Axiron

Indicated For

hypogonadism

About This Medication

# Lilly Cares Patient Guide: How to Get Axiron at Low or No Cost ## About This Program The **Lilly Cares Foundation Patient Assistance Program** is a nonprofit charitable organization created and funded by Eli Lilly and Company to help uninsured and underinsured patients access their prescribed medications at no cost. If you've been prescribed Axiron (testosterone) and are struggling with the cost, this program may be able to help you receive your medication for free for up to 12 months. ## Who Qualifies for Lilly Cares To be eligible for the Lilly Cares program, you must meet ALL of the following requirements: - Be a permanent, legal resident of the United States, Puerto Rico, or the U.S. Virgin Islands - Have a valid prescription for Axiron from your healthcare provider - Be uninsured OR enrolled in Medicare Part D - Not have private insurance that covers prescription medications (with limited exceptions for Medicare Part D patients) - Have a household income that does not exceed the program's income limits ## Income Eligibility Lilly Cares uses the Federal Poverty Level (FPL) to determine income eligibility. Axiron falls under the program's medication groups, and your household income must not exceed specific thresholds based on your family size. The program sets income limits at or above **300% of the Federal Poverty Level** for all Lilly-owned or supported patient assistance programs. Your specific income limit depends on your family size: | Family Size | Income Limit (300% FPL) | |---|---| | Individual | Approximately $41,580 annually | | Couple (2 people) | Approximately $56,100 annually | | Family of 3 | Approximately $70,620 annually | | Family of 4 | Approximately $85,140 annually | *Note: These figures are based on 2024 Federal Poverty Level guidelines. Income limits are adjusted annually. Contact Lilly Cares for current thresholds.* ## Insurance Requirements You must be either: - **Uninsured** (no health insurance plan), OR - **Enrolled in Medicare Part D** and spending 4% or more of your gross annual income on prescription drugs If you have private insurance that covers prescriptions, you generally will not qualify unless you meet specific exceptions. Lilly Cares will verify your insurance status during the application process. ## How to Apply ### Step 1: Gather Your Information Before applying, have the following ready: - Your Social Security number - Proof of income (recent tax return, pay stubs, or benefit statements) - Information about your current insurance (if any) - Your prescription for Axiron - Contact information for your healthcare provider ### Step 2: Complete the Application You can apply in two ways: **Online Application (Recommended):** - Visit www.lillycares.com - Complete the electronic application form - The online process is faster and reduces paperwork delays **Mail-In Application:** - Call 1-800-545-6962 to request an application by mail or fax - Complete the form and mail it to: PO Box 230999, Centerville, VA 20120 - Include copies of required documentation ### Step 3: Have Your Doctor Submit a Prescription Your healthcare provider must submit your Axiron prescription to Lilly Cares. They can do this by: - **Electronic Prescription:** Selecting Neovance Specialty Pharmacy (NPI 1780811125) in their eRx software - **Fax:** Sending the prescription to 1-844-431-6650 using the optional prescription template provided by Lilly Cares - **Provider-Generated Prescription:** Faxing their own prescription format to the same number ### Step 4: Wait for Approval Lilly Cares will review your application and verify your eligibility. Once approved, you'll be notified and your medication will be arranged. ## Timeline and Medication Delivery After submitting a complete application with all required documentation, you can typically expect: - **Processing Time:** Applications are reviewed promptly; most decisions are made within 1-2 weeks - **Delivery Method:** Your Axiron will be dispensed through Neovance Specialty Pharmacy - **Duration:** You'll receive free medication for up to 12 months from your approval date ## Reauthorization and Refills Your Lilly Cares assistance lasts for up to 12 months. Before your coverage expires, you'll need to reapply to continue receiving free medication. **For Medicare Part D Patients:** - You can begin reapplying on **October 15** each year - You must reapply by **December 31** to maintain continuous coverage **For Other Eligible Patients:** - Contact Lilly Cares at 1-800-545-6962 to learn about your reauthorization timeline Refills during your 12-month coverage period are handled automatically through Neovance Specialty Pharmacy. Your healthcare provider may need to submit refill authorizations as needed. ## What If Your Application Is Denied? If you don't qualify for Lilly Cares, you have several options: - **Review the Denial Reason:** Contact Lilly Cares to understand why you were denied. You may be able to reapply if your circumstances change. - **Explore Other Programs:** Lilly offers additional patient assistance programs, including LillyMedicareAnswers for Medicare recipients and specialty programs for specific medications. - **Contact Partnership for Prescription Assistance:** Call 1-888-4PPA-NOW (1-888-477-2669) or visit www.pparx.org to find other prescription assistance programs you may qualify for. - **Speak with Your Healthcare Provider:** They may have information about manufacturer discounts, samples, or alternative medications. ## Important Reminders - **No Fees:** Lilly Cares does not charge patients any fees for enrollment, medication refills, or program participation. Be cautious of third-party services that charge for assistance that Lilly Cares provides at no cost. - **Privacy:** Your personal information and prescription details are kept confidential and used only for program administration and improvement. - **Over 20 Years of Service:** Lilly Cares has helped more than one million patients access medications over the past two decades. ## Contact Information **Lilly Cares Foundation** - **Phone:** 1-800-545-6962 - **Website:** www.lillycares.com - **Mailing Address:** PO Box 230999, Centerville, VA 20120 - **Prescription Fax:** 1-844-431-6650 ## Disclaimer This guide provides general information about the Lilly Cares Patient Assistance Program. Program details, income limits, and eligibility requirements may change. For the most current and accurate information, please contact Lilly Cares directly or visit their official website. This information is not a guarantee of eligibility or approval. All applications are reviewed individually based on current program guidelines and your specific circumstances.

Program information last verified: March 30, 2026