Although the state has yet to work out the details of the "Hawai'i Rx Plus" program, such as how to enroll, it is scheduled to begin July 1.

Officials estimate about 300,000 residents who do not have prescription drug coverage or are underinsured will be eligible to participate.

Advocates and lawmakers warn that the discounts in the first year will be nominal — about 9 percent to 20 percent — but they still encourage people to enroll. That's because the more people enrolled in the program in the first year, the more leverage the state will have to seek deeper savings with drug manufacturers in the following years.

After the first year, discounts could grow to as much as 15 percent to 60 percent, advocates and lawmakers say.

Maui residents Joe and Kathleen Stewart, both 62, are among those looking forward to enrolling in Hawai'i Rx. They pay about $500 a month for Kathleen's medications for chronic conditions, including diabetes, congestive heart failure, asthma and high blood pressure. They expect those costs to be higher when her disability benefits run out late next year, and with a total combined income of $39,000 a year they'd like to see some relief.

"We're always juggling the budget to make sure that we have enough money in the account to pay the mortgage and for medication," Joe Stewart said. "Every month, we have to kind of pay attention to what we're doing and where our money's going."

The discounts projected for the first year of the program likely won't be very much help for the Stewarts, but Joe said he wants to enroll anyway to be part of a purchasing pool for more savings in the future.

State Department of Human Services director Lillian Koller said her department, which is in charge of the program, hopes to begin enrolling people later next month. The department plans to set up a Web site and call centers, as well as distribute enrollment applications to community health centers and other public places.

AARP Hawai'i, which has been involved in the legislation, also plans to help enroll residents once the program takes off, said AARP Hawai'i state director Greg Marchildon.

Koller's department also is working to get Hawai'i pharmacies to participate in the program. Koller said she expects most — if not all — pharmacies to jump on board, and that residents enrolled will be given a list of participating pharmacies.

The program is open to Hawai'i residents who earn no more than 3› times the federal poverty level. In Hawai'i, that would be about $37,450 for a single person, $50,260 for a couple, and $75,880 for a family of four. There are no age restrictions and no enrollment fees.

Officials say the program is for people who are uninsured or underinsured, not those who have a comprehensive drug plan that covers the bulk of their medicine costs.

"This is just a discount program," Koller said. "This is not as good as insurance."

The program will work in two phases. During the first phase, which begins July 1, those enrolled will be given the Medicaid price on drugs at participating pharmacies. That is estimated to save consumers the 9 percent to 20 percent. The Department of Human Services plans to send consumers' eligibility information to pharmacies electronically, eliminating the need for cards, Koller said.

But the first year of the program is largely aimed at enrolling as many participants as possible to make up a purchasing pool.

The size of the purchasing pool becomes critical in the program's second phase, which begins July 2005. Starting then, the state will use the number of participants in the purchasing pool as leverage to negotiate supplemental rebates with drug manufacturers. The rebates will bring additional savings to consumers, who would buy the discounted drugs at a participating pharmacy.

Like the Stewarts, Ruby Silva of Wai'anae is looking forward to saving money on prescription drugs.

In the past few years, she and her husband, Gilbert, have been spending about $650 a month on their medicine. That pays for the roughly 10 pills Gilbert needs to take twice a day for congestive heart failure, diabetes and other chronic illnesses, as well as Ruby's five daily pills to control her blood pressure and cholesterol.

"Sure, we have savings, but I've noticed in the last few years here that my credit card balances are higher than ever," Ruby said.

"We were the kind who never ran a high credit card bill. ... I've never had to short ourselves and not have our medicine, but when you face the reality, how much longer could I have existed doing this? I'd be in deep trouble soon."