What's New?

2014 Program Highlights

The 2014 EPIC program highlights flyer is now available. The document includes the 2014 EPIC Fee Plan Schedule and the Deductible Plan schedule.

Attention Members, Prescribers and Pharmacists - July 2012

There were articles in the July 2012 Medicaid Update for EPIC members, prescribers and pharmacy providers giving information regarding the upcoming 2013 program changes to EPIC coverage.

SFY 2012-2013 Key Points and Additional FAQs

Beginning January 1, 2013, Executive Budget Changes have restored the EPIC program with additional provisions. The frequently asked questions are listed in SFY 2012-2013 Key Points and Additional FAQs.

EPIC 2011-2012 Program Changes

The Executive Budget, covering the state's Fiscal Year which runs from April 1, 2011 through March 31, 2012, was passed on March 31, 2011. It includes provisions that will affect EPIC members beginning on July 1, 2011 and again on January 1, 2012.

July 2011 Changes

Beginning July 1, 2011, EPIC members in the Deductible Plan with Medicare Part D will see the following changes:

  • EPIC will expand monthly Part D premium assistance (up to $38.69) from the current annual income levels of $20,000 if single and $26,000 if married to $23,000 if single and $29,000 if married.
  • The EPIC deductible credit (up to $464) will be eliminated. Members will be responsible for meeting up to an additional $464 toward their EPIC deductible.

January 2012 Changes

Beginning January 1, 2012, there will be additional changes to the EPIC program benefit.

  • EPIC will be free, having no fees or deductibles and will expand Part D premiums for members with incomes up to $23,000 if single and $29,000 if married.
  • All seniors must first be enrolled in a Medicare Part D plan to obtain EPIC benefits and maintain coverage.
  • EPIC members will be responsible for their Part D deductible (if they have one) and Part D co-payments until they reach the Medicare coverage gap (donut hole).
  • EPIC will provide supplemental coverage to lower out-of-pocket expenses for drugs that are first covered by Medicare Part D only when a member reaches the coverage gap. EPIC will also cover drugs in Medicare Part D excluded classes purchased during the coverage gap.
  • EPIC will continue to help members apply for Medicare's Low Income Subsidy (LIS) and Medicare Savings Programs to help them save more on drugs.

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May 2011