Medical Prescription Program

Medical Prescription Program

If you have prescriptions that your insurance doesn’t cover, or if you don’t have prescription health coverage, the Community Services Agency Medical Prescription Program can help.

Eligible households can receive up to $1000 once per program year.

Prescription must be new or refillable and non-narcotic. Call us if you have any questions or want more information.

To Qualify

This program is for Memphis and Shelby County residents whose monthly income falls at 200% at or below the Federal Poverty Income Guidelines and have prescription medication that is not covered by insurance.

To Apply

You will need:

  • State Issued ID
  • Social Security Cards for all household members
  • Income information for household (i.e. check stubs, award letter)
  • Written Prescription from doctor or refillable bottles
  • Complete fillable application and print it  (optional)

Complete and Print Application

download application form


Eligible Pharmacies

Madison Pharmacy
1350 Concourse Ave. #111
Memphis, TN 38104

The Medicine Shoppe
4770 Knight Arnold Rd
Memphis, TN 38118
Alliance Healthcare Services (3 locations) 

2579 Douglass Ave. Memphis, TN 38114  901-369-1484 

2150 Whitney Ave.  Memphis, TN 38127 901-354-7621  3810 Winchester Rd. Memphis, TN 38118     901-369-1421 
Variety of Non-Proprietary Medicine Bottles and Large Pills on Reflective Surface With Grey Background.WE DO NOT ACCEPT PAYMENT FOR OUR SERVICES. IF ANY PERSON OR AGENCY REQUESTS PAYMENT FOR OUR GRANT FUNDED SERVICES IT IS A SCAM.


This program is offered throughout the year or until funds are exhausted. Customers can submit an application by clicking on the "Download Application Form" to complete fillable application and printing.  Completed application can be mailed along with all supporting documentation to 1188 Minna Pl., Memphis, TN  38104 or fax to 901-222-4240.  There is also a drop box at this location. 


                   CSBG/Medical Prescription Income Guidelines for FY 2022
                                   (EFFECTIVE October 1, 2022)

                      200% Federal Poverty Guidelines 

People in HouseholdAnnual IncomeMonthly Income
01 $27,180.00 $2,265.00
02 $36,620.00 $3,051.67
03 $46,060.00 $3,838.33
04 $55,500.00 $4,625.00
05 $64,940.00 $5,411.67
06 $74,380.00 $6,198.33
07 $83,820.00 $6,985.00
08 $93,260.00 $7,771.67
For Each Additional Person Add: $9,440.00 $ 786.67


Shelby County
Community Services Agency
1188 Minna Pl. Memphis TN 38104