What is Medicare Prescription Drug Plans?

  • Also called Part D and sometimes called "PDPs"-

  • Are plans that add drug coverage to Original Medicare, some Medicare Cost Plans, some Medicare Private Fee-for-Service (PFFS) Plans, and Medicare Medical Savings Account (MSA) Plans

Coverage Gap

  • Medicare drug plans may have a "coverage gap", which is sometimes called the "donut hole". This means that after you and your drug plan have spent a certain amount of money for covered drugs, you may have to pay more for your drugs (until you reach the out-of-pocket threshold)

Catastrophic Coverage

  • Means a small coinsurance amount paid by you or a co-payment for the rest of the year for covered drugs. You automatically get this coverage once you reach Out of Pocket Threshold (your spending on prescription drugs reaches a certain amount).

Brand - name Drug

  • A brand-name drug is a medication researched and developed by a pharmaceutical company and then patented to protect against other companies making copies and selling the drug.

Generic Drugs

  • According to the Food and Drug Administration (FDA) generic drug is a prescription drug with the same active - ingredients as a brand drug with less cost.

Extra Help

  • Qualifies you for the full low-income subsidy for Medicare prescription drug coverage and you pay $0 deductible, no more than $8,35 (brand) or $3,35 (generic) for your prescription with full extra help.

 Elderly Pharmaceutical Insurance ( EPIC) Program

  • The Elderly Pharmaceutical Insurance Coverage (EPIC) program is a New York State program for seniors administered by the Department of Health. It helps more than 320,000 income-eligible seniors aged 65 and older to supplement their out-of-pocket Medicare Part D drug plan costs. Seniors can apply for EPIC at any time of the year and must be enrolled or eligible to be enrolled in a Medicare Part D drug plan to receive EPIC benefits and maintain coverage.

  • EPIC provides secondary coverage for Medicare Part D and EPIC-covered drugs purchased after any Medicare Part D deductible is met. EPIC also covers approved Part D-excluded drugs once a member is enrolled in Part D.

  • EPIC helps pay the Medicare Part D drug plan premiums for members with income up to $23,000 if single or $29,000 if married. Higher income members are required to pay their own Part D premiums but EPIC provides premium assistance by lowering their EPIC deductible.

  • EPIC has two plans based on income. The Fee Plan is for members with income up to $20,000 if single or $26,000 if married. The Deductible Plan is for members with incomes ranging from $20,001 to $75,000 if single or $26,001 to $100,000 if married.

  • It is easy to join the program. Just complete the application and mail or fax it to EPIC. No documentation is required. EPIC verifies information with the Social Security Administration and the New York State Department of Taxation and Finance.

  • More information about Elderly Pharmaceutical Insurance ( EPIC) Program you can find here

  • Also you can download application here