When Virginia G. Shores went to a pharmacy here to pick up five prescriptions, she thought she heard the pharmacist say she owed $250, but she was wrong. The cost, with her new Medicare prescription drug card, was just $50.

"I was flabbergasted," said Mrs. Shores, whose kitchen counter looks like a medicine chest, full of pills for high blood pressure, heart failure, arthritis, nerve pain and lung disease.

Mrs. Shores, 80, had been buying medicines from a mail-order pharmacy in Winnipeg, Manitoba, but now uses Medicare instead. "I was amazed at the amount of money it saved," Mrs. Shores said. "It was hard to believe."

She is one of Medicare's satisfied customers. They are not vocal, they are not organized, but they say it was worth wading through the hassles, confusion and complexity of the new program to enroll.

Treasury Department figures show that Medicare spent a total of $5.1 billion on prescription drug benefits in January and February, the first months of the new program, which is expected to cost more than $675 billion over 10 years. Medicare officials say the program is paying for more than a million prescriptions a day.

One way to assess the program is to talk to people in a place like Tulsa. People here are far removed from the raucous debate in Washington, where Republicans describe the drug benefit as a boon to older Americans and many Democrats call it a disaster.

The experience of those who have enrolled is particularly significant because millions of Medicare beneficiaries face a May 15 deadline for signing up. Current beneficiaries who decide to join after that date will generally have to wait until Nov. 15 and will then pay higher premiums as a penalty for late enrollment. 

In Oklahoma, Medicare beneficiaries can choose from 43 prescription drug plans, with premiums ranging from $10.07 to $70.79 a month, different co-payments and very different lists of covered drugs.

Satisfied beneficiaries say they could never have analyzed the options or made a choice without the help of friends and relatives, pharmacists or counselors from groups like LIFE Senior Services, a private nonprofit group, which offers advice at seminars and enrollment clinics in the Tulsa area.

The counselors are adept at using the Medicare Web site to compare drug plans and identify the ones with the lowest overall annual cost for a particular beneficiary. Before selecting a plan, a beneficiary typically must spend an hour with a counselor, but some spend much more time. 

For example, Bobby G. Brown, a retired letter carrier, and his wife, Anna, both 71, spent four hours with a LIFE counselor. "It was well worth the time," said Mrs. Brown, who is being treated for congestive heart failure, rheumatoid arthritis, lupus, high cholesterol, depression and other ailments.

He takes 6 drugs; she takes 18. They enrolled in different plans — WellCare's Signature plan and the basic plan offered by Blue Cross and Blue Shield of Oklahoma — and their combined drug costs will plunge to $4,900 or less a year, from more than $25,000.

Mrs. Brown, 71, had been relying on free samples from doctors for some expensive medications, but she found it demeaning to ask for them. "You get the feeling you're a beggar," she said.

The satisfaction of some beneficiaries stands in contrast to the frustration of many others, who were overcharged or unable to get essential medicines in the first chaotic weeks of the program.

"People who are satisfied are the quieter voices," said Leslie A. Dick, executive director of the Burgundy Place retirement community in Tulsa.

Many beneficiaries say they are grateful to local insurance counselors, rather than to Medicare, the government or politicians.

"We had a whole lot better deal before the government started messing with it," said Francis A. Murphy, 79, a retired airline mechanic who is losing drug benefits from a former employer. He said he did not expect to see any savings under Medicare. Beneficiaries are anxious about their choices for good reason. Their out-of-pocket costs under different plans can vary by hundreds or thousands of dollars a year.

Jack L. Coffey, associate dean of the University of Oklahoma College of Pharmacy, owns four drugstores. "In a majority of cases, I have seen some reduction in costs to the patient," Mr. Coffey said. "But for some people, their medications will cost them more." 

People may pay more if they already had good coverage, from Medicaid or private insurance, or if they select a Medicare drug plan that does not cover the drugs they need.

Even those who save money may complain because the new program is "much too complicated for a lot of people to understand," Mr. Coffey said.

Todd E. Pendergraft, owner of a Medicine Shoppe pharmacy in Broken Arrow, Okla., outside Tulsa, said the new drug coverage was "significantly beneficial" to one-third of his 750 Medicare patients, "marginally beneficial" to half the patients and "no benefit at all" to the remainder. 

People satisfied with the new drug benefit appear to share these characteristics:
They did not sign up for one plan and then switch to another. 

They did not rely on advertising or their own instincts, but got help from Medicare experts, insurance counselors or computer-savvy friends and relatives, who used the automated "plan finder" at the medicare.gov Web site.

They are not on Medicaid, the federal-state program for the poor. People eligible for both Medicaid and Medicare had comprehensive drug coverage under Medicaid, but lost it on Jan. 1 and were assigned at random to private Medicare drug plans. The Medicare plans may charge slightly higher co-payments and often cover fewer drugs.

Also, Medicare beneficiaries are more likely to appreciate the new benefit if they live in places like Oklahoma that did not have generous state-financed programs to help them with their drug costs. Drug benefits have been available for years to low-income people through state programs in Maine, New Jersey, New York and Pennsylvania, among other states. 

Dr. M. Jean Root, a geriatrician in Tulsa with several hundred Medicare patients, said: "About half of my patients say they like the new benefit and are saving money. The people most likely to benefit have enough education and perseverance to navigate the system, which is extremely convoluted and complex. Or they have friends and relatives to help them." 

But Dr. Root said, "The other half of my patients, including those with dementia and terminal illnesses, don't have the energy, the interest or the mental capacity to work through the system."

Counselors are reaching a small fraction of all beneficiaries. Carol H. Carter, a spokeswoman for LIFE Senior Services, said: "Many beneficiaries are terrified of making the wrong decision and overwhelmed by having so many choices. The only reliable way to compare plans is on the Medicare Web site, and that in itself is scary to some seniors."

Beneficiaries could face new problems in coming months. Insurers can impose stricter limits on access to certain drugs after March 31, when a 90-day transition period ends. In addition, some beneficiaries will have to pay more at the pharmacy counter, because most drug plans have a gap in coverage after a person's total drug costs reach $2,250. The gap lasts until the beneficiary incurs total drug costs of $5,100. Beyond that point, Medicare pays about 95 percent of the cost of each prescription. 

Still, counselors say, many beneficiaries will come out ahead if they enroll.

Those who have signed up say the total cost of all their drugs under Medicare is often less than the amount they were paying for just one prescription in the past.

Mary N. Hooser, 89, of Sapulpa, Okla., takes eight medications for heart disease, ulcers, depression and early signs of Alzheimer's disease. Her children had been chipping in to cover the cost, $476 a month, including $155 for the Alzheimer's drug. Under Medicare, the cost for all her drugs is less than $100 a month.

"This is a tremendous help to my mother and me," said Mrs. Hoser's 73-year-old daughter, Mary L. Ward.

Charlene G. Bandurski, who had polio as a young child, was not enthusiastic about the prospect of signing up for the Medicare drug benefit. Indeed, she said: "I looked forward to it with dread. We had heard that it was a mess, and so confusing."

But since signing up in December, Ms. Bandurski said, she has been pleasantly surprised. "For a medicine that cost $120, we now pay $20," she said. "At first, you don't believe it. It's almost like it's too good to be true."