Applying for a GLP-1 patient assistance program: step by step — glp1.how · GLP-1 Guides
Applying for a GLP-1 patient assistance program: step by step
Novo Nordisk's PAP and Lilly Cares can provide Ozempic or Trulicity free to people who qualify by income and insurance status, but as of September 2026 neither covers Wegovy, Zepbound, Saxenda, or Foundayo. Here's who qualifies, the 2026 income limits in dollars, the documents you need, your prescriber's role, turnaround and renewal, what to do if you're denied, and how PAPs differ from savings cards and direct-pay.
Updated Sep 26, 2026Evidence-backed
If you're uninsured and your household income is at or below 200% of the federal poverty level ($31,920 for one person in 2026), Novo Nordisk will ship you Ozempic free of charge. Eli Lilly's charitable foundation does the same for Trulicity, up to 300% of poverty. That is most of the GLP-1 story for manufacturer patient assistance programs (PAPs) right now. As of September 2026, neither company's free-medication program covers Wegovy, Zepbound, Saxenda, or Foundayo, the GLP-1s approved for weight management. Here's who these programs do cover, what the rules are, and how to apply step by step without getting stuck.
What a patient assistance program is (and isn't)
A PAP gives brand medication free to people who meet income and insurance rules. It's the one manufacturer option built around financial need rather than insurance status, and it's easy to confuse with the other two:
Can I get Wegovy or Zepbound free through a patient assistance program?
Not as of September 2026. Novo Nordisk's 2026 PAP product list includes Ozempic (for uninsured patients only) and Xultophy, but not Wegovy, Rybelsus, Victoza, or Saxenda. Lilly Cares' only GLP-1 is Trulicity; Mounjaro, Zepbound, and Foundayo aren't on its list. For weight-management GLP-1s, the options are a savings card if you have commercial coverage, manufacturer direct-pay, the Medicare GLP-1 Bridge if you're eligible, or an insurance appeal.
What are the income limits for the GLP-1 patient assistance programs?
For Ozempic through Novo Nordisk's PAP, uninsured applicants need household income at or below 200% of the federal poverty level, which is $31,920 for one person or $66,000 for a family of four in 2026. For Trulicity through Lilly Cares, the limit is 300%: $47,880 for one person or $99,000 for four. Alaska and Hawaii have higher guidelines. Limits reset each year when HHS updates the poverty guidelines.
Can I use a patient assistance program if I have Medicare?
It depends on the drug. Novo Nordisk says Medicare beneficiaries with prescription drug coverage are no longer eligible to get Ozempic through its PAP as of 2026. Lilly Cares does accept Medicare Part D enrollees for Trulicity if household income is at or below 300% of the poverty level and they don't receive full Extra Help. Part D enrollees are enrolled only through the end of the calendar year and must reapply.
Can I apply if I have insurance through my job?
Generally no, for these drugs. Novo Nordisk's PAP excludes anyone with private or commercial insurance, and Lilly Cares' Trulicity group is for people with no insurance or with Medicare Part D. If you have commercial coverage, a manufacturer savings card (if your plan covers the drug) or an insurance appeal (if it doesn't) is the better route.
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Which GLP-1s the programs cover, as of September 2026
Novo Nordisk Patient Assistance Program
Novo Nordisk narrowed its PAP for 2026. Its product list, effective January 1, 2026, includes two GLP-1 products:
Ozempic (semaglutide injection, approved for type 2 diabetes), for uninsured patients only, with household income at or below 200% of the federal poverty level (FPL).
Xultophy 100/3.6, a combination of insulin degludec and liraglutide. For uninsured applicants, the income limit for medicines other than Ozempic is 400% FPL.
Wegovy, Rybelsus, Victoza, and Saxenda are not on the 2026 list. Saxenda's exclusion matches what our savings card guide reports. Novo also says that Medicare beneficiaries with prescription drug coverage are no longer eligible to get Ozempic through the PAP, because most Medicare drug plans cover it. The program still covers several Novo insulins for Medicare patients under separate rules.
Lilly Cares Foundation
Lilly Cares, Eli Lilly's charitable patient assistance foundation, sorts its medicines into income groups. Its only GLP-1 is Trulicity (dulaglutide, approved for type 2 diabetes), in Group 1: for people with no insurance or with Medicare Part D and household income at or below 300% FPL. Lilly Cares says it is once again accepting new Trulicity applications without a medical exception request. Mounjaro, Zepbound, and Foundayo are not on the Lilly Cares medication list.
What that means for you
Prescribed Ozempic or Trulicity, and uninsured with low income? A PAP may get it to you free. This is the path this guide walks through.
