Continuing need FAQ

The continuing need program requires insulin manufacturers to provide insulin to eligible individuals for up to one year, with the option to renew annually. Throughout the year you are determined eligible, the manufacturers will provide your prescribed insulin for a co-pay of no more than $50 for each 90-day supply.

Some individuals with insurance may be referred to a manufacturer’s co-pay program, which waives all or part of the co-pay that the patient normally has to pay, if the co-pay program provides you a better value.

To be eligible for the continuing need program you must:

• Live in Minnesota.
• Present identification proving Minnesota residency in the form of a valid Minnesota identification card, driver’s license or permit, or tribal-issued identification. If you don't have one of these but you have an Individual Taxpayer Identification Number (ITIN), you can provide that instead. If you are a minor under the age of 18, your parent or legal guardian must provide the pharmacy with proof of residency or an ITIN.
• Have a family income that is equal to or less than 400% of the federal poverty guidelines (FPG) income. See the Minnesota Board of Pharmacy website for more information about the FPG guidelines.
• Not be enrolled in Medical Assistance or MinnesotaCare.
• Not be eligible to receive health care through most federally funded programs. Note: An individual who is enrolled in Medicare Part D is eligible for a manufacturer's insulin safety net program if the individual has spent $1,000 on prescription drugs in the current calendar year and meets the other eligibility requirements.
• Not be eligible to receive prescription drug benefits through the Department of Veterans Affairs.

If you have insurance that covers drugs, you may be eligible to receive insulin on a continuing need basis. However, if you pay $75 or less in out-of-pocket costs for a 30-day supply of insulin, you are not eligible. (Out-of-pocket costs include co-pays, co-insurance and deductibles.)

If you need insulin immediately, see if you qualify for the urgent need program.

The continuing need program operates through the existing "patient assistance programs" offered by insulin manufacturers. Insulin manufacturers are required to provide the Board of Pharmacy with information about their patient assistance programs so that information about each program is located in one place. The board has information about each program, including a link to the manufacturer’s patient assistance websites. 

Individuals who want to enroll in one of the programs can apply through:

• The manufacturer.
• The prescriber of the insulin (if the prescriber agrees to assist).
• MNsure-certified navigator. Certified navigators are experts at local, trusted community organizations that can help you apply for one of the manufacturer’s programs.

After reviewing your application, the manufacturer might decide that its insulin co-pay assistance program is a better option for you. In that case, it must provide you with coupons that you can use at the pharmacy to have your co-pay reduced or eliminated. (This applies only if you have insurance that covers your insulin and requires a co-pay.)

The Board of Pharmacy has information about each manufacturer program on its website including links to the manufacturer’s patient assistance websites.

Yes. As long as the benefits are at least as good as those required by state law, the manufacturer can offer such programs to Minnesota residents. If manufacturers end the other programs or reduce the benefits of the programs, they must still offer programs as required by state law.

Please visit the Minnesota Board of Pharmacy website for more information.

If a manufacturer has decided that you are not eligible for the continuing need program that they have set up for residents of Minnesota, you may ask the Board of Pharmacy to review your eligibility.

This review is not available for other assistance programs that manufacturers might offer. You can’t ask the board for a review if the manufacturer finds you aren’t eligible for those programs.

Find more information about the pharmacy board’s review process here.

It depends on the manufacturer.

You need to give your pharmacy the statement of eligibility you received from the manufacturer. You also need to give the pharmacy a prescription for insulin (unless the pharmacy already has a prescription on file for you). In other cases, your insulin will be shipped directly to your home.

In all cases, you should begin the application process at least a couple weeks in advance of when you will run out of insulin.

You can get help applying for the continuing need program from a MNsure-certified navigator. Navigators are experts at local, trusted community organizations that can help you apply for one of the manufacturer’s programs.

You can also get help by contacting the Minnesota Board of Pharmacy  

Your county social services department may be able to help. The Minnesota Department of Human Services maintains a directory of county and tribal human service offices on its website. 

Counties may refer to the department that can help you by different names, such as: Economic Assistance, Financial Services, Human Services, Community Services, etc.