Symbyax

Indicated For

Bipolar depression, treatment-resistant depression

About This Medication

# Lilly Cares Patient Guide: How to Get Symbyax (Olanzapine/Fluoxetine) at Low or No Cost Symbyax is a prescription medication combining **olanzapine** (an antipsychotic) and **fluoxetine** (an antidepressant), used to treat conditions like bipolar depression or treatment-resistant depression in adults. The **Lilly Cares** program from Eli Lilly helps eligible patients get Symbyax at no cost if you meet income, residency, and insurance rules.[1][2] ## Who Qualifies for Lilly Cares? To join Lilly Cares for Symbyax, you must: - Be a permanent U.S. resident (including Puerto Rico and U.S. Virgin Islands).[1][2] - Have a prescription for Symbyax from your healthcare provider.[1] - Meet household income guidelines (up to 400% of the Federal Poverty Level, or higher in some cases up to $200,000 for families).[1][2] - Not be enrolled in Medicaid, full Low-Income Subsidy (LIS/Extra Help), or VA Benefits.[1][2] - Meet insurance rules for Symbyax, which is a Group 4 self-administered medication: no insurance, Medicare Part D, or Medicare Part B without supplemental coverage.[2][5] **Important:** Symbyax works alongside existing coverage if your insurance doesn't fully cover it, but check Group 4 rules.[2] ## About Symbyax Symbyax capsules treat: - Bipolar I disorder depression. - Major depressive disorder that doesn't respond to other antidepressants. It works by balancing brain chemicals like serotonin and dopamine. Common side effects include weight gain, sleepiness, dry mouth, and increased cholesterol. **Always follow your doctor's instructions** and report side effects. This guide isn't medical advice—talk to your provider about Symbyax.[1] ## Income Eligibility Breakdown Lilly Cares uses household adjusted gross income at or below **400% of the Federal Poverty Level (FPL)**. Guidelines can flex for larger families up to $200,000/year.[1][2] Here's a table for 2026 (FPL updates yearly; confirm current at application): | Household Size | Max Income (400% FPL) | |----------------|-----------------------| | 1 (Individual) | $50,000 | | 2 (Couple) | $70,000 | | 3 | ~$85,000 | | 4 | ~$100,000 | | Add ~$15,000 per extra person | Up to $200,000 possible | *Notes: Enter $0 if no income. Lilly may request proof like tax returns or pay stubs.[1] ## Insurance Requirements Lilly Cares **works alongside any existing coverage** if it doesn't cover Symbyax fully. For Group 4 meds like Symbyax: - Uninsured, Medicare Part D, or Medicare Part B (no supplemental/secondary insurance).[2][5] - **Not eligible** if on Medicaid, full LIS/Extra Help, or VA.[1][2] - Medicare Part D patients: Reapply Oct 15–Dec 31 for next year.[2][3] - Insurance verification may be needed (except Medicare Part D for self-administered meds).[1] ## Step-by-Step Application Process 1. **Check eligibility:** Review income, residency, insurance at www.lillycares.com.[2] 2. **Get application:** Online (recommended, fastest), download/print, or call 1-800-545-6962.[1][2][3] 3. **Fill patient sections:** Pages 4-7: Personal info, income, sign certifications (Patient Agreement, HIPAA).[1] 4. **Doctor completes:** Prescriber section (pages 8-9), prescription via eRx (Neovance NPI 1780811125), fax, or template.[1][2] 5. **Gather documents:** Prescription, financial proof (taxes/pay stubs), proof of residency. Insurance verification if needed.[1] 6. **Submit:** Online upload docs, fax to 1-844-431-6650, or mail to PO Box 501847, San Diego, CA 92150.[1][2] **Tip:** Online reduces delays. Doctor's office can fax.[1] ## Timeline and Delivery - **Processing:** 2-4 weeks. You'll get mail/text notice; doctor gets fax.[1][2] - If approved, meds ship to **your home** or **doctor's office** (choose on app). Pharmacy calls to schedule.[1][2] - Enrollment: Usually 12 months or end-of-year for Medicare Part D.[2] - **Refills:** Call 1-800-545-6962 or pharmacy on label (if not auto-refill). New prescription if needed.[2] - **Reauthorization:** Required yearly; reapply before expiration.[1][2] If >14 business days post-approval with no meds, call 1-800-545-6962.[2] ## Alternatives if Denied - **Appeal:** Review denial letter; fix issues (e.g., update income) and reapply.[2] - **Other programs:** Check NeedyMeds, RxAssist, or PAN Foundation for Symbyax.[5] - **Manufacturer coupons:** Eli Lilly may have savings cards (ask doctor). - **Generic options:** Fluoxetine + olanzapine separately if appropriate (discuss with provider). - **State assistance:** Local Medicaid waivers or charity clinics. - **No biosimilars** for Symbyax currently.[1] **Contact Lilly Cares** at 1-800-545-6962 for guidance.[1][2] ## Disclaimer This guide is for informational purposes based on Lilly Cares details as of 2026. Programs change—verify at www.lillycares.com or call. Not medical/financial advice. Eligibility not guaranteed. Consult your healthcare provider. Eli Lilly not liable for guide info.

Program information last verified: March 29, 2026