On January 1, 2013, the NYS Elderly Pharmaceutical Insurance Coverage (EPIC) program will have 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 based on the cost of the drug.
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.
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.
For an application or more information, please call the toll-free EPIC Helpline at 1-800-332-3742 Monday through Friday from 8:30 AM to 5:00 PM or visit the EPIC website at www.health.ny.gov and click on EPIC for Seniors on the left side of the page.
Join now to get increased benefits in 2013!