Share this article

print logo

EPIC drug plan to drop 91,000 seniors

About 91,000 seniors, including 9,300 seniors in Erie and Niagara counties, will be pushed off a popular state-run prescription drug plan and onto the troubled Medicare drug program July 1.

The cost-cutting move is buried in Gov. George E. Pataki's 2007 budget proposal. It affects about a quarter of the people on the Elderly Prescription Insurance Coverage plan, commonly known as EPIC.

Sen. Charles E. Schumer, who issued the projections about the numbers of people to be affected locally, said Wednesday that he is concerned that those seniors will face the same chaos that others have encountered under the new federal program.

"It's the lowest-income people under EPIC who will be affected," said Schumer, D-N.Y. "They could have kept them under EPIC. The state saves money here, but the seniors lose out."

Amy Button, Medicare/EPIC coordinator for the New York Statewide Senior Action Council, echoed Schumer's concerns. The new Medicare drug program, which began Jan. 1, "is working so poorly," Button said.

Most notably, countless New Yorkers who had been getting their drugs under Medicaid, the government health plan for the poor, were supposed to be automatically switched to the new Medicare benefit. But glitches disrupted many of those transfers, sometimes leaving seniors without their prescriptions.

Similarly, affected EPIC recipients are supposed to be automatically transferred into Medicare on July 1. "We think it will repeat a lot of the same problems," Button said.

EPIC is a state drug program for seniors who are too well-off to qualify for Medicaid, but who still struggle to pay for their prescriptions. The change included in Pataki's budget affects EPIC enrollees who would qualify for a special low-income subsidy under the Medicare Part D prescription plan. Spokesmen at the state Health Department and the Budget Division did not respond to inquiries about the proposed move.

EPIC is a simple, traditional insurance plan where seniors pay no more than a $20 co-pay for their medication. In contrast, the federal Medicare prescription program is a collection of private-sector drug plans that offer widely varying benefits and co-pays.

Schumer said he was especially concerned that EPIC recipients may be automatically transferred into drug plans that don't cover all the prescriptions they need.

To prevent that, New York should put explicit protections in place to make sure that EPIC recipients continue to get the medicines they need once they transfer to Medicare, Schumer said.

In addition, Schumer introduced a bill that would prevent the state from transferring its remaining 276,000 EPIC enrollees into the federal program. "The fear is that they will move the others," Schumer said.

Schumer also said that he and several of his colleagues introduced a bill to prohibit Medicare prescription plans from narrowing the list of drugs they cover unless seniors are given an option to change plans when that happens.

Schumer, Sen. Hillary Rodham Clinton, D-N.Y., and several other legislators have offered other bills that aim to improve the much-criticized Medicare Part D program. But both Schumer and Clinton have said that the best solution would be to replace that program with something simpler and better.

Asked what seniors might want to do if they think they might get switched from EPIC to Medicare, Button suggested that they contact their state legislators, who will be voting on the budget plan that authorizes the switch.


There are no comments - be the first to comment