EPIC (Elderly Pharmaceutical Insurance Coverage) is the New York State Pharmaceutical Assistance Program (SPAP). EPIC is available to New York state residents who are 65 or older and have annual incomes below $75,000 for an individual and $100,000 for a couple. EPIC can help people pay for prescription drugs.
All EPIC members who also appear eligible for either Extra Help or a Medicare Savings Program are asked to complete and return a Request for Additional Information (RFAI) form from EPIC. This form lets EPIC apply on your behalf to these low-income programs.
- Extra Help is a federal government program that helps pay Part D drug costs.
- Medicare Savings Programs (MSPs) are state-based programs that can help pay Medicare health care costs including the premiums, deductibles and coinsurances for Parts A and B. There are income and asset limits for both programs.
Some people with Medicaid spend-downs have EPIC. A Medicaid spend-down is for people whose income is higher than would normally qualify them for Medicaid, but who have medical expenses that reduce their income to the Medicaid level. People with Medicaid spend-downs get Extra Help automatically.
People with full Medicaid also get Extra Help automatically. However, people with full Medicaid can’t have EPIC.