Fiasp

Indicated For

Diabetes mellitus

About This Medication

# Novo Nordisk Patient Assistance Program Patient Guide: How to Get Fiasp at Low or No Cost ## About This Program The **Novo Nordisk Patient Assistance Program (PAP)** helps eligible patients access Fiasp (insulin aspart) at no cost when they cannot afford their medication. Fiasp is a rapid-acting insulin used to help control blood sugar in people with diabetes. If you're struggling to pay for your insulin, this program may be able to help you get the medication you need. ## Who Qualifies for This Program? To be eligible for the Novo Nordisk PAP, you must meet all of the following requirements: - **U.S. Citizenship or Legal Residency**: You must be a U.S. citizen or legal resident - **Income Requirement**: Your total household income must be at or below **400% of the Federal Poverty Level (FPL)** - **Insurance Status**: You must be uninsured or have Medicare. If you have private or commercial insurance (such as an HMO or PPO), you are not eligible - **Age**: You must be 18 years or older (or have a parent, legal guardian, or legal representative apply on your behalf) - **No Other Government Programs**: You cannot be enrolled in or eligible for Medicaid, Medicare Extra Help/Low Income Subsidy (LIS), other federally funded insurance programs (except Medicare Part D), or receive prescription drug benefits through the U.S. Veterans Administration (except Medicare) ## Understanding the Income Requirement The program uses the **Federal Poverty Level (FPL)** to determine eligibility. Your household income must not exceed 400% of the FPL. Here's what this means for different household sizes: | Household Size | 100% FPL | 400% FPL (Maximum Income) | |---|---|---| | 1 person | ~$15,060 | ~$60,240 | | 2 people | ~$20,440 | ~$81,760 | | 3 people | ~$25,820 | ~$103,280 | | 4 people | ~$31,200 | ~$124,800 | *Note: These figures are approximate and based on 2024 guidelines. The FPL is updated annually. To calculate your exact eligibility, use the FPL Calculator tool available on the NeedyMeds website or contact the Novo Nordisk helpline.* ## Insurance Requirements Explained The program is designed for patients without adequate insurance coverage: - **Uninsured patients**: If you have no health insurance at all, you are eligible - **Medicare patients**: If you have Medicare (including Medicare Part D), you are eligible - **Private/Commercial insurance**: If you have private or commercial insurance (HMO, PPO, or similar plans), you are **not eligible**, even if you have high out-of-pocket costs - **Medicaid**: If you are enrolled in or eligible for Medicaid, you are not eligible for this PAP ## Step-by-Step Application Process ### Step 1: Gather Required Documents Before starting your application, collect the following: - Your healthcare provider's name, state, and email address (you'll need to verify the email) - If you have Medicare, your insurance card(s) - Tax documents from the most recent year you filed taxes - Proof of income, which may include: - Your two most current paycheck stubs - Last year's federal income tax return (Form 1040) - Social Security income statements (SSA 1099) - Other documentation showing your current income - Your Social Security number - A valid prescription for Fiasp from your healthcare provider ### Step 2: Start Your Application You have two options for applying: **Online Application** (English only): 1. Visit **www.novocare.com** and start the online application 2. Your healthcare provider will receive a secure email link to complete their portion 3. Once your provider finishes, you'll receive a code by email to complete your section 4. Upload your proof of income and other required documents 5. Submit your application **Paper Application** (English and Spanish available): 1. Download the application from www.novocare.com 2. Complete your sections with your personal and financial information 3. Bring the application and proof of income to your healthcare provider 4. Your provider completes the prescriber and prescription sections and signs the form 5. Your provider faxes the completed application to **1-866-441-4190** or mails it to the address on the form **Important**: You cannot complete the application without your healthcare provider's participation and signature. ### Step 3: Submit Additional Documentation During the application process, you may be asked to provide: - Proof of income (paycheck stubs, tax returns, or income statements) - Medicaid denial letter (if applicable) - Government-issued ID - Medicare Part D documentation (if applicable) Submit all requested documents promptly to avoid delays. ## Application Timeline and Medication Delivery **Processing Time**: If your application is complete with all required documents and fields filled out, Novo Nordisk will process it within **2 business days**. Incomplete applications may take longer. **Decision Notification**: You and your healthcare provider will receive a decision by mail. If you opt in for automated phone alerts during the application, you'll also receive an automated phone call or text message. **Medication Delivery**: Once approved, allow **10-14 business days** (up to 21 days) for your medication to be delivered to your healthcare provider's office. ## Enrollment Duration and Reauthorization **Uninsured Patients**: Your enrollment lasts for **12 months** from the date of approval. **Medicare Patients**: Your enrollment lasts until **December 31st** of the calendar year. You must apply by **November 30th** each year to maintain continuous coverage. You can reapply starting **October 15th** for the next year's program. **Reauthorization**: When your enrollment period ends, you must reapply if you want to continue receiving assistance. The reapplication process is the same as the initial application. ## What If Your Application Is Denied? If your application is denied, you have several options: - **Contact Novo Nordisk**: Call the helpline at **1-866-310-7549** to understand why your application was denied and whether you can reapply - **Reapply**: If your circumstances have changed (income decreased, insurance status changed), you may be eligible to reapply - **Explore Other Resources**: Ask your healthcare provider about other patient assistance programs, state pharmaceutical assistance programs, or nonprofit organizations that help with medication costs - **Discuss with Your Provider**: Your healthcare provider may know of alternative insulin options or other resources to help you access medication ## Need Help? For questions about eligibility, the application process, or your application status, contact the **Novo Nordisk Patient Assistance Program helpline**: **Phone**: 1-866-310-7549 **Website**: www.novocare.com The helpline can assist you with: - Eligibility questions - Application guidance - Help completing each section - Questions about your application status ## Important Disclaimer This guide provides general information about the Novo Nordisk Patient Assistance Program. Program requirements, eligibility criteria, and procedures may change. For the most current and complete information, visit www.novocare.com or call 1-866-310-7549. This guide is not a guarantee of program eligibility or approval. All applications are reviewed individually based on the information provided and current program requirements.

Program information last verified: March 25, 2026