Novo Nordisk Patient Assistance Program: Wegovy and Lilly Cares

Free GLP-1 medicine through a manufacturer program is real, but the door is narrow. The Novo Nordisk Patient Assistance Program (PAP) provides medicine at no cost to those who qualify — there is no registration charge and no monthly fee — but only for people who have Medicare or no insurance, and its published pages are built around diabetes products ^[1][2]. Lilly Cares, a separate nonprofit foundation, provides certain Eli Lilly medicines at no cost to qualifying patients ^[4][5]. Neither program’s current published materials confirm the two drugs most readers ask about: Novo keeps its covered-product list in a separate PDF rather than on the page itself, and Lilly Cares’ current medication lists include the GLP-1 Trulicity but not Zepbound or Mounjaro ^[1][2][4][5].

The other two kinds of “manufacturer help” are not assistance at all. Savings cards lower copays only for people with active commercial insurance and are barred for Medicare, Medicaid, TRICARE, and VA patients ^[6][7]. Manufacturer self-pay channels, such as LillyDirect, charge a cash price with no income test and no charity involved ^[6][7]. Knowing which of the four you are looking at explains most of the confusion, because patient assistance and savings cards have opposite eligibility rules.

What is the difference between a patient assistance program, a savings card, and self-pay?

There are four separate kinds of help, and they cannot be combined:

Type of help	What you get	Who it is for
Novo Nordisk PAP	Free medicine, no fees [1][2]	Medicare or uninsured only; private/commercial insurance bars eligibility [1][2]
Lilly Cares PAP	Certain Lilly medicines at no cost [4][5]	Uninsured or Medicare patients meeting income limits; not Medicaid, full LIS, or VA [4][5]
Savings (copay) cards	Lower copays at the pharmacy [6][7]	Active commercial insurance only; barred for Medicare, Medicaid, TRICARE, VA [6][7]
Manufacturer self-pay (e.g., LillyDirect)	A discounted cash price [6][7]	Anyone with a prescription; no income test; cannot be combined with commercial insurance, Medicare, or Medicaid [6]

A patient assistance program is charity for people with low income and little or no drug coverage. A savings card is a marketing tool that requires private insurance. A self-pay channel is just a price. Under these rules, private or commercial insurance closes the Novo PAP to a patient, while Medicare or no insurance closes the savings cards ^[1][2][6][7]. Lilly Cares is more granular: its Group 4 path allows some insured patients whose plan does not cover the medication to still qualify ^[4][5].

Is Wegovy covered by the Novo Nordisk Patient Assistance Program?

That cannot be confirmed from the program’s own web pages, and it should not be assumed either way. The NovoCare PAP pages link to a separate product-list PDF (PAP_Product_List.pdf) for the current covered medicines ^[1][2]. The pages are framed around diabetes, and the products actually named on them are the Ozempic pen at 0.5 mg, 1 mg, or 2 mg, along with Novo Nordisk insulins ^[1][2].

What the pages do say is that some medicines will no longer be part of the PAP for 2026, and they direct readers to that same covered-list PDF ^[1][2]. According to Novo text reproduced by a 340B industry publication, the products removed from the PAP for 2026 are Rybelsus 7 mg and 14 mg tablets and all unbranded biologic insulins, while a consulting pharmacist’s summary reports the program retains Tresiba and Novolog ^[3]. Novo’s own verification routes are the current PAP product list PDF linked from the NovoCare PAP page and its toll-free line at 1-866-310-7549 ^[1][2].

Two cautions apply. Product availability is subject to change without notice, and Novo Nordisk reserves the right to modify or cancel the program at any time without notice ^[1][2]. So even a product confirmed on the list today is not guaranteed tomorrow.

Who qualifies for the Novo Nordisk PAP in 2026?

