Prescription Costs

Depending on your age and other factors listed below, you may need to pay a small fee (of $1) per covered prescription.* This fee is also called a copayment.

How Much Will I Pay?

Network Pharmacy

Mail Order or Retail-90 Pharmacy 
(A retail pharmacy where you can get a 90-day supply of maintenance medications. Learn more.)

For: 1-month supply 3-month supply
Generic Drugs (Tier 1)

All covered generic over-the-counter and prescription drugs


Brand Name Drugs (Tier 2)

Standard Medicaid

NH Health Protection Program





Contraceptives $0 $0

You will not have to pay a copayment if:

  • You are under age 18
  • You are receiving care in a nursing facility
  • You are receiving prescriptions for family plan­ning products (for example, birth control pills)
  • You are pregnant (you must ask your doctor to request prior approval from us along with your due date)
  • Your pregnancy ended within the last 60 days and you are receiving services for conditions related to your pregnancy
  • You are taking Clozaril (clozapine)
  • You are in a home and community based care (HCBC) waiver program

*Pharmacies may not refuse to fill your prescription if you can’t pay the fee. However, the pharmacist may bill you for the fee.

Search Covered Drugs

Enter a drug by name

What's the difference between a generic drug and a brand-name drug?


When a pharmaceutical company makes a new drug for the first time, they are the only ones who are legally allowed to make and sell it under that brand name for a certain number of years. This is a brand-name drug. After that time, other companies can make and sell the same drug and give it a different name, making it a generic drug.