Check Your Eligibility
You may be eligible for the Lilly Cares Program if:
- You are a permanent resident of the United States (inclusive of Puerto Rico and the U.S. Virgin Islands).
- Your healthcare provider has prescribed a medication offered through Lilly Cares.
- The following applies to you with regard to your insurance coverage:
- You are not enrolled in Medicaid, full Low Income Subsidy (LIS, “Extra Help”) or Veterans (VA) Benefits;
- For all Medications, you do not have an insurance plan or third party that requires you to apply to the Lilly Cares Program as a condition, requirement, or prerequisite for coverage of specific Eli Lilly and Company medications. Additional information on such ineligible programs, often referred to as alternative funding programs, for-profit patient advocacy programs, or specialty cost-containment networks (collectively known as "AFPs"), is provided below*.
- You meet the insurance requirements for the medication for which you are applying. Insurance requirements are listed below for each Medication Group.
- You meet the household income guidelines for the Program.
See applications for additional Program guidelines.
*The Lilly Cares Foundation offers the Lilly Cares Patient Assistance Program as a charitable program for patients in financial need based on income and other eligibility criteria. If an employer, plan, or other third-party directs patients to apply to the Lilly Cares Program as a condition of, requirement for, or prerequisite to coverage, or in any way adjusts coverage based on application to or availability of the Lilly Cares Program, those individuals are not eligible for the Lilly Cares Program. Moreover, if an employer or plan requires an application to Lilly Cares be submitted by or with an AFP, as defined above, that applicant is not eligible for the Lilly Cares Program, even if eligibility criteria are otherwise met. Applications that violate these requirements will be blocked from participating in the Lilly Cares program, and Lilly Cares reserves the right to take further action as necessary, including against third parties. More information regarding Lilly Cares eligibility criteria as well as a list of AFPs is available at https://lillycares.com/assets/pdf/toapplycheckEligibility.pdf.
Household Income Guidelines
- The total number of persons in the household (applicant and all family members).
- Total annual (yearly) income including incomes from all earners in your household.
- To qualify, your household annual income before taxes cannot be more than the values listed below.
Annual Adjusted Gross Income Limit
If you live in Alaska or Hawaii, please contact us for annual adjusted gross income limits.
Medication Groups
|
1 Person Household*
|
2 Person Household*
|
3 Person Household*
|
4 Person Household*
|
5 Person Household*
|
6 Person Household*
|
|---|---|---|---|---|---|---|
| Group 1 Medications | 1 Person Household*: $45,180 | 2 Person Household*: $61,320 | 3 Person Household*: $77,460 | 4 Person Household*: $93,600 | 5 Person Household*: $109,740 | 6 Person Household*: $125,880 |
| Group 2 Medications | 1 Person Household*: $60,240 | 2 Person Household*: $81,760 | 3 Person Household*: $103,280 | 4 Person Household*: $124,800 | 5 Person Household*: $146,320 | 6 Person Household*: $167,840 |
| Group 3 & 4 Medications | 1 Person Household*: $75,300 | 2 Person Household*: $102,200 | 3 Person Household*: $129,100 | 4 Person Household*: $156,000 | 5 Person Household*: $182,900 | 6 Person Household*: $209,800 |
*Total Number of Persons in your Household (including applicant).
Note: These income limits are 300% (Group 1 Medications), 400% (Group 2 Medications), and 500% (Group 3 & 4 Medications) of 2024 Federal Poverty Guidelines. Visit
www.aspe.hhs.gov/poverty
for information on the Federal Poverty Level.
Group 1 Medications: For patients who have no insurance or have Medicare Part D and have a household annual adjusted gross income ≤ 300% Federal Poverty Level (FPL).
- Cialis® (tadalafil) tablets
- Cymbalta® (duloxetine delayed-release capsules)
- Evista® (raloxifene hydrochloride) Tablet
- Forteo® (teriparatide injection)
- Prozac® (fluoxetine capsules)
Group 2 Medications: For patients who have no insurance or have Medicare Part D and have a household annual adjusted gross income ≤ 400% FPL.
- Basaglar® (insulin glargine injection)
- Emgality® (galcanezumab-gnlm) injection
- Humalog® (insulin lispro injection)
- Humulin® (insulin human injection)
- Lyumjev® (insulin lispro-aabc) injection
- Reyvow® (lasmiditan) tablets C-V
- Trulicity® (dulaglutide) injection
Group 3 Medications: For patients who have no insurance or have Medicare Part D (not applicable to infused medications†) or have Medicare Part B but have no supplemental or secondary insurance and have a household annual adjusted gross income of ≤ 500% FPL.
- Humatrope® (somatropin) for injection
- Olumiant® (baricitinib) tablets
- Omvoh™(mirikizumab-mrkz) infusion†
- Omvoh™(mirikizumab-mrkz) injection
- Taltz® (ixekizumab) injection
Group 4 Medications: For patients who have a household annual adjusted gross income of ≤ 500% FPL and have no insurance or have Medicare Part D (not applicable to infused medications†), or have Medicare Part B without supplemental or secondary insurance. If your insurance does not cover a Group 4 Medication, you may qualify for Lilly Cares. For detailed information on the required insurance verification documentation, please visit: Lilly Cares Insurance Verification Requirements.
- Alimta® (pemetrexed for injection)†
- Cyramza® (ramucirumab) injection†
- Erbitux® (cetuximab) injection†
- Jaypirca® (pirtobrutinib) tablets
- Kisunla™ (donanemab-azbt) injection†
- Retevmo® (selpercatinib) capsules
- Verzenio® (abemaciclib) tablets
† indicates infused medication provided in an outpatient setting.
Use of Third Parties to Apply
The Lilly Cares Foundation does not charge patients a fee for help with enrollment, medication refills, or for participation in the Program. Lilly Cares is not affiliated with third parties that charge for assistance that Lilly Cares provides to you at no cost. For support, please call Lilly Cares at 1-800-545-6962.
For more information about Lilly's privacy practice (as followed by Lilly Cares Foundation), please see the Privacy Statement.
Application Options
You can choose to fill out your application in one of three ways:
- You can complete an online application. Choosing to use the online application reduces paperwork and potential for delays.
Newly recommended application processing option!
- You can download a blank application, print it, and then fill in your information by hand.
- You can download a blank application, fill in the application on your computer, then save and print the completed application.
Lilly Cares now has a single application! A separate application for oncology medications is no longer required.
Ask to have an application mailed to you by calling 1-800-545-6962.
Complete the Application
Fill out and sign the patient sections on the application. Your healthcare provider will need to fill out the prescriber section and submit a prescription.
Submit your online application, or fax or mail the completed paper application to:
Lilly Cares Patient Assistance Program
PO Box 501847
San Diego, CA 92150
Fax: 1-844-431-6650
Next Steps
Lilly Cares will review your application and provide you and your healthcare provider with an enrollment decision. You will receive notification of the enrollment decision by mail and text message (if applicable). Your healthcare provider will receive a fax notification.
If your application is approved, your enrollment notification letter will tell you when your enrollment expires (generally in 12 months or at the end of the calendar year for those with Medicare Part D).
Medications will either be shipped to your home or to your healthcare provider's office. Our pharmacy partner will call you to schedule delivery, if applicable.
At the end of the enrollment period, you must reapply to remain eligible in the Program.