Q:

What is EPIC health insurance?

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Quick Answer

New York's Elderly Pharmaceutical Insurance Coverage, or EPIC, program helps more than 265,000 seniors in the state to supplement out-of-pocket prescription drug care costs, according to the New York State Department of Health. Income-eligible people age 65 and older may apply for this coverage at any time, and each person must enroll in or have eligibility for Medicare Part D, as of 2015.

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Full Answer

After Medicare Part D coverage ends, EPIC may help seniors with new prescriptions, prescription refills, insulin doses, brand-name prescription drugs and generic prescription drugs, reports the New York State Department of Health. To maximize benefits, an individual must choose a pharmacy that participates in both Medicare Part B and the EPIC program. EPIC does not cover medical devices or any prescription drugs purchased before joining the program.

The EPIC program kicks in after a person meets the Medicare Part D deductible, explains the New York State Department of Health. EPIC also helps members pay for Medicare Part D premiums if they have an income of up to $23,000 if single or $29,000 if married. Those with higher incomes must pay Medicare Part D premiums, but EPIC then lowers its deductible. Members complete the application and send the document to the program's administrators. EPIC verifies an applicant's information through the U.S. Social Security Administration and the New York State Department of Taxation and Finance.

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