Omvoh

Indicated For

Moderately to severely active ulcerative colitis (UC), moderately to severely active Crohn's disease (CD)

About This Medication

# Lilly Cares Foundation Patient Guide: How to Get Omvoh at Low or No Cost ## About This Program The **Lilly Cares Foundation** is a nonprofit charitable organization that helps patients with financial need receive prescribed Eli Lilly medications at no cost for up to 12 months. Over the past 20 years, Lilly Cares has assisted more than one million patients in accessing their medications.[8] ## About Omvoh (Mirikizumab-mrkz) Omvoh is a prescription medication used to treat ulcerative colitis. It is available as both an infusion and a subcutaneous (under-the-skin) injection. Your healthcare provider will determine which form is appropriate for your condition and prescribe it accordingly.[7] ## Who Qualifies for Lilly Cares To be eligible for the Lilly Cares program, you must meet all of the following requirements:[2] - Your healthcare provider has prescribed Omvoh - You are a permanent resident of the United States (including Puerto Rico and the U.S. Virgin Islands) - You meet the household income guidelines for the program - You are **not** enrolled in Medicaid, full Low-Income Subsidy (LIS/"Extra Help"), or Veterans (VA) Benefits - You meet the insurance requirements for your medication group ## Income Eligibility Lilly Cares bases eligibility on household annual adjusted gross income as a percentage of the Federal Poverty Level (FPL). For **Group 4 medications** (which includes Omvoh), you must have a household annual adjusted gross income of **≤500% of the Federal Poverty Level**.[1] The specific income thresholds vary based on household size. Here is an approximate breakdown based on 2026 Federal Poverty Guidelines: | Household Size | 500% FPL (Approximate Annual Income) | |---|---| | 1 person | $31,200 | | 2 people | $42,000 | | 3 people | $52,800 | | 4 people | $63,600 | | Each additional person | Add ~$10,800 | *Note: These figures are estimates based on federal poverty guidelines. Contact Lilly Cares at (800) 545-6962 for exact current thresholds for your household size.* ## Insurance Requirements Your insurance status affects your eligibility:[1] - **Uninsured patients**: You may qualify for Lilly Cares - **Medicare Part D patients**: You may qualify for Lilly Cares if you meet income requirements - **Medicare Part B patients**: You may qualify if you do not have supplemental or secondary insurance - **Commercial insurance**: If your insurance does not cover Omvoh, you may qualify for Lilly Cares - **Not eligible**: Patients enrolled in Medicaid, full Low-Income Subsidy (LIS), or VA Benefits cannot use Lilly Cares If you have insurance and are applying for Omvoh (a Group 4 infused medication), you will need to provide insurance verification documentation.[2] ## How to Apply: Step-by-Step ### Step 1: Access the Application You have three options for completing your application:[1] 1. **Online application** (recommended): Complete your application at www.lillycares.com. This method reduces paperwork and potential delays. 2. **Paper application**: Download a blank application, print it, and fill it in by hand 3. **Digital form**: Download a blank application, fill it in on your computer, save it, and print it Always use the latest application available on the website—outdated applications will not be accepted.[2] ### Step 2: Gather Required Documentation Before starting your application, collect the following documents:[2] - Proof of household income (recent tax return, pay stubs, or benefit statements) - Proof of U.S. residency - Insurance information (if applicable) - Insurance verification documentation (if you have insurance and are applying for an infused medication) For details on insurance verification requirements, visit the Lilly Cares website or call (800) 545-6962. ### Step 3: Complete Your Application - Fill out and sign all patient sections of the application - Your healthcare provider must complete the prescriber section and submit a prescription - If you have insurance and are applying for an infused medication, include insurance verification documentation ### Step 4: Submit Your Application **For online applications**: Submit directly through www.lillycares.com **For paper applications**: Fax or mail your completed, signed application to: Lilly Cares Patient Assistance Program PO Box 501847 San Diego, CA 92150 Fax: 1-844-431-6650 Your healthcare provider's office can submit the fax on your behalf if needed. ## Timeline and What to Expect After you submit your application:[1] - Lilly Cares will review your application and supporting documents - You will receive notification of the enrollment decision by **mail and text message** (if applicable) - Your healthcare provider will receive a **fax notification** - If approved, your enrollment notification letter will specify when your enrollment expires (generally 12 months or at the end of the calendar year for Medicare Part D patients) *Note: The search results do not specify an exact processing timeline. Contact Lilly Cares at (800) 545-6962 for information about expected review times.* ## If Your Application Is Approved Once enrolled, you will receive your Omvoh medication at no cost through the program. Your enrollment typically lasts for 12 months or until the end of the calendar year (for Medicare Part D patients). Your healthcare provider will coordinate medication delivery and administration with you. ## If Your Application Is Denied If you do not qualify for Lilly Cares, ask your healthcare provider about: - Other patient assistance programs - Manufacturer rebates or savings cards - State pharmaceutical assistance programs - Clinical trials - Discussing alternative treatment options with your provider ## Reauthorization and Renewal You will need to submit a new application and documentation yearly to continue receiving assistance through Lilly Cares.[6] ## Contact Information **Lilly Cares Foundation** Phone: (800) 545-6962 Website: www.lillycares.com ## Important Disclaimer This guide provides general information about the Lilly Cares Foundation Patient Assistance Program for Omvoh. Program eligibility, requirements, and benefits may change. For the most current and complete information, visit www.lillycares.com or call (800) 545-6962. This information is not a guarantee of program enrollment or medication coverage. Your healthcare provider and Lilly Cares will determine your final eligibility based on your individual circumstances.

Program information last verified: March 30, 2026