Verzenio

Lilly Cares Foundation Patient Guide: How to Get Verzenio at Low or No Cost

About This Program

The Lilly Cares Foundation Patient Assistance Program helps eligible patients access Verzenio (abemaciclib) and other Eli Lilly medications at no cost or reduced cost. If you've been prescribed Verzenio but are struggling with the cost, this program may be able to help you get your medication for free.

Who Can Apply?

To qualify for Lilly Cares, you must meet all of the following requirements:

• Be a permanent resident of the United States (including Puerto Rico and U.S. Virgin Islands)
• Have a valid prescription for Verzenio from your healthcare provider
• Meet the income guidelines for your household size
• Meet the insurance requirements (see details below)
• Not be enrolled in Medicaid or full Low Income Subsidy (LIS/"Extra Help") benefits

Income Eligibility

Your household income must be at or below 400% of the Federal Poverty Level (FPL). Use the table below to see if you qualify based on your household size:

If your household is larger than 4 people, contact Lilly Cares at (800) 545-6962 to determine your income limit.

Insurance Requirements

You must be one of the following:

• Uninsured (no health insurance coverage)
• Underinsured (have insurance but it doesn't cover Verzenio adequately)
• Medicare patient with limited prescription drug coverage

You cannot be enrolled in:

• Medicaid
• Full Low Income Subsidy (LIS/"Extra Help")
• Veterans (VA) Benefits

If you have Medicare Part D coverage, you may still qualify depending on your specific plan. Contact Lilly Cares to confirm your eligibility.

How to Apply: Step-by-Step

Step 1: Choose Your Application Method

You can apply in three ways:

1. Online application (recommended) — Fastest option with less paperwork and fewer delays
2. Download and print — Fill out by hand, then mail or fax
3. Download and fill digitally — Complete on your computer, then print and mail or fax

Visit https://www.lillycares.com/apply to access the online application or download forms. You can also request an application by calling (800) 545-6962.

Step 2: Gather Required Documents

Before starting your application, collect the following:

• Proof of income — Recent tax return, pay stubs, or benefit statements
• Proof of residency — Utility bill, lease agreement, or government ID
• Current prescription — Your Verzenio prescription from your doctor
• Insurance information — Details about your current coverage (or confirmation you're uninsured)

Step 3: Complete the Patient Section

Fill out all patient information including:

• Your full name and date of birth
• Current address and contact information
• Household income and family size
• Insurance status and details
• Your signature

Step 4: Have Your Doctor Complete the Prescriber Section

Your healthcare provider must:

• Verify that Verzenio is medically necessary for you
• Confirm the prescription details
• Sign and date the form
• Submit the prescription

Give your doctor the prescriber section of the application. They can submit it along with your completed application.

Step 5: Submit Your Application

Online submission (fastest):

• Complete and submit through the online portal at https://www.lillycares.com/apply
• Upload copies of your supporting documents

Mail submission:

• Mail your completed application and documents to:
  • Lilly Cares Patient Assistance Program
  • PO Box 501847
  • San Diego, CA 92150

Fax submission:

• Fax to the number provided on the application form

Timeline and What to Expect

Processing Time

Lilly Cares typically reviews applications within 2-4 weeks. You will receive notification by:

• Mail — Enrollment decision letter
• Text message — If you provided a phone number
• Fax — Your healthcare provider will receive notification

After Approval

If approved, your enrollment notification letter will include:

• Your enrollment start date
• When your enrollment expires (typically 12 months or end of calendar year for Medicare Part D patients)
• Instructions for receiving your medication

Your Verzenio will be shipped to your healthcare provider's office or your home. Lilly Cares' pharmacy partner will contact you to schedule delivery if needed.

If Your Application Is Denied

If you don't qualify, the denial letter will explain why. Common reasons include:

• Income exceeds the 400% FPL limit
• You have insurance that covers Verzenio
• Missing or incomplete documentation
• You're enrolled in Medicaid or other government benefits

If denied, ask about:

• Whether you can reapply if your circumstances change
• Other patient assistance programs
• Manufacturer discounts or copay cards
• State pharmaceutical assistance programs

Reauthorization and Refills

Annual Reauthorization Required

Your enrollment in Lilly Cares is not permanent. You must reapply each year to continue receiving free Verzenio.

For Medicare Part D patients: You can begin reapplying on October 15 for the upcoming year. Lilly Cares encourages reapplication by December 31.

For other patients: Contact Lilly Cares to learn when you should reapply based on your enrollment end date.

Refill Process

Once enrolled, refills are handled automatically through Lilly Cares' pharmacy partner. You do not need to reapply for each refill—only for annual reauthorization.

Important Information

No Fees for Assistance

The Lilly Cares Foundation does not charge any fees for:

• Help with enrollment
• Medication refills
• Program participation

Beware of third-party services that charge fees for assistance that Lilly Cares provides free. Lilly Cares is not affiliated with these services.

Contact Information

For questions or support:

• Phone: (800) 545-6962
• Website: https://www.lillycares.com
• Mailing Address: Lilly Cares Patient Assistance Program, PO Box 501847, San Diego, CA 92150

Disclaimer

This guide provides general information about the Lilly Cares Foundation Patient Assistance Program. Program eligibility, requirements, and benefits may change. For the most current and complete information, visit https://www.lillycares.com or call (800) 545-6962. Always consult with your healthcare provider about your treatment options and medication access.