New York EPIC Prescription Assistance
New York's EPIC program is one of the largest state prescription assistance programs in the country, supplementing Medicare Part D for over 300,000 seniors.
New York residents 65+ with prior-year income under $75,000 (single) or $100,000 (married) can get help with Medicare Part D premiums and copays through EPIC (Elderly Pharmaceutical Insurance Coverage) — no separate asset test.
Most states no longer run a dedicated State Pharmaceutical Assistance Program (SPAP) — only a handful still do, largely because Medicare Part D, especially after the Inflation Reduction Act's reforms, now covers much of what these programs used to fill in. New York's EPIC program is one of the largest and best-known SPAPs still operating, run by the New York State Department of Health.
What EPIC Covers
EPIC is secondary coverage that works alongside Medicare Part D. It helps pay your Part D plan premium up to a state benchmark amount, and once any Part D deductible is met, it reduces your copay on covered drugs to a flat $3, $7, $15, or $20 depending on the drug's cost. EPIC also covers many drugs that Part D plans exclude. Members are placed into either a Fee Plan or a Deductible Plan depending on income.
Who Qualifies
To qualify, you generally need to be a New York resident who:
- Is 65 years of age or older
- Has a permanent home in New York State
- Has prior-year income below $75,000 if single, or below $100,000 if married
- Is enrolled or eligible to enroll in a Medicare Part D drug plan (Medicare Advantage members need Part D drug coverage as part of their plan)
How to Apply
EPIC is administered by the New York State Department of Health. You can apply at any time of year. For current program details and to start an application, visit the official program page.
Apply on health.ny.gov →Frequently Asked Questions
Who qualifies for EPIC in New York?
New York residents 65 or older with prior-year income below $75,000 if single or $100,000 if married, who are enrolled or eligible to enroll in a Medicare Part D plan.
What does EPIC actually pay for?
EPIC helps pay your Medicare Part D premium up to a state benchmark amount and reduces your drug copays to $3, $7, $15, or $20 depending on the drug's cost, once any Part D deductible is met.
Does EPIC replace Medicare Part D?
No. EPIC is secondary coverage that works alongside a Medicare Part D plan — you generally must be enrolled in or eligible for Part D to receive and keep EPIC benefits.
Illustrative summary — verify exact current income limits, benchmark amounts, and copay figures with the New York State Department of Health before relying on this page for an application decision. This site is not affiliated with the State of New York.