EPIC, (Elderly Pharmaceutical Insurance Coverage) is a New York State program for seniors administered by the Department of Health. It helps eligible seniors supplement their out-of-pocket Medicare Part D drug plan costs. Eligibility requirements are:
- Resident of New York State
- Age 65 or older
- Income up to $75,000 (single) or $100,000 if married.
EPIC offers two plans, based on your income:
- Fee Plan for members with income up to $20,000 if single or $26,000 if married.
- Deductible Plan members with incomes ranging from $20,001 to $75,000 (single) or $26,001 to 100,000 (married.)
EPIC members are required to be enrolled in a Medicare Part D drug plan or a Medicare Advantage health plan which includes Part D. Enrolling in EPIC will give a member a Special Enrollment Period (SEP) to join a Medicare Part D drug plan. Medicare Part D provides primary drug coverage for EPIC members. After a Part D deductible is met, if applicable, EPIC provides secondary coverage for approved Part D and EPIC covered drugs. EPIC also covers approved Part D-excluded drugs such as prescription vitamins as well as cough and cold preparations after enrolling in a Part D drug plan.
You or someone you know may now be eligible for EPIC help. Download the EPIC Application and call me at (518) 346-2115 for assistance with submitting your request.