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Save Money on Medicare Part D Prescription Drugs with EPIC


What is EPIC?

The NYS Elderly Pharmaceutical Insurance Coverage* (EPIC) Program helps pay for Medicare Part D prescriptions, including some that are not covered under Part D. While this is not a discount card, this program offers Medicare prescription help to make your prescriptions more affordable and possibly lower your monthly premium. EPIC has two plans based on your prior year's income: The Fee Plan and the Deductible Plan. 

Why should I join?

  • There's little to no cost to you
  • Receive help paying Medicare premiums
  • EPIC may cover Medicare Part D excluded drugs

Am I eligible?

You may be eligible if the following apply to you:

  • New York State resident age 65 or older
  • Annual income below $75,000 if single; below $100,000 if married
  • Enrolled or eligible to enroll in a Medicare Part D plan, and 
  • Not receiving full Medicaid benefits

What are the differences between the Fee Plan and the Deductible Plan?

 

The Fee Plan:

Members pay an annual fee to EPIC based on their prior year's income. After any Medicare Part D deductible is met, (if the member has a deductible) Fee Plan members only pay the EPIC copayment for prescriptions. EPIC will pay for the Medicare Part D plan premiums up to $39 per month for members in this plan.

 

The Deductible Plan:

Members must meet an annual EPIC deductible based on their prior year's income before they pay EPIC copayments for prescriptions. Once you meet your EPIC deductible, you will only pay the EPIC copayment for prescriptions. EPIC will pay for the Medicare Part D plan premiums up to $39 per month for members in this plan. To provide Part D premium assistance, the EPIC deductible is reduced by $468 per year, the annual cost of a basic benchmark Part D drug plan.

 

When can I join?

You can join EPIC at any time during the year! Once you enroll, you will receive a Special Enrollment Period to join a Medicare Part D plan. 


Ready to start saving?

Contact us today! We can help you find the EPIC plan that's right for you. Call 1-833-735-4510  (TTY 711) Monday - Friday, 8:00 a.m. - 8:00 p.m.


This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments, and restrictions may apply. Benefits, premiums and/or copayments/coinsurance may change January 1 of each year. The Formulary, pharmacy network, and/or provider network may change at any time. You will receive notice when necessary. Out-of-network/non-contracted providers are under no obligation to treat BlueShield of Northeastern New York members, except in emergency situations. For a decision about whether we will cover an out-of-network service, we encourage you or your provider to ask us for a pre-service organization determination before you receive the service. Please call our customer service number or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services. Medicare evaluates plans based on a 5-star rating system. Star Ratings are calculated each year and may change from one year to the next. BlueShield of Northeastern New York is a Medicare Advantage plan with a Medicare contract and enrollment depends on contract renewal.

 

A division of HealthNow New York Inc., and independent licensee of the BlueCross BlueShield Association.

*The Elderly Pharmaceutical Insurance Coverage (EPIC) program is a NYS program for seniors administered by the Department of Health. To learn more about this program, call 1-800-332-3742 (TTY 1-800-290-9138) or visit www.healthy.ny.gov/health_care/epic.

 

A salesperson will be present with information and applications. For accommodations of persons with special needs at sales meetings, please call 1-800-329-2792 (TTY 711). BlueShield of Northeastern New York complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-800-329-2792 (TTY: 711). 注意:如果您使用繁體中文,您可以免費獲得語言援助服務。請致電 1-800-329-2792 (TTY: 711).

 

Y0086_MRK2182 Pending
Content Last Updated April 9, 2018

 


 

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