The Elderly Pharmaceutical Insurance Coverage (EPIC) Program is a New York State program that helps income-eligible adults age 65 and older with prescription drug costs. EPIC works together with Medicare Part D to provide additional assistance with prescription medications and, for eligible individuals, Medicare Part D premiums.
EPIC provides secondary coverage for Medicare Part D- and EPIC-covered drugs after any Medicare Part D deductible has been met. EPIC also covers certain approved prescription drugs that are excluded from Medicare Part D once a member is enrolled in a Part D plan. EPIC members generally pay a small copayment for covered prescriptions after meeting applicable deductibles.
Who Can Apply for EPIC?
To be eligible, you must:
- Be a New York State resident age 65 or older.
- Have an annual income of less than $75,000 if single or less than $100,000 if married.
- Be enrolled in or eligible to enroll in a Medicare Part D prescription drug plan.
- Not be receiving full Medicaid benefits.
Individuals enrolled in a Medicare Advantage plan can participate in EPIC if their plan includes Medicare Part D prescription drug coverage. EPIC can also work with certain retiree coverage; individuals with retiree drug coverage should check with their benefits administrator to determine how the coverage will work with EPIC.
Two EPIC Plans
EPIC has two plans based on income. The Fee Plan is available to individuals with income up to $20,000 or married couples with income up to $26,000. The Deductible Plan is available to individuals with income from $20,001 to $75,000 or married couples with income from $26,001 to $100,000.
For 2026, EPIC may pay Medicare Part D premiums up to $58.82 per month for members with income up to $23,000 if single or $29,000 if married. Individuals with higher incomes may have their EPIC deductible reduced to help offset the cost of their Medicare Part D premium.
Apply for EPIC
There are two ways to apply for EPIC. You can complete a paper application or apply online.
Online application:
Applications can be completed online through the New York State EPIC program at:
If completing a paper application, mail it to:
EPIC
P.O. Box 15018
Albany, NY 12212-5018
Applications may also be faxed to 518-452-3576.
There is no need to wait for Medicare Open Enrollment to apply for EPIC. EPIC applications are accepted throughout the year. Once enrolled, EPIC can provide a Special Enrollment Period to help a new member enroll in a Medicare Part D plan if needed. However, you must be enrolled in a Part D plan to receive EPIC benefits.
For more information about EPIC, call the EPIC Helpline at 1-800-332-3742 or visit the New York State EPIC website.
If you need assistance understanding EPIC, Medicare Part D, or other programs that may help with prescription and Medicare costs, contact the Chautauqua County Office for Aging Services and NY Connects. You can visit one of our office locations, email CCNYC@chqgov.com, or call 716-753-4582.
