Sarafem

Indicated For

Premenstrual Dysphoric Disorder (PMDD)

About This Medication

# Lilly Cares Patient Guide: How to Get Sarafem (fluoxetine) at Low or No Cost Sarafem (fluoxetine hydrochloride) is a brand-name prescription medication manufactured by Eli Lilly and Company, primarily used to treat premenstrual dysphoric disorder (PMDD), a severe form of premenstrual syndrome (PMS) that causes emotional and physical symptoms.[1][2] The **Lilly Cares Foundation Patient Assistance Program** offers this and other Lilly medications **completely free** for up to 12 months to eligible U.S. patients facing financial hardship, helping over one million people in the past 20 years.[1][2] ## About Sarafem and Why Assistance Matters Sarafem contains **fluoxetine**, a selective serotonin reuptake inhibitor (SSRI) antidepressant that helps balance brain chemicals to reduce PMDD symptoms like severe mood swings, irritability, depression, bloating, and breast tenderness.[2] Without insurance or with high costs, a month's supply can be expensive—often over $100 or more depending on dosage (typically 20 mg capsules taken daily or during the luteal phase of the menstrual cycle).[8] The Lilly Cares program eliminates this barrier by providing the medication at **no cost** if you qualify, shipped directly to your doctor's office.[1][3][6] This guide explains eligibility, how to apply, and next steps in simple terms. Always consult your doctor before starting or changing medications. ## Who Qualifies for Lilly Cares? To join, you must meet **all** these criteria:[1][2][3] - Be a **permanent legal resident** of the U.S., Puerto Rico, or U.S. Virgin Islands. - Have a valid prescription for Sarafem (fluoxetine) from a U.S. healthcare provider. - Have **household income** below program limits (detailed below). - Be **uninsured** or have Medicare Part D (with limits—see insurance section). - **Not** be enrolled in Medicaid, full Medicare Low-Income Subsidy (LIS/Extra Help), or VA Benefits. The program groups medications into tiers with different income limits based on the **Federal Poverty Level (FPL)**. Sarafem (fluoxetine) falls under Lilly's eligible products; confirm your specific tier via lillycares.com as it may be Group 1, 2, or 3 (typically Group 1 or 2 for SSRIs).[2][9] ## Income Eligibility Breakdown Eligibility is based on your **total household adjusted gross income** (from your most recent tax return or pay stubs). Limits are **300-500% of FPL** depending on the medication group and household size. Here's a table for 2026 FPL estimates (actuals update yearly; check lillycares.com for exact figures).[2] | Household Size | Group 1 (300% FPL) | Group 2 (400% FPL) | Group 3 (500% FPL) | |----------------|--------------------|--------------------|--------------------| | 1 (Individual) | ~$45,180 | ~$60,240 | ~$75,300 | | 2 (Couple) | ~$61,320 | ~$81,760 | ~$102,200 | | 3 | ~$77,460 | ~$103,280 | ~$129,100 | | 4 | ~$93,600 | ~$124,800 | ~$156,000 | *Add ~$16,140 per extra person for 300% FPL, ~$21,520 for 400%, ~$26,900 for 500%. These are approximate; use the official FPL calculator on the application.[2][3]* **Notes:** Income includes wages, Social Security, etc. Assets are not counted, but provide proof like tax returns.[2] ## Insurance Requirements - **Uninsured preferred:** No prescription drug coverage at all.[2][3] - **Medicare Part D:** Possible if you're spending **4% or more of gross annual income** on prescriptions. Enrollment lasts through the calendar year end; reapply annually.[2] - **Ineligible if:** You have Medicaid, full Extra Help/LIS, VA coverage, or any insurance paying for prescriptions.[3] If you have insurance but hit high out-of-pocket costs, explore Medicare's Extra Help first (income ~150% FPL).[8] ## Step-by-Step Application Process 1. **Get your prescription:** Ask your doctor to prescribe Sarafem and confirm it's Lilly-eligible (most fluoxetine brands are).[1][9] 2. **Gather documents:** Proof of income (tax return, W-2, pay stubs, SSI letter), photo ID, proof of residency, prescription details.[3][4] 3. **Apply online (recommended):** Visit www.lillycares.com, create an account, fill out the form, upload docs electronically. Faster and less paperwork.[1][3][4] 4. **Or download/print:** Get the PDF from lillycares.com, have your **doctor complete their section** (confirm diagnosis, prescription).[3] 5. **Submit prescription:** Doctor sends e-prescription to Neovance Specialty Pharmacy (NPI 1780811125) or faxes to 1-844-431-6650.[3] 6. **Mail if needed:** PO Box 230999, Centerville, VA 20120, or call 1-800-545-6962 for help/faxed app.[6] Your doctor signs off; you authorize info sharing for processing.[3] ## Timeline and Delivery - **Processing:** 4 weeks after receiving a complete application (faster online).[6] - **Approval notice:** Mailed or via portal. - **Delivery:** Medication shipped **free to your doctor's office** (up to 12 months supply).[1][3][6] Pick up there; doctor dispenses. - **Refills:** Automatic while eligible; reapply after 12 months.[2] ## Alternatives if Denied or Ineligible - **Reapply:** Fix issues (e.g., update income) and resubmit.[2] - **Medicare Extra Help:** For Part D users; covers copays if low-income.[8] - **GoodRx coupons:** Discount Sarafem at pharmacies (not free).[8] - **State programs:** Check Medicare's tool for Pharmaceutical Assistance Programs.[8] - **Generic fluoxetine:** Cheaper alternative; ask your doctor.[2] - **Simplefill or Advocate My Meds:** Third-party help, but may charge fees.[2][7] No biosimilars for Sarafem noted.[ ] ## Important Disclaimer This guide is for informational purposes based on publicly available data as of 2026. Eligibility, FPL, and rules change; **always verify at www.lillycares.com or call 1-800-545-6962**.[1][6] Lilly Cares may share your info with pharmacies/providers for processing.[3] Not legal/medical advice—consult professionals. Program availability not guaranteed; supplies limited.[1]

Program information last verified: March 30, 2026