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Elderly Pharmaceutical Insurance Coverage Program (EPIC)

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* * Note: See our section on Medicare Part D for discussion of EPIC and Medicaid Spenddown.

EPIC is a New York State sponsored prescription plan for senior citizens who need help paying for their prescriptions.   EPIC is a cost sharing program.  Seniors with moderate incomes pay a low quarterly fee and a small deductible per prescription.   Fees and deductibles are set based upon your income - there are no resource limits.

Effective January 1, 2012 for all EPIC Memebers
  • Epic is a free program, wth no fees or deductibles.
  • You must be enrolled in a Medicare drug prgram in order to receive benefits.
  • EPIC only provided coverage for Medicare Part D covered drugs or Part D excluded drugs purchased during the Part D coverage gap (donut hole).
  • Your EPIC copayment for drugs purchased during the Part D coverage gap (donut hole) will be $3 - $20, depending on the cost of the drug.

EPIC will pay the monthly Part D drug premium up to $39.79 in 2013 for members with income up to $23,000 if single or $29,000 if married.  Those with higher incomes must pay their Part D premiums each month.

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If you are single and have an income that is between $20,000 and $35,000 per year ( or married with income between $26,001 and $50,000 per year ) you may be eligible for EPIC. 

To download an EPIC application and learn more about the EPIC fee plan and copays - click here to go to the Official New York State Web Site.

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