On January 1, 2013, the NYS Elderly Pharmaceutical Insurance Coverage (EPIC) program had many prescription benefits restored. EPIC will provide expanded coverage for those enrolled in Medicare Part D drug plans throughout the year instead of just in the Part D coverage gap. This change will result in additional savings for members to purchase needed medications.
EPIC members must be enrolled in a Medicare Part D drug plan in order to receive benefits. EPIC will provide secondary prescription coverage for Medicare Part D and EPIC covered drugs after any Medicare Part D deductible is met. Additionally, EPIC will also cover many Part D excluded drugs. EPIC co-payments will continue to be $3, $7, $15 and $20.
The EPIC Fee and Deductible Plans will be restored. Lower income members will pay an annual fee for coverage and will pay EPIC co-payments for drugs. Higher income members must meet an annual EPIC deductible before paying EPIC co-payments for drugs.
For many seniors, it is less expensive to enroll in EPIC and Medicare Part D than just Part D alone. EPIC pays the Part D drug plan premiums up to $43.22 per month in 2013 for members with incomes up to $23,000 single or $29,000 married. Higher income members are responsible for paying their Medicare Part D premiums but will receive Part D premium assistance in the form of a reduced EPIC deductible.
An NYS EPIC Regional Outreach Representative will be at the following locations to help answer questions and enroll seniors who would like to join EPIC:
6/24/13 – Genesee County Office for the Aging, 2 Bank Street, Batavia – 2 pm to 4 pm
6/26/13 – Lockport Senior Center, Ontario St, Lockport – 10 am to noon
6/28/13 – YMCA Southtowns, Southwestern Blvd, West Seneca – 9 am to 11 am
6/28/13 – Orchard Park Senior Center, 70 Linwood, Orchard Park – 10 am to 11:30 am
Please bring proof of 2012 income (including Social Security income) and Medicare ID Card.
It is easy to join EPIC. You must be a NYS resident, 65 years of age or older, have annual income below $35,000 single or $50,000 married, be enrolled in a Medicare Part D drug plan and not receiving full Medicaid benefits. You may apply for EPIC at any time during the year and will receive a Special Enrollment Period from Medicare allowing you to join a Part D drug plan. If you have union or retiree benefits, you should contact your benefit office to see if you are eligible to join a Part D drug plan. If you would like more information on the NYS EPIC program, please call the toll-free EPIC Helpline at 1-800-332-3742 or visit the EPIC website at www.health.ny.gov