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Though many seniors desperately need help paying for prescription drugs, most New York City seniors who are eligible have not joined a state program that offers that help, according to a study released today by City Comptroller Alan G. Hevesi. The survey of 897 seniors found that of the 331 eligible for EPIC (Elderly Pharmaceutical Insurance Coverage), 270, or 82 percent, had not enrolled. The need for EPIC is demonstrated by the fact that of the 270 not enrolled, 44 percent had no drug insurance and 11 percent were skipping medications because they could not afford them.

"The soaring cost of prescription drugs is an especially serious problem for seniors who are 13 percent of the population, but account for 42 percent of the total amount spent on drugs," said Hevesi. "New York State's solution, EPIC, ensures that seniors can afford to take all the drugs they need without sacrificing other essentials. The only problem is too many seniors don't even know the program exists."

EPIC offers prescription insurance to New York State seniors who are 65 or older and meet income and other requirements. While most prescription plans have a maximum benefit they will pay, EPIC has a maximum that seniors pay, about seven percent of their income. All prescription costs above that are free. Seniors who have insurance that covers prescription medicines can use EPIC to pay their costs when they exceed the maximum coverage of their other insurance.

In 1999, the most recent year for which data are available, the 118,400 New York State seniors enrolled in EPIC saved $142 million on their prescriptions. However, less than 28,000 of 610,000 City seniors eligible for EPIC were enrolled. Seniors age 65 or older with incomes less than $20,000 a year qualify for EPIC. As of January 2001, the program was expanded by doubling the income eligibility to $35,000 a year for individuals and $50,000 for married couples.

The Comptroller's Office interviewed 897 seniors who come for lunch at 27 centers in the five boroughs. Because they regularly come to centers, the seniors interviewed are more likely to find out about programs such as EPIC. As a result, the data from this survey most likely understates the percent of seniors who are eligible but not enrolled.

"Seniors who regularly attend centers tend to be the most informed about the services available to them, " said Hevesi. "That makes the results of this survey all the more troubling. We have a very good program but we have not done enough to spread the word. This survey should serve as a wake-up call - the State needs to do more to make sure our seniors know about EPIC."
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HEVESI ON EPIC PAGE 2

The survey found of the total 897 seniors:
· 754, or 84 percent, take prescription medicine.
· 81, or 9 percent, skip medicine because they can't afford it.
· 167, or 19 percent, have no prescription insurance.
· 331, or 37 percent, are eligible for EPIC.
· 270, or 82 percent of the 331 eligible, are not enrolled.
· The State estimates that 43 percent of eligible seniors are enrolled in EPIC in New York State, but the Comptroller's survey of New York City seniors in centers found that only 18 percent of those eligible were enrolled.

Many seniors have no insurance for prescription medicine and, as a result, may not be able to afford medicine they need. Of the 270 in the survey who are eligible for EPIC but not enrolled, 119, or 44 percent, have no prescription insurance. And 30, or 11 percent, are skipping medications because they cannot afford them. Nationally, it is estimated that a third of seniors have no prescription insurance.

Of the seniors in the survey, 754, or 84 percent, were taking prescription medicine. Of those, 25 percent were using four or more prescriptions per day. One senior in the survey reported spending $12,000 a year for medicine. Twenty percent were spending $840 a year or more and 10 percent were spending $1,800 a year or more.

The study recommends:
· Significantly increasing outreach in New York City by increasing staff hired by the State and seeking the aid of community organizations. Now, the State pays for only three EPIC outreach staff in the City.
· Increasing advertising about EPIC in major media and foreign language press.
· Developing new outreach programs targeted at hospitals, doctors, and pharmacies.
· Helping seniors enroll through mobile enrollment vans and other programs that go to places where seniors congregate.

"Increased outreach will ensure more seniors know about EPIC, but we also need to increase education efforts so that seniors know if they qualify," said Hevesi. "Mobile enrollment vans would expand outreach beyond centers and bring information to seniors who are unable to travel far from their homes."

Hevesi, who supported the creation of EPIC when he was in the State Legislature, has been working to publicize EPIC. The Comptroller's Office sent information about the program to more than 190,000 retired City workers along with their pension check. The Comptroller's Office also organized and publicized an outreach event in Manhattan to inform and enroll seniors. Later this month, the Office plans to mail flyers to religious leaders throughout the City urging them to inform their congregations about the EPIC program.

The study was conducted with the help of the Council of Senior Centers and Services, the New York City Department of the Aging and the 27 senior centers.

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