RYBELSUS

Indicated For

Type 2 Diabetes Mellitus

About This Medication

# Novo Nordisk Patient Assistance Program (PAP) Patient Guide: How to Get RYBELSUS (semaglutide) at Low or No Cost RYBELSUS® (semaglutide) tablets are a prescription medicine used along with diet and exercise to improve blood sugar in adults with type 2 diabetes and to reduce the risk of major cardiovascular events like heart attack, stroke, or death in adults with type 2 diabetes at high risk.[8] The **Novo Nordisk Patient Assistance Program (PAP)** offers this medication at no cost to qualifying uninsured or underinsured U.S. patients who meet strict income and eligibility criteria.[1][2] ## Who Qualifies for the Novo Nordisk PAP? The program is designed for patients struggling to afford their medications due to financial hardship. To qualify in 2026, you must meet **all** these criteria:[1][2][4] - Be a **U.S. citizen or legal resident** (proof required, such as birth certificate, passport, or green card).[4] - Have **no private prescription insurance** (e.g., HMO, PPO, or employer-sponsored plans). You cannot have or qualify for private coverage.[1][4] - **Household income at or below 300% of the Federal Poverty Level (FPL)**. This is calculated based on your total household size and income before taxes.[2][4] - If **Medicaid-eligible**, you must have applied and been denied (submit denial letter).[1][4] - **Medicare Part D enrollees**: May require a denial letter if eligible for Low-Income Subsidy (LIS). Note: Some Novo Nordisk products like Ozempic have restrictions for Medicare patients starting 2026, but RYBELSUS remains covered—confirm your status.[1][9] - Not be eligible for other government programs without denial proof.[1] **Important 2026 Update**: Check the official list of covered products, as some medicines are being removed from PAP eligibility.[1][9] RYBELSUS is confirmed as covered.[9] ## About RYBELSUS (semaglutide) RYBELSUS is an oral GLP-1 receptor agonist tablet (7 mg or 14 mg) taken once daily. It mimics a hormone that helps control blood sugar by increasing insulin release, slowing digestion, and reducing liver glucose production. Clinical studies show it lowers A1C and supports heart health in high-risk type 2 diabetes patients when combined with diet and exercise.[8] **Key Safety Notes**: - Possible side effects include nausea, stomach pain, diarrhea, vomiting, constipation, abdominal pain, headache, fatigue, dizziness, and heartburn. - Serious risks: Pancreatitis (severe abdominal pain), vision changes, low blood sugar (especially with other diabetes meds), gallbladder issues, kidney problems, allergic reactions (swelling, rash, breathing issues), and thyroid tumors (boxed warning—symptoms like neck lump or hoarseness).[8] - Do not use if you have personal/family history of medullary thyroid carcinoma or Multiple Endocrine Neoplasia syndrome type 2. Inform your doctor of pancreas/kidney issues, retinopathy, or upcoming surgery.[8] Always discuss with your healthcare provider (HCP) if RYBELSUS is right for you. ## Income Eligibility Breakdown Eligibility hinges on **total household income ≤ 300% FPL**. Use the table below for 2026 estimates (FPL adjusts annually; verify current levels at ASPE.hhs.gov or Families USA). Include all household members' income (wages, Social Security, etc.).[4] | Household Size | 100% FPL | 300% FPL (Max Eligible Income) | |---------------|----------|-------------------------------| | 1 | $15,060 | $45,180 | | 2 | $20,440 | $61,320 | | 3 | $25,820 | $77,460 | | 4 | $31,200 | $93,600 | | 5 | $36,580 | $109,740 | | +1 person | +$5,380 | +$16,140 | *Example*: A family of 3 with $75,000 annual income qualifies; $80,000 does not.[4] Alaska/Hawaii have higher thresholds—check official sources. ## Insurance Requirements - **No private insurance allowed**. If you have any commercial coverage, you do not qualify.[1][4] - **Medicare/Medicaid**: Submit denial letters if applicable. Medicare patients may face changes in 2026 for some products, but RYBELSUS is listed as covered.[1][9] - Uninsured or those who lost coverage (e.g., job loss) are prime candidates. No one from Novo Nordisk will charge fees—beware of scams.[2] ## Step-by-Step Application Process 1. **Gather Documents**: Proof of residency/citizenship, income (tax returns, pay stubs, W-2s for past year), insurance denial letters (if applicable), HCP contact info.[1][2] 2. **Complete Patient Portion**: Download or submit online at NovoCare.com/diabetes/help-with-costs/pap.html. Enter your details and HCP's email.[1] 3. **HCP Completes Their Section**: They'll verify diagnosis and prescribe (up to 120-day supply).[2][4] 4. **Submit**: Upload docs online or mail. Processing starts within 2 business days.[2] 5. **Approval Notification**: Via SMS, mail, or phone (if opted in). If approved, Neovance™ Specialty Pharmacy (1-800-488-5908) contacts your HCP.[1] No registration fees—program is free.[1][2] ## Timeline and Delivery - **Processing**: At least 2 business days after receipt.[2] - **Total Time**: 10-14 business days (up to 21 days) for delivery to your **HCP's office** (not home).[1][2] - **Supply**: 120-day free medication, subject to availability. Shipped to doctor for pickup/dispensing.[2][4] - They'll call to schedule.[1] ## Alternatives if Denied - **Reapply** with updated docs or after insurance changes.[2] - **Savings Card**: Check Rybelsus.com/savings-and-support.html for copay assistance (commercial insurance only).[8] - **Third-Party Help**: Programs like Simplefill (1-877-386-0206) match you to assistance.[6] - **Other PAPs**: State programs, NeedyMeds, or RxAssist.org. - **Generic/Biosimilars**: None widely available yet for semaglutide; monitor FDA updates.[9] - **Lifestyle/Other Meds**: Discuss metformin, SGLT2 inhibitors, or DPP-4s with your doctor. ## Disclaimer This guide is for informational purposes based on publicly available 2026 data and is not medical/financial advice. Eligibility, coverage, and program terms can change—Novo Nordisk reserves the right to modify/cancel anytime without notice.[1] Product availability varies. Always consult your HCP and verify details at NovoCare.com or by calling 1-888-693-6742. Figures approximate; use official FPL calculators. Not affiliated with Novo Nordisk.

Program information last verified: March 30, 2026