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  • House What is Lilly Cares
    • Available Medications
    • How to Apply
    • Lilly Cares Applications
    • Resources
      • Available Medications and Eligibility
      • Applications
      • Healthcare Provider Prescription Forms and Resources
      • Lilly Cares News and Reports
Phone:
1-800-545-6962
Monday–Friday

Fax:
1-844-431-6650

Address:
PO Box 13185
La Jolla, CA 92039

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

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Annual reenrollment for Medicare Part D patients is now open (early enrollment October 15 to December 31). To continue receiving medication through Lilly Cares, Medicare Part D patients must reapply and meet program eligibility requirements. Reenrollment notification letters are being sent to patients and Healthcare Providers. For questions about the Medicare Part D re-enrollment process, please contact Lilly Cares at 1-800-545-6962.

Warning Lilly Cares is currently not accepting new applications for Trulicity due to limited availability of this medication. Please contact your healthcare provider for assistance.
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Available Medications and Eligibility

Available medications prescription bottle
Available Medications
Check Your Eligibility person with check mark
Check Your Eligibility

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.

Applications

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.
Program Notice
Newly recommended application processing option!
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
Print application sheet on clipboard with molecule

Lilly Cares Oncology Application

Print Application

Healthcare Provider Prescription Forms and Resources


General Prescription Fax Form

Prescription Fax Form Diabetes

Prescription Fax Form Emgality

Prescription Fax Form Humatrope

Prescription Fax Form Taltz

Prescription Fax Form Verzenio and Retevmo

Lilly Cares News and Reports


News


Lilly Cares News Release - 05/2020

Lilly Cares News Release - 03/2019

Reports


Lilly Cares 2021 Annual Report

Lilly Cares 2021 State Level Data

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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 02/2023 ©Lilly USA, LLC 2023. All rights reserved.
All Lilly product names mentioned herein are either trademarks or registered trademarks owned or licensed by Eli Lilly and Company, its subsidiaries, or affiliates.

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