The baseline rules, straight from the program’s 2026 eligibility section ^[1][2]:

• US citizenship or legal residency is required.
• Medicare or no insurance is required. Private or commercial insurance makes a patient ineligible.
• Enrollment in or qualification for Medicaid, the Medicare Low-Income Subsidy (Extra Help), or VA benefits disqualifies an applicant. Applicants eligible for Medicaid or LIS must submit a copy of their denial letter with the application.
• Total household income must fall under the limit for the applicant’s situation.

The income limits work like this ^[1][2]:

Situation	Household income limit	Extra document required
Uninsured, taking Ozempic	At or below 200% of the federal poverty level	Medicaid denial letter if income meets the state’s FPL thresholds [1][2][3]
Uninsured, any other PAP medicine	At or below 400% of the federal poverty level	Same Medicaid denial rule [1][2]
Medicare patient on Novo Nordisk insulins	At or below 400% of the federal poverty level	Extra Help denial letter if income is below 150% of the federal poverty level [1][2][3]

These are income ceilings for getting free medicine, not prices — approved patients pay nothing for the medicine or the shipping ^[1][2]. Novo points applicants to the NeedyMeds website, which lists the current federal poverty level guidelines, for the dollar figures that match each percentage ^[1][2].

What changed in the Novo Nordisk PAP for 2026?

The biggest change hits Medicare patients on Ozempic. Medicare beneficiaries with prescription drug coverage will no longer be eligible to receive Ozempic through the PAP, because most Medicare prescription plans cover it ^[1][2][3]. A 340B industry article quoting Novo’s announcement gives the company’s rationale: 98% of Medicare beneficiaries have access to Ozempic ^[3]. Existing PAP patients continued receiving Ozempic through the end of 2025 ^[3].

For Medicare patients who lose PAP access, Novo points to the Medicare Prescription Payment Plan (M3P) at medicare.gov/prescription-payment-plan, describing it as a way of spreading prescription costs throughout the plan year ^[1][2][3]. It is a payment schedule, not assistance — it does not provide free or discounted medicine.

Other 2026 changes:

• The old rule requiring Medicare Part D patients to spend $1,000 out of pocket before applying no longer applies. Novo’s FAQ now answers that question with a plain no ^[1][2].
• Novo’s materials direct Medicare patients to evaluate their plan options before 2026 Open Enrollment, which the company states begins on October 15, 2025 and ends on December 7, 2025 ^[3].
• Faxed applications are no longer processed. All applications go through the online enrollment system, and the Spanish application is listed as “coming soon” ^[1][2].

One current requirement for Medicare insulin patients: beneficiaries with household income below 150% of the federal poverty level must show a Part D Extra Help denial to qualify for insulin through the PAP ^[1][2][3].

How does the Novo PAP application work, and how long does it take?

Applications go through diabetespap.novocare.com ^[1][2]. Either the patient or the provider’s office can start the application; once one party finishes its portion, a secure emailed link goes to the other party, who uses that link rather than starting a new application ^[2]. The application requires an accurate email address for the provider’s office, or it cannot proceed ^[1].

Documents the program may request ^[1]:

• Medicare patients: a copy of the Low-Income Subsidy (Extra Help) denial letter.
• Uninsured patients: a copy of the state Medicaid denial letter.
• Residents of Maine or Minnesota: a copy of a government photo ID.
• Patients who did not file taxes or had a life event affecting income: proof of income — the last 3 paystubs, W-2, or 1099 forms for the patient and household.

A complete application, with all documents and all fields filled in, is processed within 2 business days. Missing or incomplete information causes delays ^[1][2]. Approval comes as a letter in the mail, plus an automated phone or text alert for patients who opted in ^[1][2]. Once approved, medicine ships to the home within 5 business days, and Neovance Specialty Pharmacy calls at 1-800-488-5908 to schedule delivery ^[1][2]. Shipping costs are covered by the program, and the pharmacy cannot ship to a local pharmacy for pickup ^[1].

