A final version of the Gregg report will be sent to the Senate Budget Committee to guide Republicans preparing an alternative to the five-year budget blueprint that the White House issued last month. But Republican officials indicated today that they expected few important changes in the report's recommendations.

The draft offers the most specific recommendations for major deficit reduction proposed so far by leaders of either party. They fall into five major areas.

One is health care. The draft would require Medicare beneficiaries to pay a fifth of the cost of home health care and laboratory tests, both of which are now fully covered. It would raise better-off retirees' premiums for Part B services, primarily physician care. In the longer term, it would also cut costs by giving retirees vouchers that they could use either to buy coverage from managed care organizations or pay their Medicare premiums; the beneficiaries could keep most of the savings.

Those changes, with an additional $20 billion that the Republicans take from White House budget proposals, would reap a total Medicare saving of at least $120 billion, the draft says.

Medicaid, the insurance system for the poor, would be shifted entirely to the states and financed by a Federal block grant that would grow by 4 percent a year. That would save $115 billion.

A second area of proposed cuts is welfare. The draft adopts Republican governors' plan to turn most Federal welfare services over to the states and finance them with block grants, saying this would save $40 billion. Supplemental Security Income, a fast-growing benefit for the disabled, would be "fundamentally reformed" to limit eligibility and costs, at a $22 billion saving. And the growth in the earned-income tax credit, which assists low-income working families, would be cut $27 billion, not only by eliminating fraud but also by closing loopholes that now prevent investment returns from being counted as income.

A third area is Federal pensions. The draft proposes applying cost-of-living increases only to the first $13,800 of annual Federal retirement benefits, the same level used to calculate increases in Social Security checks. The report also suggests increasing Federal workers' contributions to some pension accounts. Total saving: $17 billion.