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Elderly Pharmaceutical Insurance Coverage (EPIC) Program

Generated from the gc-benefits catalog. It lists what the owner record states. It is not an eligibility decision; confirm current rules with the program.

EPIC supplements seniors' out-of-pocket Medicare Part D drug plan costs.

  • Owner record: ny/elderly-pharmaceutical-insurance-coverage
  • Jurisdiction code: NY
  • Frame: care_recipient
  • Review by: 2026-11-15
  • Authority: New York State Department of Health
  • Also called: EPIC

Offering 1: prescription drug cost assistance

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

  • Availability (owner codes): {"intake": "unknown", "type": "unknown"}

Conditions:

  • All of these:
  • Fact rule: recipient.age ≥ 65
  • Stated condition, not checked automatically: "To enroll in EPIC, you must be a resident of New York State. This means that your permanent home (not a summer or winter home) is located in New York State. It also means you live in the State on a regular, ongoing basis, and your New York State address is listed as your home address on official and legal documents."
  • Stated condition, not checked automatically: "have an annual income below $75,000 if single or $100,000 if married"
  • Stated condition, not checked automatically: "be enrolled or eligible to be enrolled in a Medicare Part D plan (no exceptions)"
  • Stated condition, not checked automatically: "not be receiving full Medicaid benefits"

Access route 1.1

  • Where: Online application
  • How: Complete the online application.
  • Url: http://nyepic.primetherapeutics.com/

Access route 1.2

  • Where: Paper application
  • How: Download and print the application, complete and sign it, then mail or fax it to EPIC.
  • Url: https://www.health.ny.gov/forms/doh-5080.pdf

Access route 1.3

  • Where: EPIC Helpline
  • How: Call for more information or to request an application. TTY: 1-800-290-9138.
  • Phone: 1-800-332-3742

Owner confirmations

  • /offerings/0/access/1: sha256:be34eecee995f20c95cd4a685d93c6f6e58125031cabbd1233832629b9c3a7ec

Evidence

  • /name: "# Elderly Pharmaceutical Insurance Coverage (EPIC) Program" (source, capture 9e88e50460f9f861aa6e0d3e6cdea6d79bb352e38b34a607c55801baa75584b5)
  • /authority: "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 325,000 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." (source, capture 9e88e50460f9f861aa6e0d3e6cdea6d79bb352e38b34a607c55801baa75584b5)
  • /caregiving_effect: "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 325,000 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." (source, capture 9e88e50460f9f861aa6e0d3e6cdea6d79bb352e38b34a607c55801baa75584b5)
  • /offerings/0/summary: "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." (source, capture 9e88e50460f9f861aa6e0d3e6cdea6d79bb352e38b34a607c55801baa75584b5)
  • /offerings/0/rules: "* be a New York State resident age 65 or older\n* have an annual income below $75,000 if single or $100,000 if married\n* be enrolled or eligible to be enrolled in a Medicare Part D plan (no exceptions), and\n* not be receiving full Medicaid benefits." (source, capture 58f57ba22e8e0890a114b58e2285f6672cd9f1c34a50f5c48be6835f9562413a)
  • /offerings/0/rules: "To enroll in EPIC, you must be a resident of New York State. This means that your permanent home (not a summer or winter home) is located in New York State. It also means you live in the State on a regular, ongoing basis, and your New York State address is listed as your home address on official and legal documents. You need to notify EPIC whenever you change your address." (source, capture 58f57ba22e8e0890a114b58e2285f6672cd9f1c34a50f5c48be6835f9562413a)
  • /offerings/0/access/0: "* Download then print the EPIC Application form in English\n* Download, fill in the fields in the EPIC Fill-in Application form in English then print to sign for completion\n* Complete an Online Application\n* Descargar e imprimir la aplicación de EPIC en español (PDF)\n* Other languages that the EPIC Application form is available in: \n * Albanian (PDF)\n * Arabic (PDF)\n * Bengali (PDF)\n * Chinese (PDF)\n * French (PDF)\n * Greek (PDF)\n * Haitian Creole (PDF)\n * Italian (PDF)\n * Korean (PDF)\n * Polish (PDF)\n * Russian (PDF)\n * Tagalong (PDF)\n * Urdu (PDF)\n * Yiddish (PDF)" (source, capture d17a80a9914679aa5fc28a6c0880eb1d5836d10b7d1cf6d52560ecc03f70a7fd)
  • /offerings/0/access/1: "* Download then print the EPIC Application form in English\n* Download, fill in the fields in the EPIC Fill-in Application form in English then print to sign for completion\n* Complete an Online Application\n* Descargar e imprimir la aplicación de EPIC en español (PDF)\n* Other languages that the EPIC Application form is available in: \n * Albanian (PDF)\n * Arabic (PDF)\n * Bengali (PDF)\n * Chinese (PDF)\n * French (PDF)\n * Greek (PDF)\n * Haitian Creole (PDF)\n * Italian (PDF)\n * Korean (PDF)\n * Polish (PDF)\n * Russian (PDF)\n * Tagalong (PDF)\n * Urdu (PDF)\n * Yiddish (PDF)" (source, capture d17a80a9914679aa5fc28a6c0880eb1d5836d10b7d1cf6d52560ecc03f70a7fd)
  • /offerings/0/access/1: "It is easy to join the program. Just complete the application and mail/fax it to EPIC or apply online. No documentation is required. EPIC verifies information with the Social Security Administration and the New York State Department of Taxation and Finance." (source, capture 9e88e50460f9f861aa6e0d3e6cdea6d79bb352e38b34a607c55801baa75584b5)
  • /offerings/0/access/2: "* Request an EPIC Application using the on-line Application Request Form\n* Call 1-800-332-3742 (TTY 1-800-290-9138) for more information or an application " (source, capture d17a80a9914679aa5fc28a6c0880eb1d5836d10b7d1cf6d52560ecc03f70a7fd)