On the prescriber side, the doctor sends an electronic prescription to Neovance Specialty Pharmacy (NPI 1780811125). Patients who are titrating their dose get a maximum 2-month supply per prescription; other patients can have up to 12 months of fills ^[2]. Enrollment lasts 12 months for uninsured patients and through December 31 of the current calendar year for Medicare patients, and patients can renew each year for as long as they qualify ^[1][2].

Who qualifies for Lilly Cares, and what are the income limits?

Lilly Cares is the patient assistance program of the Lilly Cares Foundation, a nonprofit that helps qualifying patients obtain certain Lilly medicines at no cost ^[4][5]. Its published requirements ^[4][5]:

• Permanent residency in the United States, including Puerto Rico and the US Virgin Islands.
• No enrollment in Medicaid, full Low-Income Subsidy (Extra Help), or VA benefits.
• A prescription for a medication offered through the program.
• Meeting the insurance requirements for that medication’s group and the household income limit for that group.

The income limits are set as percentages of the 2026 Federal Poverty Guidelines: 300% for Group 1 medications, 400% for Group 2, and 500% for Groups 3 and 4 ^[4]. In dollars, the annual adjusted gross income ceilings are ^[4][5]:

Household size	Group 1 (≤300% FPL)	Group 2 (≤400% FPL)	Groups 3 & 4 (≤500% FPL)
1	$47,880	$63,840	$79,800
2	$64,920	$86,560	$108,200
3	$81,960	$109,280	$136,600
4	$99,000	$132,000	$165,000
5	$116,040	$154,720	$193,400
6	$133,080	$177,440	$221,800

The website directs Alaska and Hawaii residents to call 1-800-545-6962 for adjusted limits ^[4]. The application form adds that households of more than four people should also call for adjusted gross income limits ^[5].

The insurance test depends on the medication group. For Groups 1 through 3, eligibility requires no insurance, Medicare Part D (not for infused drugs), or Medicare Part B with no supplemental or secondary insurance ^[4][5]. Group 4 adds a fourth path: patients whose insurance does not cover the medication may still qualify, with insurance verification documentation required ^[4][5]. Patients with healthcare cost-sharing ministry plans are eligible, because Lilly Cares treats those plans as voluntary sharing among members rather than health insurance ^[4]. Lilly Cares verifies income through a consumer reporting agency and insurance through an electronic benefits service, and may request more documents depending on the results ^[4].

Can you get Zepbound or Mounjaro free through Lilly Cares?

Not according to the program’s own current lists. The Lilly Cares website and its current application form (form CMAT-02998, dated 12/2025) list these medications by group ^[4][5]:

• Group 1: Cialis, Emgality, Forteo, Reyvow, Trulicity.
• Group 2: Basaglar, Humalog, Humulin, Lyumjev.
• Group 3: Ebglyss, Olumiant, Omvoh (infusion and injection), Taltz.
• Group 4: Cyramza, Erbitux, Inluriyo, Jaypirca, Kisunla, Retevmo, Verzenio.

Trulicity, a diabetes GLP-1 injection, is the only GLP-1 on the published lists. Neither Zepbound nor Mounjaro appears on either the website list or the application ^[4][5]. The website also notes that new Trulicity applications are once again being accepted and no longer require a medical exception request ^[4].

Here is where the information gets conflicting. Secondary commercial pages assert that Lilly Cares covers Mounjaro free for qualifying uninsured patients at or below 400% of the federal poverty level — about $63,840 for a household of one — while agreeing that Zepbound is not covered ^[6][7]. That claim conflicts with the current official lists, which do not include Mounjaro ^[4][5]. The official lists are the controlling documents, and Lilly Cares states that outdated applications will not be accepted ^[5]. For medications not listed, Lilly Cares points patients to the Medicine Assistance Tool at americasmedicines.com for other resources ^[4]. Current coverage can be verified at lillycares.com or by calling 1-800-545-6962 ^[4][5].

How does the Lilly Cares application work?

