Eli Lilly
Lilly Cares Foundation Patient Assistance Program
Free medication for up to 12 months
Income cap
400% FPL
Processing
~14 days
Approval period
12 months
Phone
1-800-545-6962
Must be uninsured
US citizen or legal resident
⚠Medicaid recipients excluded
Application steps
- 1.Verify household income is at or below 400% FPL (or 500% FPL for Medicare Part D members in coverage gap)
- 2.Download the Lilly Cares application
- 3.Patient completes financial + insurance section
- 4.Prescriber completes medical section and signs
- 5.Submit by mail or fax to Lilly Cares Foundation
- 6.Lilly ships medication directly to prescriber for patient pickup
Documents needed
- •Proof of income (tax return, pay stubs, Social Security statement)
- •Proof of residency (utility bill, lease)
- •Insurance denial or proof of being uninsured
- •Prescriber DEA + signature
Mounjaro and Zepbound formulary inclusion verified 2026-06. Medicare Part D members may qualify if income ≤500% FPL and unable to afford copays. Medicaid recipients are excluded.
Source: www.lillycares.com · Last verified 2026-06-03