State Pharmaceutical Assistance Program: New York

There are millions of Medicare beneficiaries that struggle to pay for the cost of their medications. Many of these beneficiaries have enrolled themselves into a Medicare Part D prescription drug plan but they still struggle. Some Medicare beneficiaries struggle because there has been an increase in other expenses. Some have found themselves battling medical concerns they didn’t think they would face. There are many different reasons Medicare beneficiaries struggle to pay for their medications. As these beneficiaries struggle, they look for help so they can maintain their health.

As these beneficiaries begin to look for help, many are not aware they can get help through their state. They aren’t aware their state may have started a state pharmaceutical assistance program. Not all states have started these assistance programs but those that have did so to help those in need. Many states that have started pharmaceutical assistance programs saw the Medicare beneficiaries in their state were struggling and they didn’t want to continue letting that happen.

New York is a state that offers a state pharmaceutical assistance program.

New York State Elderly Pharmaceutical Insurance Coverage (EPIC)

New York realized the residents sometimes struggled to pay for their medications and created this program. Those that are interested in getting help from EPIC should be residents of New York State. Anyone outside of New York State is not eligible. Those that are should call 800-332-3742 for more information.

Eligibility Requirements:

New York residents should be aware of the eligibility requirements.

  1. New York state resident
  2. Age 65 or over
  3. Income restrictions are: single applicants can have an income up to $35,000 and married applicants can have an income up to $50,000.
  4. Must be enrolled in a Medicare part D prescription drug plan
  5. Can NOT be eligible for or receiving full Medicaid benefits

Who to Contact

Those that are interested in applying should contact:

EPIC

Po Box 15018

Albany, NY. 12212

What are the Benefits?

Those that apply for EPIC will find there are two different benefit options. Once an applicant is approved, they will be told of which set of benefits they will be receiving if accepted.

EPIC Fee Plan

Applicants that are approved for the EPIC Fee Plan normally have an income up to $20,000 if single and $26,000 if married.

  • Their annual fee to EPIC will range from $8-$300, depending on their income.
  • After their Medicare Part D deductible (if applicable) is paid, fee members will only pay the EPIC copayment for their medications.

EPIC will also pay a portion of the Medicare Part D prescription drug plan premiums.

EPIC Deductible Plan

Those that are approved for the EPIC Deductible Plan normally have an income of $20,001-$35,000 if single. Those that are married normally have an income of $26,000-$50,000.

  • There is an EPIC deductible that has to be paid each year before the benefits begin for these beneficiaries. The deductible will range from $530-$1,715, depending upon the income of the applicant.
  • Once that deductible has been met and their Medicare Part D (if applicable) deductible has been met, beneficiaries will pay the EPIC copay for their medications.

Those that are interested in applying for EPIC assistance should apply with the program directly. If a Medicare beneficiary needs more help than EPIC provides, they are encouraged to call the Social Security Administration to apply for the Low Income Subsidy program.

Feb. 9 14'
This was very fascinating, with most of the ceridt to you the poster. Would really like to hear far more about this from you. When you could would you email me, I believe you might have my e mail with this comment and we can speak that would be magnificent. Thank you so a lot look forward to hearing from you.
May. 25 14'

Get in on the discussion!

Name
Email