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New York State Pharmacy Assistance Programs

New York State Elderly Pharmaceutical Insurance Coverage (EPIC)

:: Eligiblity Requirements
:: Important Note
:: Contact Information
:: Income Requirements

Eligiblity Requirements

You must meet the following requirements:
  • You must be a New York State resident (permanent home address),
  • at least 65 years of age, and not receiving full Medicaid benefits.
  • You must have an annual income below $35,000 if single, or a combined annual income below $50,000 if married.
  • You must be enrolled or eligible to be enrolled in a Medicare Part D plan (no exceptions). Seniors enrolled in a Medicare Advantage (HMO) plan can only join EPIC if their HMO includes Medicare Part D coverage.


Important Note

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 (up to the state LIS benchmark of $37.23 in 2014) 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 $35,000 if single or $26,001 to $50,000 if married.



Contact Information

Phone: (800) 332-3742
Email: epic@health.state.ny.us

Address
EPIC,
P.O. Box 15018
Albany, NY 12212-5018

Income Requirements


  Income Lower Income Upper
Single $0 $1,916.67 per month.
Married $0 $2,416.67 per month

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Last updated on: 01/10/2014

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