There are three ways to apply: online at lillycareseservice.com (recommended by the program to reduce paperwork and delays), a printed blank application filled out by hand, or a fillable PDF completed on a computer ^[4]. An application can also be requested by mail by calling 1-800-545-6962 ^[4].

The patient fills out and signs the patient sections, the Patient Certification Agreement, and the HIPAA authorization; the healthcare provider completes the prescriber section and submits the prescription ^[4][5]. Completed paper applications go to Lilly Cares PAP, PO Box 501847, San Diego, CA 92150, or by fax at 1-844-431-6650 ^[4][5]. Applicants with insurance applying for a Group 4 medication or an infused medication must attach insurance verification documentation — though it is not required for Medicare Part D patients applying for a Group 4 self-administered product ^[5]. Infused medicines must be given in an outpatient setting, and a provider seeking replacement product for an infused oncology drug must show treatment within the last 180 days ^[5].

After review, the enrollment decision arrives by mail and text message (if applicable), and the provider gets a fax notification ^[4]. If approved, the enrollment letter states the expiration date — generally 12 months, or the end of the calendar year for Medicare Part D patients ^[4]. Reapplication is required at the end of the enrollment period, and it is allowed up to 60 days before the end date ^[4]. Medicines ship to the home or the provider’s office, and the pharmacy partner calls to schedule delivery ^[4]. Lilly Cares charges no fee for enrollment help, refills, or participation, and it is not affiliated with third parties that charge for that help ^[4][5].

What is an alternative funding program, and why can it disqualify you?

An alternative funding program (AFP) is a third party — Lilly uses the phrases “for-profit patient advocacy programs” and “specialty cost-containment networks” — that some employers or insurance plans use to steer patients toward manufacturer charity programs ^[4][5]. Lilly Cares treats this as a serious eligibility problem, and it can disqualify a patient who meets every other requirement.

Under the program’s rules, an applicant is not eligible for Lilly Cares if an employer, plan, or other third party directs the application as a condition of, requirement for, or prerequisite to coverage, or adjusts coverage based on the application to or availability of Lilly Cares ^[4][5]. An applicant is also ineligible if an employer or plan requires that the application be submitted by or with an AFP, even if all other criteria are met ^[4][5]. Applications that violate these requirements are blocked, and Lilly Cares reserves the right to take further action, including against the third parties ^[4][5]. Lilly publishes its eligibility criteria and a list of AFPs at lillycares.com/assets/pdf/toapplycheckEligibility.pdf ^[4][5].

The practical point: an employer or plan that signs a patient up with one of these middlemen to get free medicine can shut the door on the charity program — through no fault of the patient and possibly without the patient knowing how the application was submitted.

What if neither program covers your GLP-1? Cash prices and Medicare routes

If the PAPs do not cover a drug, the remaining routes are cash prices, savings cards, and Medicare programs. For tirzepatide, secondary pricing pages report these manufacturer-channel figures for 2026 ^[6][7]:

Channel	Reported cost	Rules
LillyDirect self-pay, Zepbound	$299/month (2.5 mg); $399/month (5 mg); $449/month (7.5–15 mg)	45-day refill rule; no income test; cannot be combined with commercial insurance, Medicare, or Medicaid [6][7]
LillyDirect self-pay, Mounjaro	$499/month, all doses	Roughly 54% below list price; same no-insurance-combination rule [6]
Retail list price (WAC)	Zepbound $1,086/month; Mounjaro $1,079.77/month	The comparison baseline [6][7]
Zepbound savings card	As low as $25/month; $100/month maximum savings; $1,300 annual limit	Commercial insurance only; expires December 31, 2026 [6][7]

These figures come from secondary pricing pages, not from the manufacturers’ own terms pages, so they are reported figures rather than official terms. On the savings card, the reported 2026 terms are $100 per month in maximum savings and a $1,300 annual limit, both lower than the prior year’s $150 and $1,950 — so the card’s help can run out sooner in 2026 than it did before ^[7].

