What is EPIC? - New York State Department of Health 2025

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The Elderly Pharmaceutical Insurance Coverage (EPIC) program in New York State assists seniors with co-payment for Medicare Part D prescription drugs, covering both included and excluded medications. Eligibility requires enrollment in Medicare Part D, and income limits apply for participation. The program offers two plans: Fee Plan and Deductible Plan, with varying fees based on income. EPIC also helps apply for 'Extra Help' benefits to reduce costs further. Seniors aged 65 or older with specific income thresholds can apply, and the document outlines the application process and required information.

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What is the Epic program in New York State?

The Elderly Pharmaceutical Insurance Coverage (EPIC) program is a New York State program for seniors administered by the Department of Health. It helps more than 325,000 income-eligible seniors aged 65 and older to supplement their out-of-pocket Medicare Part D drug plan costs.

What is a New York State epic number?

EPIC operates a toll-free Helpline which is available from 8:00AM to 5:00PM, Monday through Friday. Call 1-800-332-3742 (TTY 1-800-290-9138) for more information or to request an application.

Do you have to pay for NYS epic?

You must pay an annual fee based on your income last year (fees range from $8 to $300). EPIC will mail you bills to pay this annual fee in quarterly installments (every three months). This fee is waived if you have Extra Help.

How does the NYS Epic program work?

It provides seniors with co-payment assistance for Medicare Part D covered prescription drugs after any Part D deductible is met. EPIC also covers many Medicare Part D excluded drugs. Fee Plan members pay an annual fee to EPIC based on their income. The EPIC co-payments range from $3-$20 based on the cost of the drug.

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How much does NYS Epic cost?

EPIC Fee Plan Schedule Who Pays PremiumAnnual IncomeAnnual Fee EPIC pays Part D Premium Up to $6,000 $8 $ 6,001 - $ 7,000 $16 $ 7,001 - $ 8,000 $22 $ 8,001 - $ 9,000 $2812 more rows

What is the income limit for Epic in NY?

To join EPIC, a senior must: be a New York State resident age 65 or older. have an annual income below $75,000 if single or $100,000 if married.

What is EPIC? - New York State Department of Health 2025

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