Program changes to EPIC

December 2012

The December 2012 NYS Medicaid Update highlights the EPIC program changes effective Jan. 1, 2013, including many EPIC program benefits that will be restored. The provider bulletin provided information about these changes as well as how they will affect both EPIC customers and the pharmacy. The program changes cover claims, billing and participant eligibility. Programs that will be reinstated include the manufacturers’ rebate program, and fee and deductible plans.

EPIC will continue to pay Medicare Part D premiums, up to the amount of a basic plan, for members in the Fee and Deductible plans with incomes up to $23,000 (single) or $29,000 (married). Those with incomes greater than $23,000 (single) or $29,000 (married) are responsible for their Medicare Part D premiums. The EPIC deductibles for these members will be reduced by $519 in 2013 to help them pay their Medicare Part D premiums.

Contact: Cheryl Udell,cudell@leadingageny.org, 518-867-8871