Your doctor prescribes it. You need it. But your insurance says: “Not covered.” Now what?

The Problem

You finally find something that works for you—but then the pharmacy says your insurance won’t pay for it.

“It’s not on the formulary.”
“It’s in a non-preferred tier.”
“You need prior authorization or step therapy.”

And just like that, the medication you counted on is now unaffordable.
But here's the good news: there are more solutions than most people realize.

The Guide

At Mere, we’ve helped hundreds of clients in Northeast Florida solve this exact problem.
We’re not tied to just one insurance company—so we can offer real solutions when your plan doesn’t meet your needs.

You don’t have to settle. And you don’t have to pay full price.

The Plan: What to Do When Your Medication Isn’t Covered

✅ Step 1: Ask for a Tier Exception or Prior Authorization

Sometimes your plan can cover the drug—if you go through the right steps.

We’ll help your provider request:

• Tier exception: To move a costly drug into a lower, more affordable tier

• Prior authorization: To show it’s medically necessary

Many plans approve these requests when alternatives don’t work for you.

✅ Step 2: Switch to a Plan That Does Cover It

Formularies change every year. So do your options. Each fall, we help our clients:

• Review their current drug list

• Compare all plans available

• Switch to one that actually covers their prescriptions

This alone can save hundreds—sometimes thousands—each year.

✅ Step 3: Look Into Manufacturer Discounts and Patient Assistance Programs

If your medication is a brand-name or specialty drug, you may qualify for:

• Free or low-cost medication

• Copay savings cards

• Direct delivery from the manufacturer

We’ll show you what documents you need.

✅ Step 4: Try Our Canadian MedStore Partner

We partner with a U.S.-based company (right here in Florida!) that connects clients with licensed international pharmacies.

• Safe, affordable options for Tier 3–6 drugs

• Flat pricing—no insurance required

• Often $50/month or less for medications that retail over $300

We handle the legwork—just send your medication list.

Real Story: Beating a $400 Monthly Bill

Diane in St. Johns County was quoted $400/month for a rheumatoid arthritis medication not covered by her plan. We helped her apply for a tier exception, and when that failed, we connected her to a manufacturer program that brought the cost down to $0.

“I thought I’d have to stop treatment. You saved my health and my budget.” — Diane

The Success You Want

You deserve a plan that works for you, not against you.
With the right help, you can:

• Get the medication your doctor recommends

• Avoid outrageous out-of-pocket costs

• Stay on track with your treatment

• Have options, not frustration

📞 Your Next Step

Struggling to afford a prescription? Or tired of hearing “not covered”?
Let’s find a better way.

➡️ Visit www.merebenefits.com/rx-savings or call our office to talk through your options.

We’ll review your plan, check for savings programs, and give you clarity—at no cost to you.

#simplyforyourbenefit
Helping Northeast Florida clients afford the medications they rely on