Olumiant

Indicated For

rheumatoid arthritis, alopecia areata, COVID-19

About This Medication

# Lilly Cares Foundation Patient Guide: How to Get Olumiant at Low or No Cost ## About This Program The Lilly Cares Foundation Patient Assistance Program helps eligible patients receive Eli Lilly medications, including Olumiant (baricitinib), at no cost or reduced cost. Olumiant is a prescription medication used to treat certain inflammatory conditions. If you're struggling to afford your medication, this program may be able to help. ## Who Qualifies for Lilly Cares? To be eligible for the Lilly Cares program, you must meet several requirements: **Residency and Citizenship** You must be a permanent resident of the United States, including Puerto Rico and the U.S. Virgin Islands. **Insurance Status** You should be uninsured or underinsured. The program is designed for patients without adequate insurance coverage. However, some patients with Medicare Part D may also qualify, depending on your specific situation. **Income Requirements** Your household income must be at or below 300% of the Federal Poverty Level. This is a needs-based program, meaning your financial situation is evaluated to determine eligibility. Income thresholds vary based on household size and are adjusted annually according to Federal Poverty Level Guidelines. **Prescription Requirement** Your healthcare provider must have prescribed Olumiant for you, and the medication must be covered under the Lilly Cares program. **Insurance Exclusions** You cannot be enrolled in Medicaid, full Low Income Subsidy (LIS, also called "Extra Help"), or Veterans (VA) Benefits to qualify for this program. ## Income Eligibility Breakdown Since the program uses 300% of the Federal Poverty Level as its guideline, here's what that means for different household sizes in 2026: | Household Size | Approximate Maximum Annual Income | |---|---| | 1 person | ~$41,580 | | 2 people | ~$55,620 | | 3 people | ~$69,660 | | 4 people | ~$83,700 | *Note: These figures are estimates based on 2026 Federal Poverty Level Guidelines. Actual limits may vary. Contact Lilly Cares at (800) 545-6962 to confirm current income thresholds for your household size.* ## Insurance Requirements The Lilly Cares program is specifically designed for uninsured or underinsured patients. This means: - If you have no health insurance, you likely qualify - If you have insurance that doesn't cover Olumiant or has high out-of-pocket costs, you may qualify as "underinsured" - If you have Medicare Part D, you may still be eligible depending on your coverage gap or other factors - You cannot be enrolled in Medicaid or VA Benefits If you're unsure whether your insurance status qualifies, call (800) 545-6962 to speak with a Lilly Cares representative. ## Step-by-Step Application Process **Step 1: Gather Your Documents** Before starting your application, collect the following: - Proof of income (recent tax returns, pay stubs, or benefit statements) - Proof of residency (utility bill, lease agreement, or government-issued ID) - Your prescription for Olumiant from your healthcare provider - Your healthcare provider's contact information - Your insurance information (if applicable) **Step 2: Choose Your Application Method** You have three options for completing your application: - Online application (recommended for faster processing) - Download and print a blank form, then fill it out by hand - Download a blank form, fill it out on your computer, then print it Visit www.LillyCares.com to access the application or call (800) 545-6962 for assistance. **Step 3: Complete the Patient Section** Fill out all required patient information, including: - Your personal details (name, address, date of birth) - Your income information - Your insurance status and coverage details - Your health condition and medication needs - Sign and date the patient certification agreement - Review and sign the HIPAA authorization form **Step 4: Have Your Doctor Complete Their Section** Give your healthcare provider the prescriber section of the application. They must: - Confirm that they prescribed Olumiant for you - Verify your medical need for the medication - Sign and date their section - Submit a current prescription **Step 5: Attach Supporting Documents** Include copies of: - Proof of income - Proof of residency - Insurance documents (if applicable) - Proof of insurance claim denial (if applying for certain medication groups) **Step 6: Submit Your Application** You can submit your completed application in one of three ways: - Online through the Lilly Cares eService portal (fastest option) - Fax to: (844) 431-6650 - Mail to: Lilly Cares Patient Assistance Program PO Box 501847 San Diego, CA 92150 If submitting online, you can upload electronic copies of your supporting documents directly through the portal. ## Timeline and What to Expect **Processing Time** Your application typically takes 2-4 weeks to process. During this time, Lilly Cares will review your eligibility based on income, insurance status, and other program requirements. **Approval Notification** Once your application is reviewed, you will receive notification of the decision by: - Mail to your home address - Text message (if you provided a phone number) - Your healthcare provider will receive a fax notification **Enrollment Period** If approved, your enrollment generally lasts for 12 months or until the end of the calendar year (for those with Medicare Part D). You will be notified of your enrollment expiration date in your approval letter. **Medication Delivery** Once approved, your Olumiant will be shipped directly to you or your healthcare provider, depending on the program's procedures. Your approval letter will include specific delivery instructions. ## What If Your Application Is Denied? If your application is denied, you have options: - **Request clarification**: Contact Lilly Cares at (800) 545-6962 to understand why your application was denied - **Appeal the decision**: You may be able to appeal a denied claim, especially if you have new information about your insurance or financial situation - **Reapply**: If your circumstances change (such as loss of insurance or income reduction), you can submit a new application - **Explore alternatives**: Ask your healthcare provider about other patient assistance programs, generic alternatives, or other resources ## Reauthorization and Refills Since your enrollment expires after 12 months (or at the end of the calendar year), you will need to reauthorize to continue receiving assistance. Lilly Cares will notify you before your enrollment expires. You'll need to submit a new application with updated financial and insurance information to continue the program. ## Important Reminders - **Accuracy matters**: Ensure all information on your application is accurate and complete. Once submitted, you cannot edit your application, so review everything carefully before submitting - **Keep copies**: Save a copy of your completed application and all supporting documents for your records - **Update information**: If your income, insurance, or residency status changes, contact Lilly Cares immediately - **Annual updates**: Income guidelines change yearly, so check current eligibility requirements each year ## Need Help? If you have questions about the application process or need assistance completing your application, contact Lilly Cares: **Phone**: (800) 545-6962 **Website**: www.LillyCares.com Lilly Cares representatives can help you understand eligibility requirements, guide you through the application process, and answer questions about your specific situation. ## Disclaimer This guide provides general information about the Lilly Cares Foundation Patient Assistance Program. Program requirements, income thresholds, and eligibility criteria may change. For the most current and accurate information, visit www.LillyCares.com or call (800) 545-6962. This guide is not a substitute for official program documentation or professional medical advice. Always consult with your healthcare provider about your medication needs and treatment options.

Program information last verified: March 25, 2026