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Elderly Pharmaceutical Insurance Coverage (EPIC) Program {NY State Only}

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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 330,000 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.

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31 thoughts on “Elderly Pharmaceutical Insurance Coverage (EPIC) Program {NY State Only}”

  1. 我覺得可能只能和billing department negotiate a cash price.
    因為我記得如果是ER的話,不是每一個當時值班的醫生,你的保險都可以用,就算是在In network裡面的醫院。
    因為同一個保險的醫療網,每一個保險等級,所cover的醫生人數不同,而當時值班的醫師,除非當場可以查,不然的話在這種緊急的狀況下,一般很難知道,是不是你保險所cover的醫生。

  2. 我老婆去 uci emergency 也是很多寫 professional services, 保險公司付了一部份剩下的也是要自己付. 基本上不一定保險不付只是你要先把deductable付完,保险公司才付剩下的

  3. 👸🏻 老板: “今年的 Annual Dinner 地点在 Zoom上办, 记得自己准备食物”
    👯‍♂️ 员工: “Noted”
    老板偶尔也挺幽默的🤣😂
    疫情期间 大家还是少聚一聚吧
    Stay safe, take care 😷🤧

  4. 我在加州,如果去in network facility 看到 out network 的醫生,是可以比照in network。然後你記得無論如何你收費無論如何都不會超出out of pocket 的錢就對了。

  5. 不是很確定樓主去的醫院是怎麼個運作模式。
    我個人的經驗是,我去的那間醫院 ER,設備/儀器是醫院提供,其他人員服務部分都是外包(一切都是收到帳單後才知道)
    所以,ER 的醫生幫我看診的部分,就有兩筆費用,分開算,一個是 Physician service,一個是 Emergency room,這些在台灣都直接合併計算。
    其他檢查也是一樣,使用儀器檢查的費用和人員服務的費用都分開🥺
    費用的部分,逐筆,若覺得有收費過高的項目,可以和 billing department 談看看。每張帳單都有對應的 billing department

  6. 我覺得可能只能和billing department negotiate a cash price.
    因為我記得如果是ER的話,不是每一個當時值班的醫生,你的保險都可以用,就算是在In network裡面的醫院。
    因為同一個保險的醫療網,每一個保險等級,所cover的醫生人數不同,而當時值班的醫師,除非當場可以查,不然的話在這種緊急的狀況下,一般很難知道,是不是你保險所cover的醫生。

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