Department of Health
The 2024 EPIC program highlights are now available. The document includes the 2024 EPIC Fee Plan Schedule and the Deductible Plan Schedule.
EPIC Outreach
The EPIC Outreach team provides educational services to the community and professional organizations. The web page EPIC Outreach outlines the mission and services provided by the team along with contact information.
FAQ
- Medicare Savings Program
- Common billing questions are answered in this document.
- General questions are answered in this document.
- Online Enrollment questions are answered in this document.
Presentations
2024 EPIC Professional Presentation is available to be downloaded to assist professionals in serving the elderly in New York State.
The presentation used for the July 30, 2019 webinar regarding Late Enrollment Penalty (LEP) assistance is available.
ONLINE ENROLLMENT
The EPIC program now offers online enrollment. Click on the flyer for more information.
You are Here: Home Page > Elderly Pharmaceutical Insurance Coverage (EPIC) Program
Elderly Pharmaceutical Insurance Coverage (EPIC) Program
Is the text on this page too small?
The Elderly Pharmaceutical Insurance Coverage (EPIC) program is a New York State program for seniors administered by the Department of Health. It helps more than 325,000 income-eligible seniors aged 65 and older to supplement their out-of-pocket Medicare Part D drug plan costs. Seniors can apply for EPIC at any time of the year and must be enrolled or eligible to be enrolled in a Medicare Part D drug plan to receive EPIC benefits and maintain coverage.
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.
EPIC helps pay the Medicare Part D drug plan premiums for members with income up to $23,000 if single or $29,000 if married. Higher income members are required to pay their own Part D premiums but EPIC provides premium assistance by lowering their EPIC deductible.
EPIC has two plans based on income. The Fee Plan is for members with income up to $20,000 if single or $26,000 if married. The Deductible Plan is for members with incomes ranging from $20,001 to $75,000 if single or $26,001 to $100,000 if married.
It is easy to join the program. Just complete the application and mail/fax it to EPIC or apply online. No documentation is required. EPIC verifies information with the Social Security Administration and the New York State Department of Taxation and Finance.
- What are the EPIC eligibility requirements?
- How does the EPIC Fee Plan work?
- How does the EPIC Deductible Plan work?
- How does EPIC and Medicare Part D work together?
- How does EPIC provide Medicare Part D Premium Assistance?
- What does EPIC cover?
- What are the EPIC co-payments for covered drugs?
- How do I apply for EPIC?
- Where do I find Frequently Asked Questions (FAQ) for:
- Billing Topics
- General Topics
- Medicare Saving Program
- Online Enrollment
Related Links
- Medicare Plan Finder
- Medicare (Home Page)
- Health Insurance Information, Counseling & Assistance Program (HIICAP)
- New York State Office for the Aging
- Social Security Administration - Extra Help With Medicare Prescription Drug Plan Costs
- BenefitsCheckUpRx - A Decision-Support and Enrollment Service
- New York Statewide Senior Action Council, Inc.
- Medicare Rights Center
- NY State of Health
- New York State Elder Law, as it pertains to the EPIC program, can be found at the web site for the Laws of New York State.
Navigate the list at the web site to: ELD, then select it. Select: Title 3 from the next web page.
