If you qualify for the Lilly Cares program, a 120-day supply of medicine will be shipped to your health care provider's office for you to pick up. Prescription refills will be available during your 1-year enrollment period. For refills, please complete and submit the fax refill form
How to Apply:
Select one of the links below to download the application or go to the program site for more information on how to apply. Once you fill out your application, send it to the address on the application. Remember not to send program applications to the PPA.
To receive free Lilly medicines through Lilly Cares, you must:
Have no prescription drug coverage
Be a United States resident.*
Meet the household income guidelines for the program.
*This program is not available in Puerto Rico or the US Virgin Islands.
This program is for people up to age 64. Those 65 and older do not qualify.
Product(s) covered by program:
Cialis® (tadalafil) tablets
Cymbalta® (duloxetine hydrochloride) delayed release capsules
Effient® (prasugrel) tablets
Evista® (raloxifene hydrochloride) tablets
Glucagon™ (glucagon for injection [rDNA origin])
Humalog® (insulin lispro injection USP [rDNA origin])
Humalog® Mix 50/50™ (50% Insulin lispro protamine suspension, 50% insulin lispro injection [rDNA origin])
Humalog® Mix 75/25™ (75% Insulin lispro protamine suspension, 25% insulin lispro injection [rDNA origin])
Humulin® 70/30 (70% human insulin isophane suspension, 30% human insulin injection [rDNA origin])
Humulin® N (NPH human insulin [rDNA origin] isophane suspension)
Humulin® R (U-100) (regular insulin human injection, USP [rDNA origin])
Humulin® R (U-500) [regular U-500 [concentrated] insulin human injection, USP [rDNA origin]]
Prozac® (fluoxetine hydrochloride)
Quinidine Gluconate, Injection, USP
Strattera® (atomoxetine) capsules
Symbyax® (olanzapine and fluoxetine hydrochloride) capsules
Zyprexa® (olanzapine) tablets
Zyprexa® Relprevv™ (olanzapine for extended release injectable suspension)
Zyprexa® Zydis® (olanzapine orally disintegrating tablets)