1). https://www.lillycares.com/how-to-apply#check-eligibility | 1-800-545-6962

Eligibility:
• Prescribed a qualifying Lilly medication.
• No insurance or have Medicare Part D
• Not enrolled in Medicaid, Extra Help or VA Benefits
• Meets the household income guidelines for program listed below:
Group 1 Medications (1-to-6-person household) $40,770 to $111,570 Group 2 Medications (1-to-6-person household) $54,360 to $148,760 Group 3 Medications (1-to-6-person household) $67,950 to $185,950

Instructions: You can either call, apply online, mail or fax application in.
• Call 1-800-545-5962 to apply
• Apply at www.lillycares.com/how-to-apply#check-eligibility
• Mail application to:
Lilly Cares Patient Assistance Program
P.O. Box 13185
La Jolla, CA 92039
• Fax: 1-844-431-6650


2). Prescription Bliss

www.prescriptionbliss.com

Eligibility:
• Each program has different requirements, but many of our
patients come to us who are on Medicare and have a Part D plan and are unable to afford their copays or find themselves in the coverage gap of their prescription plan.
• If your insurance company has denied paying for your prescriptions or you have a high copay or coinsurance responsibility.

Instructions:
• Call 1-877-792-5477 or go to the website prescriptionbliss.com to apply
• Click on Apply Now
• Click on Begin Application


3.) RX Assistant

www.rxassistantprograms.com

Eligibility:
Its best to call to see if you qualify.
• U.S. citizen or resident
• Does not have insurance or insurance doesn't cover medication.
• On Medicare or in donut hole/coverage gap

Instructions:
• Go to rxassistantprograms.com to fill out online form
• Call 1-888-344-8915