Separately, on the Medicare side, a secondary source describes CMS policy items rather than prices: a Medicare GLP-1 Bridge demonstration covering Zepbound for obesity at a $50 per month copay from July 1, 2026 through December 31, 2027 (KwikPen formulation), and a 2026 Part D annual out-of-pocket cap of $2,100 ^[6].

For Novo products paid in cash, a 340B industry site published estimated 340B prices alongside GoodRx prices as of 10/10/2025 — these are dated comparison figures, not current consumer prices ^[3]:

Product	340B estimated price	GoodRx price
Ozempic 2 mg/dose, 1 pen	$315	$500
Rybelsus 3 mg, 30 tablets	$332	$984
Tresiba FlexTouch, 5 pens	$110	$515
Novolog FlexPen, 5 pens	$92	$153

For Wegovy specifically, no savings-offer or self-pay figures could be verified here. The NovoCare Wegovy savings pages are where to check current terms before relying on any figure circulating on third-party sites ^[8][9].

Before applying: a checklist and who to call

A few practical points from both programs’ own materials:

• Novo states that processing is delayed when applicable documents are not submitted, and missing or incomplete fields push processing past the 2-business-day window — so gather documents such as the Medicaid or LIS denial letter before applying if one applies to you ^[1][2].
• Both programs can change or disappear. Novo Nordisk reserves the right to modify or cancel its program at any time without notice, and product availability is subject to change ^[1][2]. Lilly Cares requires the latest application form and rejects outdated ones ^[5].
• Novo PAP questions: 1-866-310-7549. Neovance Specialty Pharmacy delivery: 1-800-488-5908 ^[1][2].
• Lilly Cares: 1-800-545-6962, or fax 1-844-431-6650 ^[4][5].

Neither program guarantees assistance. Approval depends on income, insurance status, documents, and whether the specific medicine is on the covered list at the moment the application is reviewed — and both manufacturers state that the lists and the programs themselves can change without notice ^[1][2][4][5].

Sources

1. Novo Nordisk. Novo Nordisk Patient Assistance Program (PAP).
2. Novo Nordisk. Novo Nordisk Patient Assistance Program (PAP) information for healthcare providers.
3. 340B Price Guide. Novo Nordisk Changes Patient Assistance Program (PAP) 2026.
4. Lilly Cares. How to Apply.
5. Lilly Cares Foundation, Inc. Patient Assistance Program Application.
6. CoveredUSA. LillyDirect Self-Pay Pricing in 2026: Zepbound and Mounjaro. June 1, 2026.
7. Honest Care. Zepbound Copay Assistance & Financial Help 2026: Discount Programs & Savings.
8. Novo Nordisk. Savings Offer Program for Wegovy (semaglutide).
9. Novo Nordisk. Wegovy (semaglutide) injection 2.4 mg Text Savings: Terms and conditions of use.
10. Eli Lilly. Savings & Insurance Options | Zepbound (tirzepatide).
11. Drugs.com. What is the Zepbound Coupon or Savings Card? June 11, 2026.
12. Drug Channels. Copay Accumulators and Maximizers in 2025: Popular, Profitable, and Problematic. February 2026.
13. Patient Advocate Foundation. How alternative funding programs prevent access to medications.
14. Pharmaceutical Commerce. FAQ: Decoding Alternative Funding Programs. January 30, 2026.
15. Fierce Healthcare. A new wave of middlemen offers ‘alternative funding’ for specialty drugs. Patients bear the risks. October 14, 2025.
16. GoodRx. Manufacturer Copay Cards: Everything You Need to Know.
17. GoodRx. GoodRx Coupons for Brand Drugs: A Detailed Overview.
18. Centers for Medicare & Medicaid Services. Medicare Prescription Payment Plan.
19. NiceRx. Zepbound patient assistance program: The complete guide to Zepbound cost & savings in 2026. October 24, 2025.
20. Eli Lilly and Company. Savings & Insurance Options | Zepbound (tirzepatide).