Pharmacies and Prescription coverage
What drugs are covered?
Almost all prescription medicines are covered, as well as insulin, and insulin syringes and needles. Both brand name and generic drugs are included.
What drug quantities are allowed?
Quantities allowed depend on what Part D or other primary drug coverage the EPIC member has. The dispensing limits under the primary coverage apply. For members without Part D or other coverage, EPIC allows prescriptions up to a 30-day supply or 100 tablets or capsules, whichever is greater. For all other drug forms (such as patches, liquids, creams, injectibles, etc.) the maximum is a 30-day supply.
What pharmacies can be used?
Most pharmacies in New York State are enrolled as EPIC providers, allowing seniors full access to EPIC benefits. However, EPIC cannot be used at pharmacies located outside of New York State, including mail order pharmacies. When traveling outside New York State, enrollees should plan to have an adequate supply of their medications with them. They can also make arrangements with their pharmacy in New York to have their prescriptions mailed or delivered to them on a short-term basis or in emergency situations.
