Patient-eligible United States residents can receive up to a full year’s worth of free prescription Lilly medication through the nonprofit Lilly Cares Foundation, Inc (Lilly Cares). Lilly Cares has provided free medicines to more than a million patients in need over the previous two decades.

What is the Lilly Cares Application?

If the COVID-19 crisis disrupted your job, you may be eligible for the Lilly Cares PAP, which allows you to obtain your prescribed Lilly medication free of charge.

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What are the Eligibility Requirements for Lilly Cares Application?

If you fall into one of the following categories:

• In the United States, Puerto Rico, or the U.S. Virgin Islands you are a permanent and legal resident.
• Your doctor has prescribed a Lilly drug that qualifies.
• Medicare Part D or no insurance at all
• Neither Medicaid nor the full Low-Income Subsidy (“Extra Help”) nor the Veteran’s Affairs (VA) Benefits is applied for on your behalf.
• You are eligible for the program because your household income is within the acceptable range.

Guidelines for Household Income

• The number of people living in the residence as a whole (applicant and all family members).
• The total annual (yearly) income of your household, including the earnings of all members.
• There is a limit on how much you can earn before taxes in order to qualify.

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Options for Application

Filling out your application can be done in any one of three ways:

• You can apply for a job online. Using the online application means less paperwork and less time waiting for your application to be processed.
• The second option is to print out a blank application and fill in your details by hand.
• Filling out the application on your computer before saving and printing the full application is an option.

To access all three possibilities, simply click on this link!

Fill out the Application Form.

1. The patient portions of the application must be filled out and signed by the patient. The prescriber section and prescription will need to be filled out by your healthcare professional.
2. Either fax or mail the completed paper application to the following address:

Lilly Cares Patient Assistance Program
P.O. Box 13185 La Jolla, CA 92039 Fax: 1-844-431-6650

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The Next Steps

• An enrollment decision from Lilly Cares will be mailed to both the applicant and their healthcare practitioner (and text message, if you choose the text option on the application). An application that is not complete will delay the admissions process.
• You will be registered for a period of 12 months if you are eligible. Until the end of the year, Medicare beneficiaries will be able to enroll in Part D.
• It is possible that medications will be delivered directly to your home or to the office of your healthcare practitioner. If necessary, our pharmacy partner will contact you to set up delivery.
• In order to continue to be eligible for the program after the enrollment period ends, you must reapply.