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Lilly Cares Patient Assistance Program

This program provides brand name medications at no or low cost

Provided by: Eli Lilly & Company

TEL: Closed Program

Languages Spoken:



Patient Assistance Applications


Generic Name Medications


Eligibility Requirements   

Insurance Status Must have no prescription coverage
Those with Part D Eligible? Determined case by case
Income Varies
Diagnosis/Medical Criteria Must be under 65 years of age
US Residency Required? Puerto Rico & US Virgin Island residents are not eligible


Obtaining Call or download
Receiving Faxed
Returning Fax or mail
Doctor's Action Complete section and sign
Applicant's Action Complete section, sign, attach required documents
Decision Communicated Patient notified of denial in writing
Decision Timeframe


Sent To
Delivery Time
Refill Process
Re-application New application, new documentation yearly

Additional Information

Closed Program
Updated Company Name. See: The Lilly Cares Foundation, Inc.
Updated April 28, 2017