Skip to main content
Lilly cares home
Menu closed
Lilly cares home
  • House What is Lilly Cares
    • Available Medications
    • How to Apply
      • Check Your Eligibility
      • Choose An Application
      • Complete the Application
      • Next Steps
      • Frequently Asked Questions (FAQ)
    • Lilly Cares Applications
    • Resources
Phone:
1-800-545-6962
Monday-Friday
8 a.m. to 6 p.m. ET

Fax:
1-844-431-6650

Address:
PO Box 501847
San Diego, CA 92150

For questions regarding your prescriptions or medication shipment, please contact Lilly Cares at 1-800-545-6962.

Expand contact lilly
Man and woman talking to nurse

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*: $46,950 2 Person Household*: $63,450 3 Person Household*: $79,950 4 Person Household*: $96,450 5 Person Household*: $112,950 6 Person Household*: $129,450
Group 2 Medications 1 Person Household*: $62,600 2 Person Household*: $84,600 3 Person Household*: $106,600 4 Person Household*: $128,600 5 Person Household*: $150,600 6 Person Household*: $172,600
Group 3 & 4 Medications 1 Person Household*: $78,250 2 Person Household*: $105,750 3 Person Household*: $133,250 4 Person Household*: $160,750 5 Person Household*: $188,250 6 Person Household*: $215,750

*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 2025 Federal Poverty Guidelines. Visit www.aspe.hhs.gov/poverty for information on the Federal Poverty Level.

Program Notices
Trulicity, Emgality, and Reyvow are now Group 1 Medications

More Information


New applications for Trulicity are currently not being accepted, except for limited medical circumstances.

See Trulicity Medical Exception Requirements

Lilly Cares will continue accepting applications for re-enrollment of those currently enrolled for Trulicity.

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
  • Emgality® (galcanezumab-gnlm) injection
  • Forteo® (teriparatide injection)
  • Reyvow® (lasmiditan) tablets C-V
  • Trulicity® (dulaglutide) injection

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)
  • Humalog® (insulin lispro injection)
  • Humulin® (insulin human injection)
  • Lyumjev® (insulin lispro-aabc) 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.

  • Ebglyss™ (lebrikizumab-lbkz) injection†
  • 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) tablets
  • 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:

  1. You can complete an online application. Choosing to use the online application reduces paperwork and potential for delays.
Online Application sheet on red computer

Online Applications


Start Online Application
  1. You can download a blank application, print it, and then fill in your information by hand.
  2. You can download a blank application, fill in the application on your computer, then save and print the completed application.
Print Application sheet on clipboard

Lilly Cares Application


Print Application
Print Application sheet on clipboard

Lilly Cares Application
(Spanish Version)


Print Application

Ask to have an application mailed to you by calling 1-800-545-6962.

Complete the Application

White number one with red background

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.

White number two with red background

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

White number one with red background

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.

White number two with red background

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).

White number three with red background

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.

White number four with red background

At the end of the enrollment period, you must reapply to remain eligible in the Program.

Frequently Asked Questions (FAQ)

Eligibility Questions

  • When looking at your insurance card, words like “Medicare”, “Medicare Advantage”, “Medicare Replacement”, or “Medicare Rx” indicate Medicare insurance.

  • Patients with healthcare cost sharing plans are eligible for Lilly Cares assistance as these are not health insurance plans, but are voluntary sharing among members for eligible health expenses.

  • Yes, Lilly Cares verifies the insurance and income information you provide on your application. Household income is verified through an income verification service provided by a consumer reporting agency, while an electronic benefits service is used to determine your health insurance coverage. Depending on the results, Lilly Cares may request additional documentation to confirm your income and insurance details.

  • If your medication is not listed or you don't meet the Lilly Cares eligibility requirements, please refer to the Medicine Assistance Tool website for additional resources.

Next Steps Questions

  • Yes. To remain in the Program, you must reapply at the end of your enrollment period. You can reapply up to 60 days before your current enrollment end date. When applying for re-enrollment, please use the newest version of the application (available online).

  • Applications are processed in the order they are received. If the application is complete, it will be processed in about three to five business days. If the application is missing information or if additional information is needed, this can delay processing time.

  • If your healthcare provider has changed, your new healthcare provider will need to submit the "Healthcare Provider" section of the application, including the signed consent, and a new prescription for each of the medications you receive through Lilly Cares.

  • Please call Lilly Cares Patient Assistance Program at 1-800-545-6962.

  • Patients enrolled in Lilly Cares will receive a 1-to-4-month supply of medication in each shipment unless a greater/lesser amount is requested by their healthcare provider or provided per Program guidelines.

  • No. Medications from the Lilly Cares Foundation Patient Assistance Program are shipped directly to patients or healthcare providers by our contracted pharmacy.

  • The Lilly Cares contracted pharmacy will send a text message (if applicable) letting you know your medication has shipped.

  • Temperature controlled medications will be delivered by the end of the following business day. Non-temperature controlled medications will be delivered within 3-5 business days.

  • No. Lilly Cares provides free Lilly medications, including shipping, for patients who meet Program eligibility requirements.

  • No. Signatures are not required for Lilly Cares medication shipments, unless requested by the patient or healthcare provider.

  • Medication refills can be provided approximately 30 days before you have used your current medication supply.

  • The patient, if enrolled in the auto-refill program, will receive a text message (if applicable) when eligible for a refill and when medication has shipped.

    If you are not enrolled in auto-refill, you must request a refill of your existing prescription by calling Lilly Cares at 1-800-545-6962 or by calling the Lilly Cares contracted pharmacy listed on the medication label.

  • Lilly Cares offers automatic refills for most medications. Patients have the option of signing up for our auto-refill program, which will automatically fill medication when it's due for a refill. When there are zero refills remaining, the healthcare provider will be contacted for a prescription renewal before the next refill due date. Auto-refills will stop at the end of the patient's Program enrollment period. If the medication is no longer needed, contact Lilly Cares at 1-800-545-6962.

  • Uninsured patients will receive medication through the duration of their enrollment period. Medicare Part D patients enrollment period expires at the end of the calendar year. Due to Program guidelines, the last medication refill of the calendar year may be a lesser amount than typically provided.

  • If your medication doesn't come with a needle, you will need to get the needles at your local pharmacy.

  • Your healthcare provider will need to fax a new prescription to 1-844-431-6650 or your healthcare provider will need to call Lilly Cares at 1-800-545-6962 .

  • If it's been longer than 14 business days since your application was approved and you haven't received your medication or have questions about your prescription, please contact Lilly Cares at 1-800-545-6962.

  • Terms of Use
  • Privacy Statement
  • Consumer Health Privacy Notice
  • Accessibility Statement
  • Sitemap
 

You are encouraged to report negative side effects of prescription drugs to the FDA.
Visit www.fda.gov/medwatch or call 1-800-FDA-1088.
You may also report negative side effects to The Lilly Answers Center (TLAC) at 1-800-LillyRx (1-800-545-5979).


This site is intended for U.S. residents age 18 and over only. Models used for illustrative purposes only. Not actual patients or healthcare providers.
PP-AP-US-0428 04/2025 ©Lilly Cares® Foundation 2025. All rights reserved.
All Lilly product names mentioned herein are trademarks owned or licensed by Eli Lilly and Company, its subsidiaries, or affiliates.

California Consumer Privacy Act (CCPA) Opt-Out Icon
Your Privacy Choices

Cookie Settings

Terms of Use Privacy Statement Consumer Health Privacy Notice Accessibility Statement Sitemap
Lilly