State Health Commissioner Announces EPIC Enrollment Reaches Nearly 295,000
218 Percent Increase Since 1998 - Makes Announcement During Visit to Bonifacio Cora Senior Center in East Harlem.
Albany, September 30, 2002 – State Health Commissioner Antonia C. Novello, M.D., M.P.H., Dr.P.H., today announced that enrollment in the Elderly Pharmaceutical Insurance Coverage (EPIC) program has reached a record 294,296, more than a 218 percent increase since 1998.
EPIC is a State–sponsored program that helps eligible senior citizens ages 65 and older pay for their prescription drugs. Under Governor Pataki, New York's EPIC program is a national model and it is one of the nation's largest prescription drug program providing comprehensive coverage to seniors.
"Under Governor George Pataki, New York has once again become a national model for the delivery of critical health care services for our seniors," said Dr. Novello. "Thanks to the leadership of Governor Pataki, nearly 300,000 New York seniors are getting the medications they need at prices that they can afford, enabling them to maintain their quality of life and independence."
Dr. Novello made the announcement while visiting the Bonifacio Cora Senior Center in the predominantly Hispanic East Harlem section of New York City. EPIC enrollment in the area has more than doubled since 1994, increasing 110 percent, from 236 to 495. The interest in EPIC has been strong across most sectors of the area's population – enrollment among Asians has risen 285 percent, among Hispanics 189 percent, among Caucasians 71 percent and among African Americans 40 percent.
Under Governor Pataki's leadership, EPIC's income eligibility for seniors increased substantially from $18,500 to $35,000 for single enrollees and from $24,400 to $50,000 for married enrollees. The Governor has also reduced the fees that lower income senior citizens pay, making them more affordable, and reduced co–payments at the pharmacy, ensuring that seniors will never pay more than $20 for even the most expensive prescription.
Coinciding with the jump in enrollment, the savings realized by seniors has climbed. In 2002, the average EPIC participant saved nearly $1,975, or 80 percent. In 1994, seniors enrolled in the program saved an average of $581, or 49 percent of their annual drug purchases. Since the program started, over 550,000 seniors have saved almost $1.8 billion at the pharmacy counter by using EPIC.
Seniors pay a quarterly fee or meet an annual deductible to receive EPIC benefits. The fee plan is available to eligible seniors in the lower income levels. The current fees range from $2 to $75 per quarter, based upon the senior's income. EPIC bills participants quarterly, with an option to pay annually if desired. The deductible plan is available only to seniors in the upper income levels. Rather than pay a fee, seniors pay for the full cost of their prescriptions until they reach an annual deductible. The deductibles range from $530 to $1,715 per year, based upon the senior's income. Once they reach their deductible, they only pay a small co–payment on their prescriptions for the rest of their coverage year.
As a result of actions taken by Governor Pataki to lower fees, a single senior making $11,000, who once paid $302 in fees for EPIC coverage, now pays only $40. A married individual (one person) making $16,000 who once paid fees of $330 for EPIC coverage, now pays only $84. A married couple with combined income of $16,000 previously paid $660 for coverage, now pays only $168. And, a married couple making $19,000 who once paid $780 for EPIC coverage, now pays only $300.
There is no cap or limit on benefits and almost all prescription medicines are covered, as well as insulin and insulin syringes. There is a limit on the amount of co–payments that seniors pay, which is extremely helpful to seniors with many prescriptions. After reaching this limit, which is based on the seniors' income level, seniors receive their prescriptions free for the remainder of their coverage year.
EPIC also protects the health and safety of enrollees by sending electronic alerts to pharmacists if there is a potentially serious drug interaction or overuse problem. In addition, enrollees' physicians are sent information about serious but less urgent problems. These alerts are extremely beneficial when seniors go to more than one physician or pharmacy and the doctor or pharmacist is not aware of all the prescriptions the senior may be using.
Applications are available at a variety of locations throughout the State –– pharmacies, doctors' offices, senior centers and county offices 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 by clicking on the EPIC link on the New York State Department of Health Web site, http://www.health.state.ny.us.