Good News for EPIC Members

EPIC New York State Senior Prescription Plan
P.O. Box 15018
Albany, NY 12212-5018
(800) 332-3742

August 2012

On January 1, 2013, the Elderly Pharmaceutical Insurance Coverage (EPIC) program will change back to a fee and deductible program and provide you with expanded prescription coverage! All members must be enrolled in a Medicare Part D drug plan to receive EPIC benefits. There will be no exceptions.

EPIC will provide secondary prescription coverage for EPIC and Medicare Part D covered drugs after the Part D deductible, if you have one, is met. EPIC will also cover many Medicare Part D excluded drugs (e.g. prescription vitamins and prescription cough and cold preparations).

You will be enrolled in either the EPIC Fee Plan or Deductible Plan, based on your income.

  • Fee Plan members will pay an annual fee to EPIC. An EPIC bill will be mailed out in December. Members will pay EPIC co-payments ranging from $3 - $20 for prescriptions after the Medicare Part D deductible, if you have one, is met. Those with full Extra Help from Medicare will have their EPIC fees waived.
  • Deductible Plan members must meet an out-of-pocket deductible before paying EPIC co-payments ranging from $3 - $20 for prescriptions. The amount paid toward the Medicare Part D deductible, if you have one, cannot be applied to the EPIC deductible.

EPIC will continue to pay Medicare Part D plan premiums, up to the amount of a basic plan, for all members with annual income below $23,000 if single or $29,000 if married. EPIC members with higher incomes will be responsible for paying their own Medicare Part D premium. However, their EPIC deductible will be lowered by the annual cost of a basic Medicare Part D drug plan.

If you have any questions about these changes please contact the EPIC Provider Helpline at (800) 634-1340 Monday through Friday from 8:30 AM to 5:00 PM. Call the toll-free EPIC Helpline at (800) 332-3742.