2007-06-27 / Seniors

Senior Spotlight

Changes In EPIC Program Coming July 1

Seniors enrolled in the New York state EPIC prescription drug plan should be aware that some major changes will take effect on July 1, just four days from now, according to Assemblymember Audrey Pheffer.

The Rockaway Democrat says the changes were enacted in the 2007- 08 budget and are designed to "reduce these costs so New York seniors can afford their medicine and enjoy a happy life".

Pheffer stated, "Seniors face increasing struggles to pay for needed prescription drugs as drug prices continue to skyrocket, especially when most live on fixed incomes."

EPIC, the Elderly Pharmaceutical Insurance Coverage program, was enacted about a decade ago to help low-income seniors get discounted prices on prescription drugs. More recently, the plan was changed to permit higher-income persons get some benefits as well.

When Medicare's Part D drug benefits program started in January 2006, EPIC members were forced to join the Part D program.

According to Pheffer, beginning July 1:

+ EPIC will provide coverage for drugs not covered by the new Medicare Part D plan and for expenses falling within the federal plan's coverage gap.

+ For seniors enrolled in the EPIC fee plan and Part D, EPIC will pay up to $24.45 for the Part D premium. It will also reduce drug co-pays. The member will pay the EPIC fee, which will be waived if you carry full "Extra Help", and part of every pharmacy prescription.

+For seniors enrolled in the EPIC deductible plan and Part D, EPIC will reduce the EPIC deductible and drug copays. You will pay the plan's premium, a reduced EPIC deductible and a portion of the costs of every pharmacy prescription.

Pheffer advises EPIC members: "Show your EPIC card at the pharmacy, whether you are enrolled in the fee or deductible plan, and prescription prices will be adjusted to the following EPIC rates:

"For prescription costs up to $15, your cost will be $3; for prescriptions which cost from $15.01 to $35, your cost will be $7; for prescriptions costing from $35.01 to $55, your cost will be $15 and for prescriptions over $55, your cost will be $20."

Pheffer said there are some caps where the EPIC changes will not apply. She said seniors who previously did not meet their EPIC deductible will not be required to join a Part D plan, nor will EPIC enrollees who would lose retiree healthcare coverage if enrolled in Part D. Seniors in Medicare Advantage plans that do not offer a cost-effective Part D option without reducing other medical benefits are also not required to join a Part D plan.

Pheffer said EPIC and Medicare Part D cards were to be mailed beginning June 15, and Medicare Part D bills were to be mailed beginning June 20. The bills have three payment options, she said: automatic deduction from monthly Social Security benefits, automatic monthly deductions from a checking account, or by direct billing.

EPIC members will be notified about the latest changes in the EPIC program, Pheffer said. In the meantime, for more information or to apply for EPIC benefits, call the EPIC Hotline at 1-800-332-EPIC (3742).


PROGRAMS: Seniors were not forgotten by City Councilmember James Gennaro (D- Fresh Meadows) when the 2007- 08 city budget was signed by Mayor Michael Bloomberg recently.

Funding for more than 30 senior programs in synagogues, churches and community centers in Gennaro's 24th Council District was included in the budget, as well as funding for the "Handyman Van", a boroughwide project that assists lowincome seniors to get general repairs done in their homes if they are unable to do them.

Return to top

Copyright 1999-2019 The Service Advertising Group, Inc. All rights reserved.