The Elderly Pharmaceutical Insurance Coverage (EPIC) program is a New York State based program designed for income-eligible seniors aged 65 and older. The program is administered by the Department of Health, and currently helps more than a quarter of a million people cover the cost of their out-of-pocket Medicare Part D drug plan costs.
Who is eligible for EPIC?
To join the EPIC program, a senior must meet the following criteria:
Eligible seniors are able to enroll in EPIC any time of the year so long as they are enrolled in or eligible to be enrolled in a Medicare Part D drug plan. If you are not yet enrolled in a Medicare Part D plan, you can enroll in EPIC, and you will receive a “Special Enrollment Period” in which you can enroll in a Medicare Part D plan.
EPIC provides secondary coverage for Medicare Part D and EPIC-covered drugs purchased after any Medicare Part D deductible is met. EPIC also covers approved Part D-excluded drugs once a member is enrolled in Part D.
There are two types of EPIC plans based on income.
The Fee Plan is for EPIC members who have an annual household income of $20,000 if single or $26,000 if married.
For those who are on the Fee Plan, EPIC will pay the Medicare Part D plan premiums up to $39.73 per month (this is the benchmark amount equivalent to the average cost of a Part D Drug plan).
The Deductible Plan is for EPIC members who have an annual income range from $20,001 to $75,000 if single or $26,001 to $100,000 if married. There is no fee to join the EPIC Deductible Plan. You pay the full price that Part D charges for your drugs until the Annual Deductible is met. This Annual Deductible is based on your previous year’s income.
EPIC is a great program to help cover the cost of Part D plans for those who need assistance. Do not hesitate to reach out to an experienced agent at Plan Medicare 516-900-7877, to learn more about EPIC and the benefits of enrolling.