Skip to main content
Lilly cares home
Menu closed
Lilly cares home
  • House What is Lilly Cares
    • Available Medications
    • How to Apply
    • 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

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.

Choose An Application

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.

  • 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