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If you are a senior living in New York state and you’re enrolled in a Medicare drug plan, you may also be eligible to receive additional financial assistance.
The Department of Health’s Elderly Pharmaceutical Insurance Coverage program (EPIC) helps more than 330,000 seniors across the state afford prescription drugs by offsetting the out-of-pocket cost of medication purchased through a Medicare Part D plan. There are several criteria you must meet in order to qualify for EPIC.
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The EPIC program covers new prescriptions and refills for any drugs that are covered by your Medicare Part D plan. To qualify to receive financial assistance, seniors must meet the following criteria: be a permanent New York state resident aged 65 or older; have an annual income of less than $75,000 if single or $100,000 if married, be enrolled in or eligible to enroll in a Medicare Part D plan; and not receive full Medicaid benefits.
If all these criteria are met, you can join EPIC at any time of the year. Once you enroll in EPIC, you will have a Special Enrollment Period during which you can join a Medicare Part D drug plan if you are not already enrolled.
EPIC works with Medicare Part D to offset the cost of prescription drugs for New York seniors. When a senior pays for their medications, any costs that are incurred after the Medicare Part D deductible is met can be submitted to EPIC for coverage.
The eligible senior will pay a co-payment based on the cost of the medication, but it is much lower than the out-of-pocket cost they will pay with just Medicare Part D alone.
If you have any questions about EPIC or need help determining your eligibility, please give us a call.