3. Health Insurance

3. Health Insurance

a. Medicare

“Medicare is the federal health insurance program for people who are 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD) (Medicare.Gov).”

Medicare.gov: What is Medicare?

Social Security: Medicare Benefits

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b. Medicaid

“Medicaid is a program for New Yorkers who can’t afford to pay for medical care.”

NYS Department of Health: Medicaid in New York State


“EPIC is a free New York State program that 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.

EPIC helps pay the Medicare Part D drug plan premiums for low to moderate income members. EPIC also provides supplementary drug coverage for Part D covered drugs and Part D excluded drugs purchased while in the Medicare Part D coverage gap.”

NYS Department of Health: Elderly Pharmaceutical Insurance Coverage (EPIC) Program

d. New York Prescription Saver Card

“NYP$ is a pharmacy discount card that can lower the cost of your prescriptions by as much as 60 percent on generics and 30 percent on brand name drugs. Just show your card at a participating pharmacy to receive your discount right at the counter.” (New York Prescription Saver, 2012).

New York Prescription Saver What Is NYP$?


e. Medicare Saving Program

1) Qualified Medicare Beneficiaries (QMB)

“This program can pay for the Medicare Part A and/or Part B premium. An individual can be elegible for QMB only or for QMB and Medicaid. This program also pays for the Medicare Parts A and B coinsurance and deductibles.”

2) Specified Low-Income Medicare Beneficiaries (SLIMB)

“This program pays for the Medicare Part B premium only. Individuals can be eligible for SLIMB only or for SLIMB and Medicaid (with a spend-down). The applicant must have Medicare Part A in order to be eligible for the program.”

3) Qualified Individual 1 (QI-1)

“This program pays for the Medicare Part B premium only. Individuals cannot be eligible for QI and Medicaid.”

NYC Department for the Aging: Medicare Savings Program

Medicare Rights Center: Medicare Savings Program Financial Eligibility Guidelines


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