As some may be aware, New York State is essentially broke. As a result, they’ve made financial cuts to programs across the board. One such cut was to the NY EPIC program, a drug supplement for senior citizens. I feel this is an example of cutting your nose off despite your face or stepping over a buck to save a nickel.
Currently, EPIC reduces out of pocket expenses on prescription drugs for patients over 65. Seniors use a primary insurance, typically Medicare D. The primary insurance will charge them a flat rate (co-pay) or a percentage (co-insurance) for their drugs. EPIC reduces this amount due to no more than $20. Medications are affordable; everyone is happy.
Next year, EPIC will not give this benefit. As a result, out of pocket expenses for most seniors will rise, dramatically at times, for most of the year. What happens when medicines or healthcare costs too much? Study after study has shows patients choose to not take their medicine.
So, out of pocket expenses rise because of a short-sighted budgetary move and as a result more patients get sick, needing more expensive and resource intensive care.
There is a way to avoid this pending disaster. Do something. We have held two educational sessions, one in Saugerties and another in Woodstock, teaching patients and their families the ins and outs of Medicare and how to brace for this upcoming change. We are encouraging people to attend, talk to someone, ask questions, DO something.
Your costs are going up next year if you use EPIC.
The funny thing is we are now encouraging more people to join EPIC. Though they will not help with direct prescription costs, EPIC is now free for all patients 65 and up who meet income requirements. This gets you three major bonuses. The first, you get a “Get out of jail free” card. If you don’t like your Medicare D plan and have EPIC, you can change plans once before open enrollment. Second, EPIC will pay $40 towards your Medicare D premium. Third, EPIC will help next year with out of pocket expenses in the donut hole only.
The bottom line: EPIC is still beneficial, but less than last year. You MUST do something to prepare or prevent the increase in expenses. If you’re not in EPIC now, sign up – and tell friends and family to do the same.
Besides the two educational sessions, held Thursday Oct. 14 at the Saugerties Village Apothecary from 5:30-7:30 p.m. and Woodstock Apothecary the following night at the same time, we are sitting down with patients, reviewing their medicines, and choosing plans that will minimize their expenses next year. We can even make suggestions on how to lower drug costs overall.
One patient we recently reviewed will have at least a $240 a month increase in expenses if she does nothing. If she changes Medicare plans, the increase will be $120. Switching to lower cost generics could DECREASE her costs by at least $30 a month.
Please, attend our educational sessions. Bring friends or family members for support. Schedule an appointment with one of our pharmacists. Just please do something. l
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