Reducing The Cost Of Your Prescription Drug Coverage

Medicare Extra Help Program

If you meet certain income and resource limits, you may qualify for a Medicare program called Extra Help to pay for prescription costs, premiums, deductibles, and coinsurance of Medicare prescription drug coverage.

In 2024, prescription costs are no more than $4.15 for each generic drug and $10.35 for each brand-name covered drug for those enrolled in the program.

Some people pay only a portion of their Medicare drug plan premiums and deductibles based on their income level.

You automatically qualify for lower prescription costs through Extra Help if you have Medicare and meet any of these conditions:

  • Have full Medicaid coverage

  • Get help from your state Medicaid program paying your Part B premiums (from a Medicare Savings Program)

  • Get Supplemental Security Income (SSI) benefits

If you don’t qualify for Extra Help, your state may have programs that can help with prescription costs. USA Benefit Consultants can help you contact your Medicaid office or your State Health Insurance Assistance Program (SHIP) for more information. Remember, you can reapply for Extra Help at any time if your income and resources change.

New York’s Elderly Pharmaceutical Insurance Coverage (EPIC)

The Elderly Pharmaceutical Insurance Coverage (EPIC) program is a state program for seniors administered by the New York State Department of Health. It helps more than 325,000 income-eligible seniors aged 65 and older to supplement their out-of-pocket Medicare Part D drug plan costs.

Seniors can apply for EPIC at any time during the year and must be enrolled or eligible to be enrolled in a Medicare Part D drug plan to receive EPIC benefits and maintain coverage. EPIC provides secondary coverage for Medicare Part D and EPIC-covered drugs purchased after any Medicare Part D deductible is met. EPIC also covers approved Part D-excluded drugs once a member is enrolled in Part D.

USA Benefit Consultants can help to complete and submit the EPIC Application (English).