EPIC AND MEDICARE PART D
The open enrollment period for Medicare Part D closed earlier this month, but there is another way to save money on your prescription drug coverage you can explore. EPIC (Elderly Pharmaceutical Insurance Coverage), is a New York State program that provides supplementary drug coverage and premium assistance for seniors with Medicare Part D. As an added benefit, EPIC enrollees are able to change their Part D plan outside of the open enrollment period one time, any time during the year.
EPIC is open to any New York State resident who is age 65 or older and has an income up to $75,000 if single or $100,000 if married. To receive EPIC benefits, you must be enrolled in a Part D plan. EPIC may even help 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.
Seniors who are not eligible to join a Medicare Part D drug plan cannot join EPIC. Examples of ineligible seniors include those with a union/retiree drug subsidy program that is not a Part D plan, and seniors without Medicare Part A or Medicare Part B. Seniors with Medicare Advantage health insurance can only join EPIC if they have Part D drug coverage with their HMO.
It is very important to show both your EPIC ID card and the Medicare Part D plan card at your pharmacy to receive the maximum prescription benefits.
Two other important things to know:
A senior who receives full Medicaid benefits is not eligible for EPIC.
If your Part D drug plan has an annual deductible, you must pay the deductible before EPIC coverage will begin.
You can find the application (in eight languages), as well as more information about the program, online at https://www.health.ny.gov/health_care/epic/application_contact.htm or by calling EPIC toll free at 1-800-332-3742.
No documentation is required. EPIC verifies information with the Social Security Administration and the New York State Department of Taxation and Finance.
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