Elderly Pharmaceutical Insurance Coverage Program
The Elderly Pharmaceutical Insurance Coverage Program, is a New York State program to help Senior Citizens, age 65 and over, pay for prescription drug costs, Application forms are available at most pharmacies or call EPIC at 1-800-332-3742
This program provides financial assistance for seniors to help with the costs of prescription medications (both generic and brand names).
You can enroll by phone, online, or download the enrollment form and mail it to EPIC.
Call us with questions, requesting applications, or for guidance with enrollment.
The program has two tiers; the Fee Plan and the Deductible Plan. Placement into one of these tiers is based on income. Both of these plans are Medicare wraparound programs, which means the benefits wrap around those benefits provided by a Medicare Part D plan, which is Medicare’s prescription drug plan. Therefore, to participate in EPIC, one must have Medicare Part D. When making a prescription purchase, Medicare Part D is the first payer, then this program contributes toward the costs that the Part D plan does not cover.
There is an annual fee for the Fee Plan that ranges between $8 and $300 and is based on income. There is no charge to participate in the Deductible Plan.
This program is overseen by the New York Department of Health.
The EPIC program will pay for Medicare Part D premiums. As of 2024, a maximum of $48.72 per month is made available for Part D premiums for participants of the Free Plan.
EPIC also helps with prescription co-payments and some drugs not covered by Part D, such as prescription vitamins and cold and cough preparations. Fee Plan members are immediately eligible for assistance, and Deductible Plan members are eligible after they’ve met a sliding scale deductible. The amount is determined by one’s income.
Co-payments for prescriptions are between $3 and $20 and are based on the cost of the medication. For instance, if a medication costs $15, the co-payment is $3, and if a medication is over $55, the co-payment is $20.