EPIC (Elderly Pharmaceutical Insurance Coverage) is a New York State program that helps seniors pay for prescription drugs. It works alongside your Medicare Part D plan to lower your co-pays, and it can pay your Part D premium if your income is lower. New Yorkers 65 and older with incomes up to $75,000 (single) or $100,000 (married) can qualify.

Many people who qualify have never heard of it. Here’s how it works.

Who qualifies for EPIC?

You may qualify if you are:

• 65 or older
• A New York State resident
• Enrolled in, or eligible for, a Medicare Part D plan
• Earning $75,000 or less a year if single, or $100,000 or less if married

There’s no asset test. Your savings, home, and investments don’t count.

How does EPIC help?

It lowers your pharmacy co-pays. After any Part D deductible, EPIC picks up part of your cost for covered drugs. Almost every pharmacy in New York accepts EPIC.

It can pay your Part D premium. In 2026, EPIC pays up to $58.82 a month toward your Part D premium if your income is $23,000 or less (single) or $29,000 or less (married).

It works with Extra Help. If you also have Extra Help, the two programs can each pay up to $58.82, or up to $117.64 combined, toward your premium.

It gives you an extra chance to change plans. EPIC members can switch Part D plans once a year outside the fall Annual Enrollment Period.

What are the two EPIC plans?

EPIC places you in one of two plans based on your income from the year before.

Fee Plan. For singles with incomes up to $20,000 and married couples up to $26,000. You pay an annual fee of $8 to $300, and EPIC co-pays start right away.

Deductible Plan. For higher incomes, up to the EPIC limits. You pay an annual deductible of $530 to $3,215 before EPIC co-pays begin. If you pay your own Part D premium, EPIC lowers your deductible by about $706 to help offset it.

If you have full Extra Help, EPIC waives the annual fee.

How do you apply for EPIC?

• Call the EPIC Helpline at 1-800-332-3742
• Download an application from the New York State Department of Health website
• Ask us. We help Erie County residents apply at no cost

When you apply, EPIC can also help you apply for Extra Help and the Medicare Savings Program.

Is EPIC worth it if I don’t take many drugs?

Often, yes. If your income is under the premium-help limit, EPIC can pay your Part D premium even if you rarely fill a prescription. If your income is higher, EPIC is a safety net for the year your drug costs jump.

Let us check what you qualify for

Between Extra Help, the Medicare Savings Program, and EPIC, many New Yorkers are leaving savings on the table. Erie Medicare Associates will review your situation and help you apply. Ask us about EPIC or call (716) 319-4613.

Frequently asked questions

What is the income limit for EPIC in 2026? EPIC is open to New York residents 65 and older with incomes up to $75,000 if single or $100,000 if married. There’s no asset limit.

Does EPIC replace Medicare Part D? No. EPIC works alongside a Part D plan. You need Part D coverage, or must be eligible for it, to use EPIC.

Can I have EPIC and Extra Help at the same time? Yes. The two programs work together, and EPIC waives its annual fee for people with full Extra Help.

You can avoid Medicare late penalties by signing up for Part B and Part D when you’re first eligible, or by keeping qualifying coverage until you do. If you delay without that coverage, Medicare adds a penalty to your premium. In most cases, you pay it for as long as you have Medicare.

Here’s how each penalty works and how to stay clear of them.

The Part B late enrollment penalty

If you don’t sign up for Part B when first eligible, and you don’t have coverage from current work, your premium goes up 10% for each full 12 months you went without it.

Example: If you waited 2 full years, you’d pay 20% more. On the 2026 standard premium of $202.90, that’s about $40.58 extra every month, for life.

The Part D late enrollment penalty

If you go 63 days or more in a row without Part D or other creditable drug coverage after your first chance to enroll, you may owe a Part D penalty. It’s 1% of the national base premium for every month you went without coverage. The penalty is added to your monthly Part D premium, usually for life.

Creditable coverage means drug coverage at least as good as Medicare’s standard plan. Employer and union plans often qualify. Your plan sends a yearly notice that tells you.

The Part A penalty (for people who pay a premium)

Most people get Part A free. If you have to buy Part A and sign up late, your premium can go up 10%. You’d pay the higher amount for twice the number of years you delayed.

6 ways to avoid Medicare penalties

1. Sign up during your Initial Enrollment Period. It’s the 7 months around your 65th birthday.
2. Keep proof of creditable drug coverage. Save the yearly notice from your employer or union plan.
3. Use your Special Enrollment Period. When work coverage ends, you have 8 months to sign up for Part B with no penalty.
4. Don’t count on COBRA or retiree coverage. Neither one lets you delay Part B.
5. Get Part D even if you take no drugs. A low-cost plan now prevents a penalty later.
6. Check for Extra Help. People who qualify for Extra Help don’t pay the Part D late penalty.

Already missed your window?

If you missed your first chance and have no Special Enrollment Period, the General Enrollment Period runs January 1 to March 31 each year. Coverage starts the month after you sign up. Penalties may still apply, so enroll as soon as you can.

Think a penalty was charged by mistake? You can ask Medicare to review it. We can help you gather the paperwork.

Get it right the first time

Erie Medicare Associates helps Erie County residents time their enrollment so they avoid penalties and gaps. There’s no cost to work with us. Schedule a free consultation or call (716) 319-4613 to check your timing.

Frequently asked questions

How much is the Medicare Part B late penalty? It’s 10% of the standard Part B premium for each full 12-month period you could have had Part B but didn’t. You usually pay it for life.

How do I avoid the Part D late penalty? Enroll in a Part D plan when first eligible, or keep creditable drug coverage with no gap of 63 days or more.

Can a Medicare late penalty be removed? In some cases, yes. If you had qualifying coverage or got wrong information, you can ask Medicare for a review. People with Extra Help don’t pay the Part D penalty.