Elderly Pharmaceutical Insurance Coverage (EPIC) Program
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EPIC is a New York State program that helps seniors pay for their prescription drugs. More than a quarter million EPIC enrollees are saving an average of 90 percent of the cost of their medicines. Most enrollees have Medicare Part D or other drug coverage, and use EPIC to lower their drug costs even more by helping them pay the deductibles and co-payments required by their other drug plan. EPIC also helps members pay for Medicare Part D premiums.
What are the eligibility requirements?
- Must be a New York State resident 65 or older with an annual income under $35,000 (single) or $50,000 or less (married).
- Must also join a Medicare Part D plan (with limited exceptions).
- Seniors with a Medicaid spend-down are eligible, but those with full Medicaid benefits are not.
How does EPIC work?
- Seniors with moderate incomes pay a low quarterly fee, and participate in the Fee Plan.
- Seniors with higher incomes must meet an annual deductible, and participate in the Deductible Plan.
- Those who pay a fee or those who have met their deductible pay a co-payment at the pharmacy when purchasing prescriptions.
- More detailed information on how EPIC works is in Your Guide to New York State EPIC.
Related Links
- Medicare
- Health Insurance Information, Counseling & Assistance Program (HIICAP)
- New York State Office for the Aging
- Social Security Administration - Help With Prescription Drug Costs
- BenefitsCheckUpRx - A Decision-Support and Enrollment Service
- New York Statewide Senior Action Council, Inc.
- Medicare Rights Center