It varies by insurance plan. I had to submit an appeal/prior authorization for non-formulary meds because Aimovig isn't in my insurance plan's 2018 or 2019 formulary. My insurance company approved it and put in on Tier 4. For me, that means my out of pocket cost is $100. Better insurance plans would have lower out of pocket cost. I submitted the appeal after I received the 2 month free trial from Amgen (The manufacturer of Aimovig).