You may be eligible for the Lilly Cares program if:
- You are a permanent, legal resident of the United States, Puerto Rico, or U.S. Virgin Islands.
- Your healthcare provider has prescribed a qualifying Lilly medication.
- You have no insurance or you have Medicare Part D.
- You are not enrolled in Medicaid, full Low Income Subsidy (LIS, “Extra Help”) or Veterans (VA) Benefits.
- Humatrope patients: Call Lilly Cares to review eligibility requirements.
- You meet the household income guidelines for the program.
See applications for additional program guidelines.
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*: $38,640||2 Person Household*: $52,260||3 Person Household*: $65,880||4 Person Household*: $79,500||5 Person Household*: $93,120||6 Person Household*: $106,740|
|Group 2 Medications||1 Person Household*: $51,520||2 Person Household*: $69,680||3 Person Household*: $87,840||4 Person Household*: $106,000||5 Person Household*: $124,160||6 Person Household*: $142,320|
|Group 3 Medications||1 Person Household*: $64,400||2 Person Household*: $87,100||3 Person Household*: $109,800||4 Person Household*: $132,500||5 Person Household*: $155,200||6 Person Household*: $177,900|
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)
- Strattera® (atomoxetine) capsules
- Symbyax® (olanzapine and fluoxetine) capsules
- Zyprexa® (olanzapine)
Group 2 Medications: For patients who have no insurance or have Medicare Part D and have a household annual adjusted gross income ≤400% FPL.
- Baqsimi® (glucagon) nasal powder
- Basaglar® (insulin glargine injection)
- Emgality® (galcanezumab-gnlm) injection
- Glucagon™ (glucagon for 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 and have a household annual adjusted gross income ≤500% FPL.
- Humatrope® (somatropin) for injection
- Olumiant® (baricitinib) tablets
- Taltz® (ixekizumab) injection
- Alimta® (pemetrexed for injection)
- Cyramza® (ramucirumab) injection
- Erbitux® (cetuximab) injection
- Portrazza® (necitumumab) injection
- Retevmo® (selpercatinib) capsules
- Verzenio® (abemaciclib) tablets
You can choose to fill out your application in one of three ways:
- You can complete an online application.
- 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.
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, please see the Privacy Statement.