What's New?

2015 Program Highlights

The 2015 EPIC program highlights are now available. The document includes the 2015 EPIC Fee Plan Schedule and the Deductible Plan Schedule.

2015 Billing FAQ

Common billing questions are answered in this document.

2014 Program Highlights

In 2014, EPIC program income limits were expanded as shown in the highlights document.

EPIC Medicare Part D Premium Assistance

EPIC will pay the Medicare Part D premium up to the benchmark amount of $36.94 in 2015 per month for members with incomes up to $23,000 if single or $29,000 if married. The benchmark amount is equivalent to the average cost of a Medicare Part D drug plan in New York State. It changes each year. If your Part D plan premium is higher than this amount, you are responsible to pay the difference each month.

If EPIC is paying your Part D premium and you currently have your premium deducted from your Social Security check, you must contact your Part D drug plan to stop the deduction.

If an EPIC member's income is above $23,000 if single or $29,000 if married then the member is required to pay their Part D premium each month. To help them pay, their EPIC deductible on the Deductible Plan schedule is further reduced by $444, the annual cost of a benchmark Part D plan in 2015.

When a member is approved for the full Medicare Low Income Subsidy (LIS) from Extra Help from Medicare, the Medicare Savings Program, or a Medicaid Spenddown, EPIC will also provide additional premium assistance up to the benchmark amount of $36.94 in 2015 if Medicare does not cover the entire premium.

When a member is approved for Extra Help from Medicare with a partial (25%, 50%, or 75%) LIS, EPIC will provide additional premium assistance towards the member's Medicare Part D plan drug premium up to the benchmark amount of $36.94 per month in 2015.