Lilly Cares Patient Assistance Program

Requirements for uninsured applicants

• Applicants must be at or below 300 % federal poverty level to qualify
  • View federal poverty guidelines
• This company sends medications as a 120 day supply
  • Prescriptions must be written as 120 day supply to qualify
• Applications are good for 1 year from the date approved by the program

Requirement for Medicare Part D applicants

• If applicant is 65 or older and eligible for Medicare Part D, company requires they are signed up for Part D
  • They will not assist applicants who are eligible but never signed up for a Medicare Part D plan
• Applications for Medicare Part D enrollees are valid until December 31st of the current enrollment year