On Jan. 1, the NYS Elderly Pharmaceutical Insurance Coverage program had many prescription benefits restored. EPIC will provide expanded coverage for those enrolled in Medicare Part D drug plans throughout the year instead of just in the Part D coverage gap. This change will result in additional savings for members to purchase needed medications.
EPIC members must be enrolled in a Medicare Part D drug plan in order to receive benefits. EPIC will provide secondary prescription coverage for Medicare Part D and EPIC covered drugs after any Medicare Part D deductible is met. Additionally, EPIC will also cover many Part D excluded drugs. EPIC co-payments will continue to be $3, $7, $15 and $20.
The EPIC Fee and Deductible Plans will be restored. Lower income members will pay an annual fee for coverage and will pay EPIC co-payments for drugs. Higher income members must meet an annual EPIC deductible before paying EPIC co-payments for drugs.
For many seniors, it is less expensive to enroll in EPIC and Medicare Part D than just Part D alone. EPIC pays the Part D drug plan premiums up to $43.22 per month in 2013 for members with incomes up to $23,000 single or $29,000 married Higher income members are responsible for paying their Medicare Part D premiums but will receive Part D premium assistance in the form of a reduced EPIC deductible.
An NYS EPIC Regional Outreach Representative will be at the following locations to help answer questions and enroll seniors who would like to join EPIC:
March 6 - Grand Island Senior Center, 3278 Whitehaven Road, Grand Island 10 to 11 a.m. with a representative from BlueCross Blue Shield of Western New York.
March 11 - Jamestown Community College, 10785 Bennett Road, Dunkirk 10 to 11 a.m. with a representative from Univera Healthcare
March 12 - Cheektowaga Senior Center, 3349 Broadway, Cheektowaga 11 a.m. to 1 p.m.
Bring proof of 2012 income (including Social Security income) and Medicare ID Card.
It is easy to join EPIC. The recipient must be a New York state resident, 65 years of age or older, have annual income below $35,000 single or $50,000 married, be enrolled in a Medicare Part D drug plan and not receiving full Medicaid benefits. Those eligible may apply for EPIC at any time during the year and receive a Special Enrollment Period from Medicare allowing participants to join a Part D drug plan. Persons with union or retiree benefits should contact their benefit office to see if they are eligible to join a Part D drug plan. For more information on the NYS EPIC program, call the toll-free EPIC Helpline at 1-800-332-3742 or visit the EPIC website at www.health.ny.gov.
