The Fairview Pharmacy Emergency Fund provides one-time prescription assistance to patients experiencing financial hardship.  Eligible patients typically have no prescription drug benefits and/or have exhausted their coverage.  They also must not be eligible for or have access to alternative sources of coverage or funding (i.e. Medicaid, MN Care, Medicare, etc.)  All applications are reviewed on a case-by-case basis

Eligibility Criteria

1. You have no insurance coverage or benefits for prescription medicines or your coverage has been exhausted.
2. Your total Gross Annual Household Income is at or below 2 times the Federal Poverty Level (see chart)

• Total number of persons in household includes yourself and those for whom you are financially responsible
• Total Gross Income includes incomes from all earners in the household before taxes and deductions

3. You have not previously utilized the FPS Emergency Fund during this calendar year
4. Your request does not exceed $500.00

How to Apply

Please complete the Fairview Pharmacy Emergency Fund Worksheet. Submit the worksheet along with proof of income to:

Cheryl Smith
Fairview Pharmacy Services
Csmith6@fairview.org
Phone:  612-672-7062
Fax:  612-672-5201