On Medicare Part D and prescribed Trulicity? You may qualify for Lilly Cares. For Ozempic on Medicare, Novo's PAP is closed. Look at your Part D plan's coverage, the Extra Help program (below), and Medicare's option to spread drug costs through the year.
Prescribed Wegovy, Zepbound, Saxenda, or Foundayo for weight management? No manufacturer PAP covers these as of September 2026. See "If a PAP isn't an option" below.
Have commercial insurance? Neither program is open to you for these drugs. Novo excludes anyone with private or commercial insurance, and Lilly Cares' Group 1 is for the uninsured and Medicare Part D. A savings card or an insurance appeal is your route.
The income limits in dollars
Both programs use the federal poverty guidelines, which HHS updates each year, usually in January. For 2026 in the 48 contiguous states and D.C.:
Household size
200% FPL (Novo, Ozempic)
300% FPL (Lilly Cares, Trulicity)
1
$31,920
$47,880
2
$43,280
$64,920
3
$54,640
$81,960
4
$66,000
$99,000
Alaska and Hawaii have higher guidelines. Lilly Cares asks residents of those states to contact it for their limits. "Household" means you plus the family members counted in your household, and income is total household income before taxes. Lilly Cares states its limits as adjusted gross income.
Step 1: Check the other eligibility rules before you start
Income isn't the only test. Any one of these rules can disqualify you, so confirm each one first.
Residency: Novo requires U.S. citizenship or legal residency. Lilly Cares requires permanent U.S. residency (Puerto Rico and the U.S. Virgin Islands count).
Medicaid, Extra Help, and VA: neither program accepts people enrolled in Medicaid. Novo also excludes people who are enrolled in or qualify for Medicaid, Medicare's Low-Income Subsidy (Extra Help), or VA benefits, and asks for a denial letter if your income falls in the range where you might qualify. Lilly Cares excludes Medicaid, full Extra Help, and VA drug benefits. If you might be Medicaid-eligible, apply there first. If you qualify, Medicaid may cover your medication directly.
Insurance steering: Lilly Cares rejects applicants whose employer or health plan requires them to apply to Lilly Cares as a condition of coverage, including plans that route members through "alternative funding programs."
The drug list: confirm that your exact medication and strength is on the program's current list. Lists change at the start of each year.
Step 2: Gather your documents
Both programs now verify income electronically. They run a soft credit check or an income-verification service with your consent, and they check your insurance through an electronic benefits lookup. You may still be asked for paperwork, so have it ready:
Proof of income for everyone in the household: recent pay stubs, a W-2 or 1099, or your most recent tax return. Novo specifically asks for these if you don't file taxes or your income recently changed.
A Medicaid denial letter (Novo, uninsured applicants whose income meets their state's Medicaid threshold).
An Extra Help denial letter if you're on Medicare and your income is low enough that you might qualify (required by Novo for its Medicare-eligible products).
Photo ID, if you live in Maine or Minnesota (Novo).
Your insurance card(s), including any Medicare card. Cards that say "Medicare," "Medicare Advantage," or "Medicare Rx" count as Medicare.
Your prescriber's contact details, including an email address for their office (Novo's online application needs one).
Step 3: Loop in your prescriber early
Neither application is complete without your prescriber, and both programs say missing information delays processing.
Novo: you complete the patient portion online and enter an email address for your provider's office. The office gets a link to complete its portion. If you're approved, Novo contacts your doctor for the prescription.
Lilly Cares: you complete and sign the patient sections, and your prescriber completes the prescriber section and submits a prescription. Online, fax, and mail are all accepted.
Tell your prescriber's office that an application is coming, and ask who handles PAP paperwork. Some practices have a staff member who handles these.
Step 4: Submit the application
Novo Nordisk PAP: apply online through NovoCare. Novo has moved enrollment online, and the application works on a phone as well as a computer. If neither is an option, Novo says your provider's office or its own phone line can help. Questions: 1-866-310-7549 (Monday to Friday, 8 a.m. to 8 p.m. ET).
Lilly Cares: apply online (the fastest option), or print the application and fax it to 1-844-431-6650 or mail it to Lilly Cares Patient Assistance Program, PO Box 501847, San Diego, CA 92150. Questions: 1-800-545-6962.
Step 5: What happens after you apply
Novo Nordisk PAP
Lilly Cares
Processing time (complete application)
Within 2 business days
About 3 to 5 business days
How you hear back
A letter in the mail, plus an automated call or text if you opted in. Novo then contacts your doctor for the prescription
A letter and text to you; a fax to your prescriber
Delivery
Ships to your home (or another address you choose) within 5 business days of approval. Neovance Specialty Pharmacy (1-800-488-5908) calls to set it up
Free shipping to your home or your prescriber's office. Temperature-controlled medicines arrive by the next business day
Enrollment length
12 months (uninsured)
Generally 12 months, or through the end of the calendar year for Medicare Part D
Refills
Not automatic; the pharmacy contacts you when a refill is due
Optional auto-refill, or call to request a refill
Missing information is the main thing that slows either program down, so double-check every required field before you submit.
