New York Provides Health Insurance to Seniors that is "EPIC"

It is called EPIC and it is does not refer to a new blockbuster at the box office. But it is going to be a "hit" with seniors as regards health insurance. It stands for Elderly Pharmaceutical Insurance Coverage and it is NY States program that makes prescription drugs much more affordable to its senior residents.

Almost 400,000 seniors in New York are already participant in the State sponsored health insurance program, which on average has saved participating seniors almost 80% on the cost of their prescription medications. Any New York resident who is over 65 and not receiving full Medicaid benefits and making under $35,000 a year for singles, $50,000 for couples can participate in the program. Seniors with Medicare or other health insurance that does not fully cover prescription drugs who meet the other criteria can also apply for the program. Like some other affordable health insurance plans EPIC is a cost sharing program. Which means seniors have a copay for prescription drugs. Based on income seniors participate in the EPIC medical insurance program either by paying a flat fee, which can be paid in installments, or by meeting an annual deductible. Seniors making less then $20,000 as singles, $25,000 for Marrieds are eligible for the participation fee. For those that do qualify, the fee is based on sliding scale of actual income. Senior residents earning over 20,000 but less than 30,000 qualify for the deductible plan, up to 50,000 for Marrieds - and again the amount of the deductible is based on actual income. In either health insurance plan the copays for enrollees range form $3 for the least expensive drugs, to a maximum of $20.00 for the most.

Under the health plan almost all prescriptions drugs are covered, including insulin and other diabetic care supplies such as insulin needles. Both generic and name brand prescription medications are covered, and seniors participating in this affordable health insurance program can purchase up to 100 pills or a thirty-day supply of any given medication. Just about every pharmacy and retail chain licensed to dispense prescription drugs in NY State participate in the program, so seniors can have their prescriptions filled practically anywhere they are in the state, however EPIC benefits do not expand beyond New York even to a chain that participates in the program within the State - so seniors who are traveling are advised to be sure they take enough of their prescription medications with them. In some cases an EPIC pharmacy may be able to mail seniors prescriptions medications to them.

EPIC benefits can be combined with other health insurance prescription drug benefits making it a rather unique and very good health insurance for the low income elderly. Seniors who have enrolled in EPIC are advised to be sure to show their pharmacist both their EPIC card and any other health insurance cards they have. This will result in the lowest possible copay for a given prescription. For example if the senior has a copay of 25.00 for a $100.00 prescription drug under another health insurance benefit, EPIC will cover the 25.00 and the enrollees final copay against that would only be $7.00. Without EPIC the copay would be the full 25.00 - and if the patients only showed that pharmacist their EPIC enrolment the EPIC copay on that 100.00 prescription would have been 20.00.