Health Insurance for Seniors

[ 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).

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

[ EPIC ]
EPIC is a free New York State program that helps more than 280,000 income-eligible seniors aged 65 and older supplement their out-of-pocket Medicare Part D drug plan costs. Seniors can apply for EPIC at any time of the year. They 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

[ Medicare Saving Program ]
1) Qualified Medicare Beneficiaries (QMB)
This program can pay for the Medicare Part A and/or Part B premium, and it also pays for Medicare Parts A and B coinsurance and deductibles. An individual can be eligible for QMB only or QMB and Medicaid.

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 SLIMB and Medicaid (with a spend-down). The applicant must have Medicare Part A to qualify 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

[ Extra Help with Medicare Prescription Drug Plan Costs ]
Anyone who has Medicare can get Medicare prescription drug coverage. Some people with limited resources and income may also be able to get Extra Help to pay for the costs–monthly premiums, annual deductibles, and prescription co-payments–related to the Medicare prescription drug plan. The Extra Help is estimated to be worth about $4,000 per year. Many people qualify for these critical savings and don’t even know it.

Click to copy link[ Last Updated: April, 2022 ]


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