OBJECTIVES: The Medicare Prescription Drug Improvement and Modernization Act will provide drug benefits for a large proportion of persons aged 65 years and older in the United States. Few studies have examined the beliefs and attitudes of older adults with respect to prescription drug insurance programs. The objective of this study was to better understand the nature and range of older adults. beliefs regarding prescription drug benefits. METHODS: This study employed a qualitative, focus group design. Three focus groups with a total of 19 community dwelling adults aged 65 years and older were conducted in June 2003. The participants were members of the Minnesota Seniors Federation and included persons with and without prescription drug insurance. Discussions were structured and guided by an interview schedule developed a priori. The focus groups were audiotaped and transcribed verbatim. Thematic textual analysis was used to identify codes and categories from the language and ideas of the group participants. RESULTS: Study participants identified a variety of important drug benefit facets. The common themes identified from the 3 groups were: (1) prescription drug access, (2) drug benefit comprehensibility, (3) powerful others, (4) affordability, and (5) equity. CONCLUSION: Older adults view drug benefits as complex entities composed of at least 5 dimensions. In addition to more commonly discussed issues such as access and affordability, seniors evaluate several other aspects of drug insurance programs such as fairness, the ease with which plan terms can be understood, and the degree to which outside actors influence plan policies.