Xultophy 100/3.6

Indicated For

type 2 diabetes

About This Medication

# Novo Nordisk Patient Assistance Program Patient Guide: How to Get Xultophy 100/3.6 (insulin degludec and liraglutide) at Low or No Cost Xultophy 100/3.6 is a once-daily injectable combination of insulin degludec (a long-acting basal insulin) and liraglutide (a GLP-1 receptor agonist) used to improve blood sugar control in adults with type 2 diabetes when diet and exercise alone are not enough.[3][6] The **Novo Nordisk Patient Assistance Program (PAP)** offers this medication **at no cost** to eligible patients, with no registration fees or monthly charges.[1][2][3] ## About Xultophy 100/3.6 **Xultophy 100/3.6** combines two proven diabetes treatments in one pre-filled pen for convenient daily dosing. Insulin degludec provides steady, long-lasting blood sugar control (up to 42 hours), while liraglutide helps stimulate insulin release, slow digestion, and reduce appetite. Clinical studies show it lowers A1C more effectively than either component alone, with a lower risk of low blood sugar compared to other insulins. Always follow your doctor's instructions for injection sites (abdomen, thigh, or upper arm) and storage (room temperature for up to 21 days after opening).[3][6][9] Common side effects include nausea, diarrhea, injection site reactions, and low blood sugar (hypoglycemia)—monitor closely and report severe symptoms like pancreatitis signs to your doctor. Xultophy is not for type 1 diabetes or diabetic ketoacidosis.[3] ## Who Qualifies for the Program? The Novo Nordisk PAP helps patients facing financial barriers access vital diabetes medications like Xultophy 100/3.6 free of charge. Key requirements include: - **U.S. citizenship or legal residency**.[6] - **No private insurance** (HMO, PPO, etc.), VA benefits, or government programs like Medicaid (uninsured patients must provide a Medicaid denial letter).[2][7][8] - **Income at or below program limits** (see table below).[6][7] - **Valid prescription** from a licensed U.S. healthcare provider.[3] **Medicare Part D patients**: Recent changes mean you're no longer required to spend $1,000 out-of-pocket, but eligibility may be limited—check current rules as some products like Ozempic have restrictions.[2][7] ## Income Eligibility Breakdown Eligibility is based on **total household income** (before taxes) compared to the **Federal Poverty Level (FPL)**. For 2026, thresholds have tightened: | Household Size | Max Income (Uninsured) | Notes | |---------------|-------------------------|-------| | 1 (Individual) | ≤200% FPL (~$30,120) | Must include Medicaid denial [7] | | 2 (Couple) | ≤200% FPL (~$40,880) | Adjusted annually; verify current FPL [6][7] | | 3 | ≤200% FPL (~$51,640) | Household includes all residents [6] | | 4 | ≤200% FPL (~$62,400) | Add ~$10,760 per additional member [7] | *Notes: Older sources cite 400% FPL (~$60,240 individual), but 2026 updates prioritize lowest-income uninsured at 200% FPL. Medicare rules vary. Use NeedyMeds or official FPL charts for exact 2026 figures, as specific thresholds aren't detailed here.*[6][7][8] ## Insurance Requirements - **Must be uninsured** or meet Medicare exceptions (no $1,000 spend requirement anymore).[1][2][7][8] - **No coverage** from Medicare Part D (with limits), Medicaid, VA, or private plans.[8] - Provide **insurance status verification** and Medicaid denial if applicable.[7] If insured, explore NovoCare savings cards or other options at novocare.com.[4] ## Step-by-Step Application Process **Effective February 23, 2026, applications are ONLINE ONLY**—no paper forms.[5] Here's how: 1. **Get Prescribed**: Ask your doctor for Xultophy 100/3.6. They ePrescribe to **Neovance Specialty Pharmacy (NPI 1780811125)** or fax/call 1-800-488-5908 if issues.[2] 2. **Gather Documents**: - Proof of income (tax returns, pay stubs, W-2s). - Proof of residency (utility bill, lease). - Prescription. - Insurance verification (none) + Medicaid denial letter.[3][7] 3. **Apply Online**: Visit novocare.com/diabetes/help-with-costs/pap.html. Complete patient section (new or re-enrollment).[2][3] 4. **Submit**: Doctor handles HCP portion; call **(866) 310-7549** (M-F 8am-8pm ET) for help. Fax: 866-441-4190.[3] 5. **Wait for Approval**: Processed in ~**2 business days**.[program details] ## Timeline and Delivery - **Processing**: 2 business days after complete submission.[program details] - **Approval Duration**: 12 months for uninsured; benefit year for Medicare Part D.[2] - **Delivery**: Free **120-day supply** shipped to your **doctor's office** or home. **Automatic refills** while eligible—no action needed.[2][3][9] - **Reauthorization**: Renew annually (Medicare after Oct 15, 2026). Use refill form if changing meds.[2][9] ## Alternatives if Denied - **Appeal**: Contact (866) 310-7549 to review denial reasons (e.g., income, insurance).[3] - **Other Programs**: Check Partnership for Prescription Assistance, NeedyMeds, or state aid. - **Savings Options**: NovoCare cards for insured patients; 340B hospitals; generic insulins (note: unbranded insulins excluded).[4][7] - **Biosimilars**: None listed for Xultophy.[program details] - **Doctor Samples** or patient assistance from clinics. ## Important Disclaimer This guide is for informational purposes only and based on available 2026 data—**rules change**. Novo Nordisk can **modify or cancel the PAP anytime** without notice. Product availability not guaranteed. Always verify eligibility at novocare.com or by phone. Not medical advice—consult your healthcare provider. Income/FPL figures approximate; use official sources. ©2026 patient-friendly summary; not affiliated with Novo Nordisk.[1][2][3][5][7] (Word count: 1028)

Program information last verified: March 30, 2026