Question: I have a Part D plan and EPIC. In past years EPIC has paid my Part D premium. I am not sure EPIC has done that yet. What should I do?

Answer: For many Seniors in New York State, EPIC has been a wonderful way to save extra money on your Prescription Drugs. For those who don’t know what EPIC is, let me explain. EPIC is the Elderly Pharmaceutical Insurance Coverage offered by the State of New York. In order to qualify for EPIC, you must live in New York State, be 65 years of age or older and have income less than $75,000 per individual or $100,000 per couple annually. After enrolling, the EPIC coverage that you receive helps you to pay for your prescription drug medications purchased at a pharmacy in New York state. EPIC also requires that you be enrolled in a Part D plan.

For those seniors whose annual income is on the lower end ($23,000 or less for a single person and $29,000 or less for a couple), EPIC has an additional benefit. EPIC will pay the premiums of their Part D plan up to $41.00 in 2017. If you have been on EPIC and are used to this benefit, you may remember that it takes a couple of months for EPIC to catch up with your plan change if you made one during the Annual Open Enrollment Period (Oct. 15 to Dec. 7). Last year the Part D plan insurance companies were not getting paid in a timely manner and many threatened to cancel coverage.

This year, EPIC announced last week it has started to make those Part D premium payments. So your Part D insurance premium has most likely been paid, or will be soon. You may want to contact EPIC if you think your plan has not been paid yet; EPIC can answer that question for you.

Some individuals may have premiums that cost more than $41 a month. Those individuals may have a partial payment to make towards their Part D premium. I always advise paying that partial premium in a timely manner. Your EPIC letter indicated how much it would pay ($41), so you can do the math and pay the difference between the total premium and the $41 EPIC will pay, or your insurer might have already sent you a statement telling you what you owe.

EPIC has done well this year with working to update their records of all of their more than 300,000 enrollees and their drug coverage for 2017. Since many people change their plan, EPIC has to wait for Medicare to inform them of your Part D choice for 2017. Once EPIC makes sure they have accurate information for their members and that they are paying the right company the correct premium for the correct enrollees, they can make those payments. EPIC this year (2017) was quicker to get that correct information and get those premiums paid than last year.

EPIC pays the premiums for those who are eligible for this benefit back to January for those that are eligible. If you paid your premiums yourself, your Part D plan will reflect that credit on future billings. If you overpaid those premiums, you don’t see that refund until you switch to a different plan (if and when that happens).

If you are over 65 and feel you are eligible for EPIC and want to apply you can call 1-800-332-3742 and talk with EPIC Customer Service about enrolling or to get an application. EPIC also has a website at www.health.ny.gov/health–care/epic/ and you can get an application on that website as well as information about the program. You can also often get EPIC applications at your local pharmacy. New York State Pharmacists are usually knowledgeable about EPIC and have applications on the counter.

I would encourage all seniors who are eligible for EPIC to apply. It can be some extra Prescription Drug Coverage that could save you money in the months and years to come. IF you are an EPIC member it also gives you an extra Special Enrollment Period (SEP) to change your insurance if you need or want to.

To contact Janell Sluga, GCMC with questions or concerns, please call 720-9797 or e-mail her at janells@lutheran-jamestown.org.