As people start looking at retiring, sometimes the questions for the future can be daunting. One of the biggest questions is having the right prescription plan. No one truly knows what the future holds. Fortunately, in the New York State area, there is a program that can help you. This program is the New York State EPIC Program.

What is EPIC?

EPIC stands for Elderly Pharmaceutical Insurance Coverage. This program helps New York state residents who are 65 and older cover the costs of prescription medications. Residents who want to use the EPIC program need to have:

  • an annual income under $75,000 if single, or $100,000 if married
  • Do not receive full Medicaid benefits
  • Are enrolled, or eligible for a Medicare Part D drug plan or Medicare Advantage Plan that provides drug coverage

How EPIC it Works

Depending on your annual income, you will be eligible for either the Fee plan or Deductible plans. If your annual income is less than $20,000 if single or $26,000 if married, you will be eligible for the Fee plan. If your income is higher than these but lower than the $75,000/$100,000 income mark, you will qualify for the Deductible plans

Almost all of the plans will cover your part D premium up to the state benchmark. Any premium cost above that will be your responsibility. This program is the only similarity between the two. With the Fee plan, you pay an annual fee to the EPIC program based on your income. However, if you are on the Extra Help program, the fee is waived. The EPIC benefits come as copayments for medications after you have met your Part D deductible.

There are two different deductible plans. The first one is for those whose income is greater than the Fee plan maximum, but less than $23,000 if you are single and $29,000 if you are married. This plan, like the fee plan, covers the state benchmark on the plan D premium. Unlike the fee plan, there is no annual fee, but there is a deductible.

If you earn more than $23,000 and you are single, or $29,000 and you are married, you qualify for the second deductible plan. Under this plan, there is no fee and no state benchmark coverage. However, your deductible will be lowered by the annual premium rate of a benchmark D plan.


Maintaining a healthy life can be challenging, especially as you start to consider retirement. Fortunately, with programs such as EPIC, your standard of health care will not be diminished. The best thing about the EPIC plan is that it is easy to apply for. Simply follow this link to request an application form, fill out the form, and send it to the EPIC office in Albany New York. If you or a loved one needs help covering expenses for medication, then the EPIC plan is perfect for you.