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Elderly Pharmaceutical Insurance Coverage (EPIC) Program

EPIC is the Elderly Pharmaceutical Insurance Coverage Program that is available to New York State residents aged 65 years or older whose incomes are under $35,000 for singles and $50,000 for couples. EPIC is not available to those who are currently receiving full Medicaid benefits. EPIC helps pay the Medicare Part D drug plan monthly premiums for members with income up to $23,000 single and $29,000 married.

EPIC helps more than 280,000 income-eligible seniors to supplement their out-of-pocket Medicare Part D drug plan costs. Seniors can apply for EPIC at any time of the year and must be enrolled or eligible to be enrolled in a Medicare Part D drug plan to receive benefits. EPIC also provides supplementary drug coverage for Part D covered drugs and provides secondary coverage for Medicare Part D and EPIC covered drugs purchased after the Part D deductible, if any, is met.

To enroll in EPIC, you must be a resident of New York State. This means that your permanent home (not just a summer or winter home) is located in New York State. It also means you live in the State on a regular, on-going basis, and your New York State address is listed as your home address on official and legal documents. You need to notify EPIC whenever you change your address.

Beginning January 1, 2013, EPIC will provide assistance with Medicare Part D covered drugs after a member pays any out-of-pocket Medicare deductible. EPIC will supplement drugs purchased in Part D initial coverage, coverage gap (donut hole) and catastrophic phases. EPIC will also cover many Medicare Part D excluded drugs. EPIC co-payments will be $3, $7, $15 or $20 based on the cost of the drug.

The EPIC Program promotes the health and safety of EPIC seniors by helping them purchase medications that improve their quality of life and keep them healthy. Seniors will save more on their prescription drugs by using EPIC and Medicare together.

EPIC operates a toll-free Helpline which is available from 8:30AM to 5:00PM, Monday through Friday. Call 1-800-332-3742 (TTY 1-800-290-9138) for more information or to request an application.

Further information can also be obtained from your local Office for the Aging Health Insurance Information Counseling and Assistance Program (H IICAP) by calling 1-800-701-0501.