Thousands of beneficiaries were turned away from pharmacies when their records weren't found or their drugs weren't covered.

"Some of these people are going to be in really difficult spots," said Jude Walsh, special assistant to Maine Gov. John Baldacci. "I think they're going to be going without medication again."

The warnings came as President Bush promoted the drug plan's virtues Wednesday at an assisted living facility in suburban Maryland. While Bush said the plan can be "confusing," he told seniors to "take a look. ... I think you're going to like what you see."

Meanwhile, Medicare officials said insurance plans need to educate seniors about what happens when the transition period ends. Some seniors could have to change drugs, file appeals or pay out of pocket.

"We have a short time to be working with the plans to make sure the beneficiaries get the information," said Peter Ashkenaz of the Centers for Medicare and Medicaid Services. "Some plans are already doing it."

But dozens of state health insurance counselors in a nationwide conference call Wednesday said they were unaware of any insurance plans helping to educate seniors. "Transition is ending," said Kelly Brantley of the Health Assistance Partnership. "We all fear this."

Doctors and pharmacists are concerned. "I do think there's going to be another big hurdle here in April," said Robin Taylor, president of Cornerstone Pharmacy Services in Indianapolis. "Even more intense, because people are going to be really without their medicines," said Judy Chamberlain, a doctor in Brunswick, Maine.

The end of the transition period represents a crucial turning point for the fledgling prescription-drug program. Beset by confusion because each region has dozens of private plans and coverage options, the program has left some seniors without the coverage they had. It also has failed to sign up millions eligible for low-income subsidies.

Problems have eased recently, and Medicare officials say more than 5 million people have signed up voluntarily. Overall, they say, about 26 million seniors and disabled Americans are benefiting, some through private employers. That's more than 60% of those eligible.

But only two months remain for people to enroll without penalties. Bush said he doesn't favor extending the May 15 deadline. The Senate defeated an effort Wednesday to extend it and eliminate the penalties.

Benedetto reported from Silver Spring, Md.

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