Two Medicare recipients taking the same drugs but living in different states could face costs that differe by thousands of dollars - even if each had chosen the lowest-cost plan available to them. And within a state, the difference in a person's costs for the same drugs could top $10,000 a year or more, depending on which plan he or she chose. Such wide variation in prices demonstrates that Medicare prescription drug plans are substantially more affordable in some states than in others. The difference in plan costs appears to have little to do with the cost of living in different states. In fact, some of the states with the lowest cost-of-living-adjusted average incomes had some of the highest drug plan costs.

For example, the 78-year-old woman might pay $4,113 out of her own pocket each year for her four medicines if she chose the lowest-cost plan available in Michigan, while the same drugs would cost her $16,856 if she lived just over the border in Ohio and had chosen the lowest-cost plan there. On average across the United States, her plan costs would be $8,146.

This shows just how high the stakes can be when a senior is deciding which plan to choose, or deciding whether or not to switch plans. It is extremely important that Medicare beneficiaries use the online cost calculator or get other assistance as they choose their plans because choosing a plan based on a familiar name may not lead to the lowest costs for a person's medicines.

The results, published in the January Journal of General Internal Medicine, online at http://www.springerlink.com/content/7177637783wu21wj/