2002-02-20 / Seniors

Pataki Says More Seniors Are Saving More $ Under EPIC

By John Toscano

More seniors in New York state are enjoying the benefits of the Elderly Pharmaceutical Insurance Coverage (EPIC) prescription drug discount plan. Those benefits have also increased dramatically, according to Governor George Pataki.

The governor said EPIC enrollment has reached an all-time high of 250,000, an increase of 250 percent since 1998.

Just as important, the governor said, "coinciding with the jump in enrollment, the savings enjoyed by seniors have also increased dramatically. In 2001, EPIC saved the average senior nearly $1,800, or 78 percent on annual drug purchases. In 1994, seniors saved an average of $581, or 49 percent annually."

Since the program started, over 486,000 seniors have saved almost $1.5 million at pharmacies throughout the state under EPIC, the governor’s report said.

Pataki said that a key factor in the surge in enrollment was the recent increase in the income eligibility standard used to establish which seniors qualify for the program. The standard was raised to an income of $35,000 annually, from $18,500 for a single person and to $50,000 for married enrollees. Pataki also approved a reduction in fees and co-payments to ensure that seniors "(will) never have to pay more than $20 for even the most expensive prescription."

According to the governor’s statement:

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, with current fees ranging from $2 to $75 per quarter, based on a given senior’s income.

The deductible plan is available only to seniors in the upper income level. Seniors in this plan pay for the full cost of prescriptions until they reach an annual deductible, which ranges from $530 to $1,175 per year, based on a senior’s income. Once they reach their deductible, they pay only a co-payment on prescriptions for the rest of their coverage year.

The governor’s statement set no cap or limit on benefits. Almost all prescription medicines are covered, as are insulin and insulin syringes. The number of co-payments that seniors pay is limited which is extremely helpful to seniors with many prescriptions. After reaching this limit, which is based on these seniors’ income level, these individual receive their prescriptions free for the remainder of the coverage year.

EPIC also provides a safety value for members by sending electronic alerts to pharmacists if there is a possibility of drug interactions or overdoses. Enrollees’ physicians are informed about serious but less urgent problems as well. These warning systems are most helpful when a member goes to more than one physician or pharmacy.

Applications for EPIC are available at pharmacies, doctors’ offices, senior centers and county offices for the aging or by calling call the EPIC hotline at 1-800-332-3742 to request an application. Or check the EPIC link on the state’s Department of Health web site, http://www.heath.state.ny.us/.

HEAT HELP: The Jackson Heights Community Development Corporation is offering help to qualified senior citizen homeowners or tenants and low-income families in paying fuel and utility costs. You are eligible for the Home Energy Assistance Program (HEAP) through the city’s Department for the Aging if you meet income guidelines and are 60 years of age or older or if you’re the head of a household and receive Social Security Disability (SSI) either live alone or with a spouse only and receive SSI Code A. Apply by calling Patricia Sabb at JHCDC at (718) 458-3600. Call early because there is a limit on funds in the program.


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