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

Eligible Pharmacies

Madison Pharmacy
1350 Concourse Ave. #111
Memphis, TN 38104
901-321-5530

The Medicine Shoppe
4770 Knight Arnold Rd
Memphis, TN 38118
901-363-0750

Variety of Non-Proprietary Medicine Bottles and Large Pills on Reflective Surface With Grey Background.

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, 2021)

200% Federal Poverty Guidelines

People in Household	Annual Income	Monthly Income
01	$25,760.00	$2,146.67
02	$34,840.00	$2,903.33
03	$43,920.00	$3,660.00
04	$53,000.00	$4,416.67
05	$62,080.00	$5,173.33
06	$71,160.00	$5,930.00
07	$80.240.00	$6,686.67
08	$89,320.00	$7,443.33
For Each Additional Person Add:	$9,080.00	$ 756.67