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Prescription medication can be expensive. You have a few different ways to get prescription coverage and help paying for medications.

In this section, see common questions about paying for prescriptions. To explore health coverage options and ways to manage your health, check out health under Your Options.  

If you can't afford your prescription copays, you might:

  • Ask your doctor about generic medications or free samples.
  • Ask your insurance plan about mail-order prescriptions.
  • Ask your pharmacy or hospital to waive the copay or provide charity care.
  • Ask your pharmacy for a promotional pharmacy price or discount generic programs.
  • Look for prescription assistance programs (which may help with copays) on the NeedyMeds website.
  • If you're on Medicare, apply for the Extra Help program from Social Security. Extra Help offers reduced copays and premiums, if you qualify.

Each insurance plan has a list of approved medications, called a formulary. Formularies vary by plan. If your prescription isn't on this list, it won't be covered by your insurance. 

If your prescription isn't covered by your insurance, you can:

  • Check with your insurance plan to see if they will cover a generic version of the drug.
  • Ask your doctor to explain to the insurance plan why you need the prescription and, if possible, why other drugs may be dangerous or less effective for you. This is called a formulary exception. 
  • Ask your doctor to check with the insurance plan about covering your prescription at a lower cost. This is called a tiering exception. 
  • File an appeal, if your insurance plan doesn't agree to make an exception for your prescription.
  • Ask your pharmacist to give you a temporary supply of your prescription through your plan's transition refill policy, if your prescription was covered before you switched plans or before your plan changed its coverage rules.
  • Apply for a local prescription assistance program from NeedyMeds.

If your pharmacy tells you they can't bill for your prescriptions, you might:

  • Call your insurance plan
  • Call the Senior LinkAge Line at 1-800-333-2433, if you have Medicare
  • Call the Minnesota Health Care Programs member help desk, if you have Medical Assistance or MinnesotaCare coverage that's not through a health plan

You can also let us help! Contact us for help talking with your insurance plan and pharmacy and troubleshooting the issue.