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Elderly Pharmaceutical Insurance Coverage (EPIC) Program

New York State Department of Health, Corning Tower, Empire State Plaza, Albany, NY 12237

Seniors may join if they are 65 or older, live in NYS, have an annual income up to $75,000 if single and up to $100,000 if married, and are not receiving full Medicaid benefits. A member must be enrolled in a Medicare Part D drug plan to receive EPIC benefits. Applicants can apply and enroll in EPIC at any time of the year and they will receive a Special Enrollment Period to join a Part D drug plan if they are not already enrolled. Service Area: NYS.
Monday 8:00 AM - 5:00 PM Tuesday 8:00 AM - 5:00 PM Wednesday 8:00 AM - 5:00 PM Thursday 8:00 AM - 5:00 PM Friday 8:00 AM - 5:00 PM
800-682-6056

Voice - Laboratory Complaints

800-522-5006

Voice - Growing Up Healthy Hotline

800-542-2437

Voice - AIDS Drug Assistance Program

866-807-2130

Voice - Occupational Disease & Fatality Reporting

800-942-3858

Voice - Child and Adult Care Food Program

800-332-3742

Voice - EPIC - Elderly Pharmaceutical Insurance Coverage Participant Helpline

866-881-2809

Voice - Public Health Duty Officer Helpline

800-541-2437

Voice - HIV/AIDS General Information: 1-800-541-AIDS

800-458-1158

Voice - Environmental Health

800-804-5447

Voice - Hospital & Diagnostic/Treatment Center Complaints

(800) 332-3742

Voice - Toll Free Helpline

800-206-8125

Voice - Managed Care Complaints

800-663-6114

Voice - Office of Professional Medical Conduct - Complaints and Inquiries

716-847-4302

Voice - Main Phone - Buffalo Office

866-693-6667

Voice - Organ & Tissue Donation Information: 1-866-NYDONOR

800-962-5064

Voice - AIDS Counseling and Testing - Buffalo

800-628-5972

Voice - Hospice Complaints

800-233-7432

Voice - HIV/AIDS General Information - Spanish

800-542-0424

Voice - EPIC - Elderly Pharmaceutical Insurance Coverage Fraud & Abuse Hotline

800-698-4543

Voice - Child Health Plus: 1-800-698-4KIDS

716-847-4320

Voice - Long Term Care & Home Care - Buffalo

888-201-4563

Voice - Nursing Home Complaint Hotline

866-893-6772

Voice - Adult Care and Assisted Living Complaints

Russian, Yiddish, Chinese, Arabic, Bengali, English, Spanish, Haitian Creole, Italian, Korean, Polish

Call the toll free Helpline listed above. The Helpline will answer questions, send out applications and other information, and resolve any problems seniors may have with the EPIC program. Seniors should complete an application and report their gross annual income from the previous calendar year. Married couples, by law, must provide joint annual income even if only one spouse is applying for EPIC.

EPIC co-pays will continue to range from $3 - $20, based on the out of pocket cost of the drug once Medicare Part D is billed. EPIC will pay the Medicare Part D drug plan premium up to the basic amount up to $72.34 per month in 2025 for those with income are $0 - $23,000 single and $0 - $29,000 married living with spouse.

Cattaraugus County, NY
Niagara County, NY
Wyoming County, NY
Orleans County, NY
Chautauqua County, NY
Genesee County, NY
Erie County, NY

Description

EPIC is a NYS senior prescription plan that provides supplementary drug coverage for those enrolled in Medicare Part D drug plans. EPIC provides secondary coverage for drugs covered by a member's Medicare D plan, after any Part D deductible, if they have one, is met. EPIC also covers many Part D excluded drugs. Seniors must purchase their prescriptions at a NYS pharmacy participating in EPIC. Almost all community pharmacies in NYS, as well as several mail order pharmacies in the state, participate in EPIC. Seniors can call the toll-free help line to inquire if their pharmacy is participating in EPIC.

Data provided by

211 Western New York

Providing organization

New York State - Health Department