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Lesson 1: Overview of the Insulin Safety Net Program

On April 15, 2020, Governor Tim Walz signed into law the Alec Smith Insulin Affordability Act.

This bipartisan bill created an Insulin Safety Net Program to help qualified Minnesotans access a supply of prescription insulin at an affordable price.

What is Insulin?

Insulin is a hormone that naturally lowers the amount of glucose (a type of sugar) in the body. A person who is diabetic cannot naturally produce the levels of insulin they need and may need an insulin prescription from their doctor.

Many people with diabetes take insulin injections based on their blood glucose levels. There are short- and long-acting doses of insulin that are produced by multiple manufacturers.

Insulin Assistance

Minnesota’s Insulin Safety Net Program allows a pharmacist to dispense the insulin as prescribed by a health care practitioner.

The safety net program does not cover:

  • Over-the-counter insulin products
  • Testing supplies
  • Insulin pens
  • Insulin pumps
  • Doctor visits
  • Emergency or hospital care

Roles for Public and Private Entities

The law established specific roles for both public and private entities.

MNsure’s responsibilities include conducting a public awareness campaign, training MNsure-certified navigators to assist Minnesotans with accessing insulin and providing compensation for eligible activities and maintaining a public list of navigators trained to assist individuals

The Minnesota Board of Pharmacy responsibilities include:

  • Publishing information and educational materials on insulin safety net programs and how to access those programs
  • Publishing a list of navigators trained to assist individuals with access to insulin
  • Providing information to pharmacies on the Insulin Safety Net Program
  • Working with insulin manufacturers to establish the application process for the Insulin Safety Net Program, levy penalties for noncompliance and establish an appeal process for consumers and collect data from manufacturers on program usage to report to the Minnesota Legislature.

Office of the Legislative Auditor responsibilities include reviewing the program to determine if manufacturers are meeting their responsibilities, whether MNsure’s training program for navigators is adequate, and whether a sufficient number of navigators are providing assistance.

Minnesota Department of Health responsibilities include conducting a satisfaction survey of individuals who have accessed the program covering a variety of topics including whether they worked with a navigator and their satisfaction with that experience.

Minnesota pharmacies responsibilities include:

  • Making the application for urgent-need insulin available to eligible individuals
  • Providing an information sheet that explains the continuing safety net program and lists navigators available to help
  • and dispensing insulin and collecting insulin co-payments as allowed.

Insulin manufacturers responsibilities include creating an application for eligible individuals to access a continuing supply of insulin and supporting the application process.

Pharmacy Participation Requirement

Every outpatient and community pharmacy that is licensed by the State of Minnesota Board of Pharmacy is required to participate in the insulin safety net program.

This includes:

  • Chain pharmacies;
  • Independent pharmacies; and
  • Outpatient pharmacies in hospitals

Non-resident pharmacies, such as mail order pharmacies and inpatient hospital pharmacies, are not required to participate.

Insulin Safety Net Program Options

The Alec Smith Insulin Affordability Act created two different insulin assistance programs as part of the Insulin Safety Net Program.

These programs have different applications and provide urgent-need or long-term assistance.

  1. Urgent Need Safety Net Program: The insulin safety net program allows eligible individuals to apply for an “urgent-need” supply of insulin with a valid prescription. The urgent need program provides up to a 30-day supply of insulin.
  2. Continuing Need Safety Net Program: Eligible individuals with a valid prescription can also apply for long-term access to insulin. The continuing need program provides up to 12 months of insulin.

Urgent Need Program vs. Continuing Need Program

Urgent Need Program Overview

Individuals that are in urgent need of insulin can access the application for an emergency supply of insulin online at or complete an application at a pharmacy when filling their insulin prescription.

The pharmacist will dispense up to a 30-day supply of insulin and provide the consumer with a list of trained MNsure-certified navigators that can help them through the process of applying for continuing need insulin.

Continuing Need Program Overview

There are currently three manufacturers that supply prescription insulin Minnesota (Eli Lilly, Novo Nordisk and Sanofi).

Individuals that need a continuing safety net supply of insulin will complete an application for a manufacturer’s patient assistance program.

The manufacturer will process the application and determine eligibility for the continuing safety net program.

If an individual qualifies, they will submit the manufacturer’s eligibility statement, along with a valid insulin prescription, to a pharmacy to receive a 90-day supply of insulin, refillable up to 12 months.

MNsure-certified navigators with contracted agencies can assist individuals through the manufacturer’s patient assistance program application process and receive a payment for eligible activities.

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