On January 1, 2013, the NYS Elderly Pharmaceutical 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 the 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 assistance in the form of a reduced EPIC deductible.
A NYS EPIC regional outreach representative will be available to help answer questions and enroll seniors who would like to join EPIC.
DATE: May 30, 2013
PLACE: The Dale Association
33 Ontario Street, Lockport, NY 14094
TIME: 10:00am – 12:00noon
Please bring proof of 2012 income (including Social Security income) and Medicare ID card.
It is easy to join EPIC. You must be a New York State resident, 65 years of age or older, have annual income below $35,000 single or $50,000 married, be enrolled in 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 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, call the toll-free EPIC helpline at 1-800-332-2742 or visit the EPIC website at www.health.ny.gov.