What is EPIC?
EPIC stands for Elderly Pharmaceutical Insurance Coverage and is a New York State program for seniors administered
by the Department of Health. It helps more than 280,000 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 of 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.
For more information about EPIC and to apply for the subsidy, please take a look at information on the New York
State, Department of Health website: https://www.health.ny.gov/health_care/epic/.
Why do I keep getting a bill when I'm paying my monthly share?
Independent Health must receive the EPIC payment before it can be credited to your account. EPIC is 60-90
days behind, since we cannot credit your account for payments not yet received, you will continue to receive
an invoice. If you no longer want to receive an invoice, you would need to submit the number of months EPIC is behind.
Do I have to pay my premium in full if I receive EPIC?
We no longer credit EPIC subsidy to a member's account without having first received payment. Until we
receive the first EPIC payment, you are responsible to pay your monthly premium in full.
When will I get refunded since I'm paying in advance?
EPIC sends us one payment per month to cover your subsidy. Since it could take several
months before we receive your initial EPIC subsidy payment, we would not receive the final payments
for 2020 until early 2021. If you remain with Independent Health for the following plan year,
those payments would be applied to your monthly plan premium for the first few months of 2021. As a
result, there will be no gap in us receiving payments from EPIC in 2021. If you choose not to stay
with Independent Health, we would refund those subsidy payments to you when we receive them in 2021.
Will I be termed if I can't pay the total cost of my monthly premium?
As with any financial obligation, we recommend that you pay whatever you can toward the premium amount
you owe. By doing so, you may be able to avoid our delinquency process. Until we receive the first
EPIC payment, you are responsible to pay your monthly premium in full.
If termed, can I be reinstated upon paying past due balances?
Members are required to make payment in full on any outstanding premiums owed to Independent Health before
being re-enrolled in any plan. All enrollment guidelines apply. The member would need an SEP or would
need to wait until Annual Enrollment. Termination due to non-payment also does not give the member an SEP
to enroll in another MA or part D plan. Payment of past due premiums does not create an opportunity for
reinstatement into the plan. The member would need a "Good Cause" to justify their failure to pay premiums.