State Health Commissioner Novello Urges Batavia Residents and Seniors to Take Advantage of Low-Cost Health Insurance and Prescription Coverage

Governor Pataki's "Capital for a Day" Brings State Government to Western New Yorkers

Albany, July 25, 2001 – State Health Commissioner Antonia C. Novello, M.D., M.P.H., Dr.P.H. was joined today by Genesee County Public Health Director Donald Rowe and Genesee County Office of the Aging Director Pamela Whitmore to encourage residents of the City of Batavia and Western New York to take advantage of the best health care in the nation by enrolling in Child Health Plus, the Elderly Pharmaceutical Insurance Coverage (EPIC) program and getting information about the soon–to–be implemented Family Health Plus program.

"One of the driving forces behind the efforts of Governor Pataki and I have always been to improve access and quality of health care in New York State," Dr. Novello said. "And these three State–sponsored programs offer the perfect health care solution for New Yorkers working hard, raising families, and building their lives in this State – but who are without health care. They can obtain the medical coverage that is so critical for their quality of life as well as the prescriptions on which so many senior citizens depend."

Under Governor Pataki's leadership, the Child Health Plus program – a national model – is providing about 500,000 previously uninsured children with comprehensive, preventive health care. In addition, the State financed EPIC program – with recent income eligibility enhancements – is providing more than 210,000 seniors across the State with low–cost access to medicines to keep them healthy. The new Family Health Plus program will begin accepting applications in September 2001, with the program commencing in October. It is estimated that up to 620,000 uninsured New Yorkers will be eligible for the new Family Health Plus program.

Genesee County Public Health Director Donald Rowe said, "We are delighted to have Governor Pataki and Commissioner Novello with us today as we celebrate Batavia as 'Capitol for a Day.' Access to affordable health care for all New Yorkers is a priority of this administration. Families who could not afford insurance for their children, can now obtain quality coverage through Child Health Plus. Seniors who struggle to afford prescription medications, now have access to EPIC, a program that lowers their prescription costs. And soon more families will be able to afford health insurance through Family Health Plus. The Genesee County Health Department strongly encourages all of our residents to find our more about these valuable programs."

Genesee County Office of the Aging Director Pamela Whitmore said, "I am pleased to join Dr. Novello in highlighting the importance of many health insurance programs that New York State provides for our citizens, especially the EPIC program for our seniors. The high cost of prescription drugs for seniors has been a major concern, but with the recent expansion and enhancements made to the State EPIC program, prescription drugs are now more affordable for seniors. This program helps seniors save money, remain healthy and active as well as improve their quality of life."

Child Health Plus:

The Child Health Plus program insures about 500,000 children, representing nearly a quarter of this country's enrollments. New York's Child Health Plus provides a comprehensive health care benefit package that includes well–child care, physical exams, immunizations, diagnosis and treatment of illness and injury, x–rays and lab tests, outpatient surgery, emergency care, prescription and non–prescription drugs, inpatient hospital medical or surgical care, short–term outpatient therapies, inpatient and outpatient treatment for alcoholism and substance abuse and mental health, dental care, vision care, speech and hearing services and durable medical equipment.

As a result of the Governor's commitment to provide health care coverage to every child in New York State, participation in the program has jumped from the 1995 level of just over 90,000 to the current enrollment of nearly 500,000. Free coverage is now provided to a family of four whose income is below $28,240; a family of four with income between $28,240 and $44,125 pay modest co–premiums of $9 to $15 per child per month for coverage. In addition, a family of four with income above this level can buy coverage at full premium, which is still less expensive than similar commercial products. To qualify for the coverage, a child must be under the age of 19, a New York State resident and must not have equivalent health insurance coverage.

Family Health Plus:

In May 2001, New York received federal approval to implement Family Health Plus, a new, bold, innovative health care program that makes coverage available to nearly 620,000 uninsured people across this State. Family Health Plus will provide comprehensive health care New Yorkers need to raise a family, work and reap the rewards of New York's economic prosperity. As a complement to the Child Health Plus program, Family Health Plus will ensure free health care coverage of lower income parents and single adults, between the ages of 19 and 65, who do not currently have coverage and who do not qualify for other public programs.

Eligibility for FHP (Initial Implementation):

Family
Size
Single or Married Adult
(Not living w/children under 21)
Parent
(Living with at least one child under 21)
1 $8,590 -----------
2 $11,610 $15,442
3 ---------- $19,458
4 ---------- $23,475
5 ---------- $27,492

Services for the Family Health Plus program will be provided by managed care plans and will include physician services; inpatient and outpatient health care; prescription drugs, including smoking cessation programs; lab tests and x–rays; vision, speech and hearing services; durable medical equipment; emergency room and emergency ambulance services; drug, alcohol and mental health treatment; diabetic supplies and equipment; radiation therapy, chemotherapy and hemodialysis.

Batavia residents may call the New York State Health Department's Family Health Plus hotline, at 1–877–9FHPLUS or 1–877–934–7587 to receive information about the program and place their name and address on an application list. The Department expects to begin formally accepting applications by September 1, 2001 and will have the program fully operational by October 1, 2001.

Elderly Pharmaceutical Insurance Coverage (EPIC):

EPIC is a State–sponsored program that enables eligible senior citizens ages 65 and older to pay for their often life–enhancing prescription drugs. Almost all prescription medicines are covered, as well as insulin and insulin syringes. Most community pharmacies in New York State, as well as several mail order pharmacies in the State, participate in the EPIC program. Seniors can use the pharmacy of their choice. In most cases, seniors can use EPIC to supplement their other insurance coverage.

To help ensure that seniors on fixed incomes have low–cost access to medicines, Governor Pataki recently expanded the annual income eligibility for EPIC to $35,000 for single enrollees and to $50,000 for married enrollees. Seniors in the low income levels pay fees ranging from $2 to $75 per quarter and co–payments of $3 to $20, depending on the cost of their prescription. Higher income seniors must meet annual deductibles. Instead of paying a fee, they pay the full cost of their medications until their annual deductible is reached, after which they only are responsible for the co–payment. There is no cap or limit on benefits, only on the amount of co–payments that seniors pay, which is extremely helpful to seniors with many prescriptions.

Currently, there are more than 210,000 seniors enrolled in EPIC, a more than 200 percent increase since 1998. There are 1,298 seniors from Genesee County participating in the EPIC program; 537 of these seniors live right in Batavia. Under Governor Pataki, seniors in Genesee County who have and continue to participate in the EPIC program have saved millions of dollars in costs. In fact, the average savings for seniors enrolled in the area is about $175 a month, or about $2,100 a year. Since EPIC started, more than 343,000 seniors have saved more than $1 billion on their prescriptions.

Applications are available at a variety of locations in the Batavia area – pharmacies, doctors' offices, senior centers and the county office for the aging. Seniors can also call EPIC's Helpline at 1–800–332–3742 to request an application. More information, and a copy of the application, is also available on the New York State Department of Health web site, http://www.health.state.ny.us.

7/25/01–86 OPA