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Resources for Families with Limited Incomes

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Here are a few resources to assist families with limited incomes:




EPIC: The New York State Health Department administers the Elderly Pharmaceutical Insurance Coverage program (EPIC), which provides seniors with co-payments for Part D-covered prescription drugs after any Part D deductible is met. It also covers many drugs excluded from Part D.  New York State residents 65 or older must be enrolled or eligible to be enrolled in a Medicare Part D drug plan to receive EPIC benefits and can apply for EPIC at any time of the year.


Annual income for eligibility is up to $75,000 for singles and up to $100,000 for married couples. EPIC offers two plans:


The Fee Plan is for members who pay an annual fee ranging from $8 to $300, based on their previous year’s income. EPIC pays the Part D monthly drug plan premiums up to the average cost of a basic Medicare drug plan. Members pay EPIC co-payments for Part D and EPIC-covered drugs after the Part D deductible, if any, is met.


The Deductible Plan is for members who must meet an annual out-of-pocket deductible based on their prior year's income before paying EPIC co-payments for drugs. EPIC also pays the Medicare Part D drug plan monthly premiums up to the amount of an average Part D plan, for members with an annual 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.


For more information, visit www.health.state.ny/us/health_care/epic  or call 1-800-332-3742.


Affordable Care Act: Under the federal Affordable Care Act, the Extra Help program pays prescription drug costs for Medicare recipients with limited income and resources.   For information or to apply online, Medicare beneficiaries or caregivers can visit www.socialsecurity.gov/prescriptionhelp  or call Social Security at 1-800-772-1213.  For additional information, log on to www.medicare.gov, and click on Your Medicare Costs, then Get help paying costs.


Medicare Savings Program


Medicare Savings Programs are government programs that help Medicare beneficiaries who have limited income and assets but do not qualify for Medicaid. The programs, also known as Medicare Buy In, aid people with low incomes. There are four kinds of Medicare Savings Programs, and depending on income and assets, qualifying individuals can have a portion of their Medicare expenses paid, including monthly premiums, deductibles, and coinsurance.


In Nassau County:  Contact the Department of Social Services for information and an application (516-227-8000).


In Suffolk County: Call the Office for the Aging (631-853-8200) or the Department of Social Services. (631-853-8730)



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PART I

PREPARING A PLAN