EPIC, short for Elderly Pharmaceutical Insurance Coverage, is a New York State program that lowers prescription costs for residents 65 and older. It works on top of your Medicare Part D plan. Singles with incomes up to $75,000 and married couples up to $100,000 can join, and there’s no asset test.

Do you qualify?

You can join EPIC if you’re:

• 65 or older
• A New York State resident
• Enrolled in, or eligible for, Medicare Part D
• Earning up to $75,000 a year (single) or $100,000 (married)

Your savings, home, and investments don’t count against you.

What EPIC does for you

• Cuts pharmacy co-pays. After any Part D deductible, EPIC pays part of what you’d owe for covered drugs.
• Pays your Part D premium if your income is $23,000 or less (single) or $29,000 or less (married), up to $58.82 a month in 2026.
• Stacks with Extra Help. With both programs, premium help can reach $117.64 a month.
• Opens an extra plan change. EPIC members can switch Part D plans once a year outside Open Enrollment.

Fee Plan or Deductible Plan?

EPIC places you based on last year’s income.

	Fee Plan	Deductible Plan
Income	Up to $20,000 single, $26,000 married	$20,001 to $75,000 single, $26,001 to $100,000 married
What you pay	Annual fee of $8 to $300	Annual deductible of $530 to $3,215
When savings start	Right away	After the deductible

Full Extra Help members don’t pay the EPIC fee. If you’re on the Deductible Plan and pay your own Part D premium, EPIC lowers your deductible by about $706.

Is EPIC worth it?

For lower incomes, EPIC can pay your Part D premium outright, even if you rarely fill prescriptions. For higher incomes, it’s protection for the year your drug costs spike after a new diagnosis or a costly medication.

How to sign up

Call the EPIC Helpline at 1-800-332-3742 or download the application from the New York State Department of Health. EPIC will also help you apply for Extra Help and the Medicare Savings Program. See 2026 limits for all three on our Financial Aid Programs page.

We’ll help you apply

Many Niagara County seniors qualify for EPIC, Extra Help, or both. We’ll check what you’re eligible for and handle the paperwork, free. Ask us about EPIC or call (716) 319-4613.

Frequently asked questions

Who is eligible for EPIC in New York? New York residents 65 and older with Part D coverage, or eligible for it, and incomes up to $75,000 (single) or $100,000 (married).

Does EPIC have an asset limit? No. EPIC looks only at your income from the previous year.

What’s the difference between the EPIC Fee Plan and Deductible Plan? The Fee Plan is for lower incomes and charges a small annual fee. The Deductible Plan is for higher incomes and requires a deductible before EPIC savings begin.

Medicare charges a late penalty if you put off Part B or Part D without other qualifying coverage. The penalty raises your monthly premium, and for most people it never goes away. Enrolling when you’re first eligible, or keeping qualifying coverage until you do, prevents it.

Part B vs. Part D penalties at a glance

	Part B penalty	Part D penalty
Triggered by	Going without Part B and without coverage from a current job	Going 63+ days in a row without Part D or creditable drug coverage
How it’s figured	10% for each full 12 months you went without	1% of the national base premium for each month you went without
How long it lasts	Usually for as long as you have Part B	Usually for as long as you have Part D
Who avoids it	People with coverage from their or a spouse’s current job, or a Medicare Savings Program	People with creditable drug coverage or Extra Help

What it looks like in real dollars

Say you waited 3 full years to sign up for Part B with no work coverage. You’d pay 30% more every month. On the 2026 standard premium of $202.90, that’s about $60.87 extra each month, or roughly $730 a year.

For Part D, a 24-month gap adds 24% of the national base premium to your monthly drug plan bill.

What counts as creditable drug coverage?

Coverage that’s expected to pay at least as much as Medicare’s standard drug benefit. Many employer, union, and VA plans qualify. Your plan sends a yearly notice saying whether yours does. Keep it, since you may need it as proof.

How to avoid Medicare penalties

• Enroll during your Initial Enrollment Period, the 7 months around your 65th birthday. Our turning 65 guide walks you through it.
• Use your 8-month window to sign up for Part B after work coverage ends. See Still Working at 65?
• Don’t count on COBRA or retiree plans. They don’t protect you from the Part B penalty.
• Pick up a low-cost Part D plan even if you don’t take prescriptions.
• Apply for Extra Help if your income is limited. It removes the Part D penalty. See our Financial Aid Programs page.

Already late?

Without a Special Enrollment Period, you can sign up during the General Enrollment Period, January 1 to March 31. Coverage starts the month after you enroll. If under-65 disability brought you to Medicare and you’re paying a Part B penalty, it goes away when you turn 65.

Think a penalty is wrong? You can ask Medicare to reconsider. We’ll help you gather what you need.

Get your timing right

We help Niagara County residents sign up at the right time so penalties never start. It’s free to work with us. Talk with our team or call (716) 319-4613.

Frequently asked questions

Is the Medicare late penalty permanent? For most people, yes. It’s added to your premium for as long as you have that part of Medicare.

How is the Part D late penalty calculated? It’s 1% of the national base premium for each full month you went without Part D or creditable coverage, rounded to the nearest $0.10.

Can I avoid the penalty if I had insurance from work? Yes, if it was coverage from your or your spouse’s current job and you sign up within 8 months after it ends.