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Help With Your Prescription Co-Pays – NYS EPIC Drug Coverage

Written by Karen Nicpon, CPA | Feb 3, 2020 11:00:00 AM

As we age, one of the largest burdens we may encounter – both emotionally and financially – is paying for healthcare. For some seniors who need help with expensive prescription drug co-pays, there is good news. The New York State Elderly Pharmaceutical Insurance Coverage (EPIC) program is available to NYS residents age 65 or older who are enrolled in a Medicare Part D drug plan. 

Eligibility requirements.

To receive benefits of EPIC, there are annual income eligibility requirements of under $75,000 for singles and $100,000 for married couples. Income includes your federal adjusted gross income from your tax return plus tax-exempt interest. To apply for coverage in 2020, you would estimate your 2019 income. If you determine, after filing your tax return, that you are not eligible, simply cancel your coverage. There is no need to pay back any benefits received.

How the benefits work.

Once enrolled, you will receive an EPIC benefit card which you will provide to your pharmacy when filling prescriptions. Once you reach your EPIC deductible, then you pay the EPIC co-payments, which can save you up to 75% on your prescriptions. The biggest benefit is achieved by those with higher prescription drug costs.

While not everyone can take advantage of this plan, for many, it can help with large prescription drug costs. If you know someone who may benefit from the EPIC program, we encourage you to pass this information along.