Forty years ago this summer, President Lyndon Johnson signed the legislation that created Medicare. It was a great moment in history because Medicare has improved health, extended life expectancy and substantially reduced the number of older Americans living in poverty.

A drug benefit was not included in the original legislation. No one knew how important prescription drugs would one day become to effective medical treatment. As prescription drugs became more vital to the health of older Americans, the absence of a benefit through Medicare caused hardship for millions, including many of Hawai'i's 184,000 Medicare beneficiaries.

AARP Hawai'i's 140,000 members are a microcosm of America's senior population, and they tell us repeatedly how difficult it is to pay for the medications their doctors prescribe. Many never fill their prescriptions because they can't afford it. Others resort to splitting pills, skipping doses and even selling their possessions.

In December 2003, we succeeded in getting Medicare coverage for prescription drugs. This voluntary drug coverage — known as Medicare Part D — is part of the Medicare Modernization Act that will take effect in January 2006.

Medicare prescription drug coverage will be of greatest benefit to Americans with limited incomes and those with the highest drug costs. For more than 15 million Medicare beneficiaries with limited incomes, this is especially good news because they may be eligible for assistance with monthly premiums, deductibles, and most of the cost of their prescriptions.

But Part D is voluntary. That means the new Medicare drug benefit will not be worth anything unless people who need it sign up for it. All Medicare beneficiaries should consider enrolling in Part D during the sign-up period from Nov. 15, 2005, to May 15, 2006.

Now is the time for limited-income beneficiaries to take action. The Social Security Administration (SSA) has already mailed more than 99,000 applications to low-income beneficiaries in Hawai'i, urging them to apply for extra assistance with their Medicare Part D prescription drug costs.

SSA will review each application to determine whether they qualify for extra assistance that would cover some or all of Part D premiums and co-pays. Therefore, it is critical that applicants, family members and caregivers complete the application and return it immediately. If you did not get an application in the mail, call SSA at (800) 772-1213 and ask for one to be sent to you.

AARP and partner organizations will be informing Medicare recipients about the benefits of Part D through an unprecedented educational outreach campaign. This process has already begun and will continue through October and November.

We cannot afford to miss this golden opportunity to improve and maintain the health of millions of Americans. We cannot allow anyone to miss out on benefits because they were unaware of the proper application procedures, didn't understand them or were unable to follow them.

Please help spread the word to Medicare beneficiaries about the new Medicare prescription drug benefit and the procedures for applying for it.

For additional information, check the Medicare Web site at www.medicare.gov. Or call 1-800-MEDICARE.

Maeona Mendelson is state president of AARP Hawai'i. She wrote this commentary for The Advertiser.