Medicare Rights Center

At the time of this grant, approximately 350,000 of New York State’s senior citizens were enrolled in both the federally financed Medicare Part D drug benefit and New York State’s Elderly Pharmaceutical Insurance Coverage (EPIC) programs; roughly 150,000 of these individuals reside in New York City.

Medicare Part D provides prescription drug coverage for these seniors, and EPIC provides wraparound coverage for prescription drug benefits not covered by Part D with State funds. An analysis of EPIC data revealed that approximately 15,000 EPIC enrollees were likely to be eligible for more generous Federal prescription drug coverage through the Medicare Part D Low-Income Subsidy (LIS) program. In addition, they may be eligible for one of three Medicare Savings Programs (MSPs). The New York Health Foundation (NYHealth) funded the Medicare Rights Center (MRC) in a two-phase project aimed at increasing the number of low-income Medicare beneficiaries enrolled in MSPs and the LIS program.

Approximately 350,000 New York State seniors are enrolled in both the federally financed Medicare Part D and New York State’s Elderly Pharmaceutical Insurance Coverage (EPIC) programs. Medicare Part D provides prescription drug coverage for these seniors, and EPIC provides “wraparound” coverage for prescription drug benefits not covered by Part D.

During Phase 1 of this project, MRC and its partner Benefits Date Trust (BDT) identified 20,000 New York seniors who were potentially eligible for more generous Federal prescription drug coverage through the Medicare Part D Low-Income Subsidy program. MRC and BDT mailed letters and informational packets to13,000 of those seniors, resulting in 3,000 securing MSP benefits.

In Phase 2, MRC and BDT aim to a) reach the remaining 7,000 (of the 20,000) seniors believed to be eligible for MSP benefits and finish 500 pending cases from Phase 1; b) ensure that seniors connected with these important benefits maintain them; and c) sustain this successful model over the long term with the commitment of EPIC funding. MRC predicts these efforts will connect another 1,650 low-income New York seniors with benefits to which they are entitled, saving a combined $10.7 million for participating seniors and the State.