Page Reviewed / Updated - Jan. 2016
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. 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 Deductible Plan is for single seniors with incomes over $23,000 but less than $75,000 or over $26,000 but less than $100,000 for couples. In monthly terms, single applicants can have income greater than $1,917 but less than $6,250 and married couples greater than $2,417 but less than $8,333.
The EPIC program will pay for Medicare Part D premiums, co-payments, coverage gap, and some drugs not covered by Part D. In 2016, a maximum of $39.73 per month is made available for Part D premiums. Fee Plan members are immediately eligible for assistance and Deductible Plan members are eligible after they’ve met a sliding scale deductible.