Lilly Cares

Lilly USA, LLC

Contact Information
Lilly Cares
PO Box 230999
Centerville, VA 20120
1-(800) 545-6962 (phone)
Physician requests should be directed to:
Lilly Cares
P.O. Box 230999
Centreville, VA 20120
1-(800) 545-6962 (phone)
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. Do NOT send it to RxResource.
Patients must be U.S. residents. Eligibility is determined on a case-by-case basis. Eligibility is based on the patient's income level, and lack of third- party drug coverage (including Medicare Prescription Drug Benefit, Medicaid, private Rx insurance, government-subsidized clinics, and other government, community, or private programs). Inpatients and those who can obtain drug reimbursement from any source are not eligible. Requests for replacement drugs cannot be honored. Medications are provided directly to the physician for dispensing to the patient. Quantity of supply is dependent upon type of product being prescribed, but usually in 4 month supply. All Lilly medications must be used as recommended in product labeling. Enrollment period is for 1 year, and refills are requested by Fax Refill Form(included in the shipment) by the prescriber.
Other Information:
Blank forms are available to anyone. This website is useful for preliminary screening, but does not determine actual eligibility. Patients can still apply for the Lilly Cares Program even if this website has shown that the patient is not eligible. Final eligibility can only be determined by completing an application.
Product(s) covered by program:
  • Cialis®
  • Cymbalta®
  • Effient
  • Evista®
  • Glucagon Emergency Kit
  • Humalog®
  • Humulin®
  • Prozac Weekly®
  • Prozac®
  • Reopro®
  • Strattera®
  • Symbyax™
  • Zyprexa Zydis
  • Zyprexa®