Step 6: Renew on time
PAP enrollment doesn't roll over. You have to reapply.
Novo: you can submit a new application up to 30 days before your enrollment ends. (Medicare Part D patients reapply for the next year after October 15.)
Lilly Cares: you can reapply up to 60 days before your enrollment end date, using the newest version of the application.
Put the renewal date in your calendar the day you're approved. Also check the product list each January, since Novo removed several medicines from its PAP for 2026 and lists can change again.
If you're denied
Find out why. Call the program and ask for the specific reason. The usual culprits are income over the limit, having commercial insurance, possible Medicaid or Extra Help eligibility without a denial letter, missing prescriber information, or a drug that isn't on the list.
Fix and resubmit if it's paperwork. A missing denial letter or an incomplete prescriber section is usually fixable.
Apply for Medicaid or Extra Help if you might qualify. A denial letter unlocks the PAP, and an approval may cover your medication directly.
Reapply if your circumstances change. A job loss, a drop in income, or losing coverage can change your eligibility mid-year.
Look at the alternatives below. A PAP isn't insurance, so a denial doesn't come with the formal appeal rights an insurance denial does. Under the application terms, eligibility is the company's decision, and the program can change at any time.
No coverage at all?LillyDirect and NovoCare Pharmacy sell brand Zepbound, Wegovy, and Ozempic at flat cash prices. That's not free, but it's often far below list price.
On Medicare? The temporary Medicare GLP-1 Bridge offers eligible Part D beneficiaries certain obesity medications for about $50 a month through December 31, 2027.
Search every program at once. NeedyMeds, a national nonprofit (needymeds.org, helpline 1-800-503-6897), and RxAssist (rxassist.org) maintain free databases of patient assistance programs, including nonprofit and disease-specific help that manufacturers don't run. Lilly Cares also points people who don't qualify to the Medicine Assistance Tool.
Avoid paying for free help
Both programs are free. Novo says there's no registration charge or monthly fee and that no one affiliated with it will ever ask you for payment. Lilly Cares says it doesn't charge for help with enrollment or refills and isn't affiliated with third parties that do. Novo also won't accept paid advocacy services as a patient's authorized representative. If a website or service charges a monthly fee to "get you" free Ozempic or Trulicity, you'd be paying for something you can do yourself with a phone call and your prescriber's help.
This is general information, not medical or financial advice. Patient assistance program rules, covered medicines, and income limits are set by each manufacturer and change often, usually each January. Figures here are as of September 2026, so confirm current terms directly with Novo Nordisk PAP or Lilly Cares before you apply.
How long does a PAP application take, and what does my doctor need to do?
Novo says a complete application is processed within 2 business days, and approved patients get their medicine shipped home within 5 business days. Lilly Cares says about 3 to 5 business days. Your prescriber has to complete part of either application. For Novo, you enter an email address for your provider's office, which gets a link to finish its portion. For Lilly Cares, the prescriber fills out the prescriber section and submits a prescription. Missing information is the main cause of delays.
Do I need to pay someone to help me apply?
No. Both programs are free, and both say they don't charge fees for enrollment or refills. Novo says no one affiliated with it will ever ask you for payment and it won't accept paid advocacy services as your authorized representative. You can apply yourself online or by calling Novo Nordisk PAP (1-866-310-7549) or Lilly Cares (1-800-545-6962), with your prescriber's office completing its section.
Novo Nordisk (NovoCare) · Reporting · Strong evidence
(2026)
Official product list (NNIPAP_11_01012026): GLP-1 products are Ozempic (uninsured patients only) and Xultophy 100/3.6; Wegovy, Rybelsus, Victoza, and Saxenda are not listed.
1Mixed findings
Related terms
Semaglutide salt forms — Versions of semaglutide such as semaglutide sodium and semaglutide acetate, which the FDA says are different active ingredients from the semaglutide base used in approved drugs, with no known lawful basis for compounding.
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Manufacturer savings cards for every branded GLP-1, including the new pills: a side-by-side guide — Novo Nordisk and Eli Lilly run copay savings cards for their branded GLP-1s, pills and injections alike, but prices, caps, and rules differ by drug, and two cards are closed to new enrollees. This guide lists every current card for Wegovy, Ozempic (pen and the new Ozempic tablets, which replaced Rybelsus in the US in May 2026), Zepbound, Mounjaro, Trulicity, and Foundayo side by side as of September 2026, plus what happened to Saxenda and Victoza.
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