Elderly Pharmaceutical Insurance Coverage
{{Short description|American prescription drug insurance}}
{{Use mdy dates|date=July 2021}}
{{Use American English|date=July 2021}}
Elderly Pharmaceutical Insurance Coverage (EPIC){{cite news |newspaper=The New York Times
|url=https://www.nytimes.com/1987/10/25/nyregion/prescription-program-for-elderly-lags.html
|title=Prescription Program For Elderly Lags
|author=Tom Callahan |date=October 25, 1987}}{{cite web
|url=https://www.health.ny.gov/health_care/epic
|title=Elderly Pharmaceutical Insurance Coverage (EPIC)}}{{cite web
|url=https://ulstercountyny.gov/aging/medical-service/EPIC
|quote=Ulster County... (EPIC) is a New York State program for seniors administered by the Department of Health.
|title=Elderly Pharmaceutical Insurance Coverage (EPIC)}} ("New York State's Senior Prescription Plan")form NON DOH-1409 was designed so that personal/out-of-pocket costs for medicines are reduced or largely paid for program participants by the state. Members are also given assistance with Medicare Part D.{{cite news
|newspaper=The New York Daily News
|url=https://www.nydailynews.com/life-style/health/understanding-medicare-part-article-1.2385869
|title=Understanding Medicare - Part D
|author=Jordan Galloway |date=October 5, 2015}}
History
Initial public response to the program, when introduced by New York State, had fewer participants than expected. EPIC(NYC.gov) {{cite web
|url=https://portal.311.nyc.gov/article/?kanumber=KA-01434
|title=Elderly Pharmaceutical Insurance Coverage (EPIC)}} was established in 1986 to help income-eligible seniors with the high costs of prescription drugs; Paul E. Harenberg, Chairman of the New York State Assembly Committee on Aging, held hearings. It soon became obvious that recent retirees faced a double problem: "sticker shock not only because you are at that age when you start to need more medications, but also because your insurance is picking up less of the cost."{{cite news
|newspaper=The New York Times
|url=https://www.nytimes.com/2003/03/18/jobs/well-being-prescription-drugs-a-guide-to-options-that-can-cut-costs.html
|title=Prescription Drugs: A Guide to Options That Can Cut Costs
|author=Julie Connelly |date=March 18, 2003}}
As introduced, eligible seniors pay 40% of a medicine's cost, up to a specified level; beyond that, the state pays 100%. Unlike managed care plans,{{cite news |newspaper=The New York Times
|url=https://www.nytimes.com/2003/03/09/business/seniority-misgivings-about-nudging-the-elderly-into-managed-care.html
|title=Misgivings About Nudging the Elderly Into Managed Care
|author=Fred Brock |date=March 9, 2003}} "it helps people with their prescription drug costs without making them leave their current doctors and join H.M.O.'s."{{cite news |newspaper=The New York Times
|url=https://www.nytimes.com/2003/03/16/business/l-managed-care-for-the-elderly-792101.html
|title=Managed Care For the Elderly
|author=Teri Koff |date=March 16, 2003}} A 2001 Department of Consumer Affairs estimate found that 27% of seniors in New York lack insurance.{{cite news
|newspaper=The New York Post
|url=https://nypost.com/2001/02/06/prescription-for-finding-best-drug-prices-in-town/
|title=Prescription For Finding Best Drug Prices In Town
|author=Kirsten Danis |date=February 6, 2001}} By 2003, 33 other states had introduced "state pharmacy assistance programs," partly to avoid what The New York Times called the "murky" choice of buying "from Canada and Mexico online or in person."
Medicare-based pharmaceutical coverage is "delivered by private plans that can establish lists of preferred drugs and can steer patients to selected pharmacies" in contrast to how EPIC and some other states "pay for almost any prescription drug and allow beneficiaries to use
virtually any pharmacy."{{cite news |newspaper=The New York Times
|url=https://www.nytimes.com/2004/01/04/us/state-officials-are-cautious-on-medicare-drug-benefit.html
|title=State Officials Are Cautious On Medicare Drug Benefit
|author1=Raymond Hernandez |author2=Robert Pear |date=January 4, 2004}}
In 1987 Mario Cuomo budgeted $70 million, to begin coverage in October for an estimated 1.2 million elderly.{{cite news
|newspaper=The New York Times
|url=https://www.nytimes.com/1987/01/21/nyregion/cuomo-budget-spending-limits-tax-cuts-excerpts-governor-s-budget-message.html
|title=The Cuomo Budget: Spending Limits And Tax Cuts; Excerpts From Governor's Budget Message To The Legislature
|date=January 21, 1987}} In 2021 the program was still running,{{cite web
|url=https://www.nysenate.gov/legislation/laws/ELD/250
|title=New York Consolidated Laws, Elder Law (ELD 250)}} with his son as governor.