Washington ? An influential group of senators proposed Tuesday that Medicare recipients pay a higher deductible for doctor services as part of sweeping legislation offering prescription drug coverage for millions of older Americans.

Under the measure, those who receive doctor and out-of-hospital care from Medicare would face an increase in the deductible from $100 to $125 beginning on Jan. 1, 2006, with future rises tied to inflation. The annual adjustments would mark a major change in policy — the current $100 level has not changed since 1991.

Overall, the legislation would give the elderly access to prescription drug coverage under Medicare for the first time. It also would create a new managed care option under the government-run health care program.

Many details of the Senate plan had been disclosed in advance, but the proposed increase in the deductible for so-called Part B of Medicare — covering doctors’ care and out-of-hospital services — was not among them.

There was no word on the overall amount of money that would be raised by the provision. Nor was it clear whether the deductible increase was included as a way of offsetting part of the cost of the drug benefit, or perhaps as a way of prodding seniors to leave traditional Medicare.

Additionally, the legislation calls for seniors to pay 20 percent of the cost of clinical lab tests performed in facilities in doctors’ offices or hospitals. Those costs are currently paid 100 percent by Medicare.

Stand-alone prescription drug coverage would begin in 2006.

For the first year, the premium is expected to be about $35 a month, and seniors would be obliged to pay the first $275 in costs. Insurance would pay half the cost for expenses between $276 and $3,450. There would be no coverage between $3,450 and $5,300, and insurance would pay 90 percent of everything above that amount.

Low-income seniors would receive government subsidies, which would gradually phase out before disappearing at 160 percent of the federal poverty level. Those levels are $14,764 for an individual and $19,766 for couples.