Page Reviewed / Updated - Mar. 2015
The New York State pharmaceutical assistance program is called Elderly Pharmaceutical Insurance Coverage or EPIC for short. This program provides financial assistance to seniors to help with the costs of medications.
The program has two tiers; the Fee Plan and the Deductible Plan. Placement into one of these tiers is based on income. For 2015, the Fee Plan requires an annual income of less than $23,000 (or $29,000 for couples). The Deductible Plan is for seniors with incomes over $23,000 but less than $75,000 (over $26,000 but less than $100,000 for couples).
Both of these plans are Medicare wraparound programs which means the benefits wrap around those benefits provided by a Medicare Part D plan. When making a prescription purchase, Medicare Part D is the first payer and then this program contributes towards those costs the Part D plan does not cover.
There is an annual fee of between $8 - $300 based on income for the Fee Plan. There is no charge to participate in the Deductible Plan.
To be eligible for this program, seniors must meet the following criteria:
The EPIC program will pay for Medicare Part D premiums, co-payments, coverage gap, and some drugs not covered by Part D. Fee Plan members are immediately eligible for assistance and Deductible Plan members are eligible after they’ve met a sliding scale deductible.