Zyprexa Relprevv

Indicated For

schizophrenia

About This Medication

# Lilly Cares Patient Guide: How to Get Zyprexa Relprevv at Low or No Cost ## About This Program Lilly Cares is a patient assistance program administered by Eli Lilly and Company that provides eligible patients with Zyprexa Relprevv (olanzapine pamoate) at no cost. Zyprexa Relprevv is an extended-release injectable suspension used to treat schizophrenia and bipolar disorder. This guide explains how to apply, what to expect, and answers common questions about the program. ## Who Qualifies for Lilly Cares? To be eligible for Lilly Cares assistance with Zyprexa Relprevv, you must meet the following requirements: - Be a permanent resident of the United States (including Puerto Rico and the U.S. Virgin Islands) - Have a healthcare provider who has prescribed Zyprexa Relprevv - Meet specific insurance requirements (see below) ## Insurance Requirements You are eligible for Lilly Cares if you meet one of these conditions: - You are **uninsured** (have no health insurance coverage) - You have **Medicare Part D** coverage - Your current insurance **does not cover** Zyprexa Relprevv You are **not eligible** if you are enrolled in: - Medicaid - Full Low Income Subsidy (LIS, also called "Extra Help") - Veterans (VA) Benefits ## Income Eligibility Lilly Cares does not publish specific income thresholds for Zyprexa Relprevv assistance. However, the program is designed to help patients who cannot afford their medications. Your healthcare provider and the program staff can discuss your financial situation during the application process to determine eligibility. ## About Zyprexa Relprevv Zyprexa Relprevv is an extended-release injectable form of olanzapine, an antipsychotic medication. Unlike daily oral tablets, Zyprexa Relprevv is administered as an injection at a healthcare facility, typically every 2-4 weeks. This formulation helps ensure consistent medication levels and may improve treatment adherence for patients with schizophrenia or bipolar disorder. ## How to Apply for Lilly Cares ### Step 1: Request or Download the Application You can obtain the Lilly Cares application in three ways: - **Call** 1-800-545-6962 and ask to have an application mailed to you - **Download** the application from the Lilly Cares website and print it - **Complete** an online application directly on the Lilly Cares website The online application is recommended because it reduces paperwork and potential delays. ### Step 2: Complete Your Section Fill out all patient sections of the application, including: - Your personal information (name, date of birth, contact details) - Your insurance status and coverage information - Your income information - Proof of residency Sign and date the application where indicated. ### Step 3: Provide Required Documents Gather and attach the following to your application: - Proof of income (such as recent tax returns, pay stubs, or benefit statements) - Insurance documentation (if applicable) - Any other financial documents requested ### Step 4: Have Your Healthcare Provider Complete Their Section Your prescribing doctor or healthcare facility must: - Complete the healthcare provider section of the application - Sign the application and provide their contact information - Submit a current prescription for Zyprexa Relprevv - Confirm that you have received a Medication Guide and been informed about the risks of Zyprexa Relprevv Your healthcare provider can submit the prescription by: - **Electronic prescription**: Selecting Neovance Specialty Pharmacy (NPI 1780811125) in their eRx software - **Fax**: Sending to 1-844-431-6650 - **Phone**: Calling 1-800-545-6962 ### Step 5: Submit Your Application Submit your completed application and documents using one of these methods: - **Online**: Complete the online application on the Lilly Cares website - **Mail**: Send to Lilly Cares Patient Assistance Program, PO Box 501847, San Diego, CA 92150 - **Fax**: Fax to 1-844-431-6650 ## Timeline and Delivery **Processing Time**: Applications typically take 2-4 weeks to process. If you haven't received your medication or heard from the program within 14 business days of approval, contact Lilly Cares at 1-800-545-6962. **Medication Delivery**: Once approved, Zyprexa Relprevv is sent to your healthcare provider's office or facility within 4 weeks. Your healthcare provider will administer the injections at their facility. **Supply**: You receive up to a 120-day supply with each approval. ## Refills and Reauthorization **Refill Process**: A refill/reorder form is included with each shipment. Your healthcare provider must complete and return this form to receive the next shipment. **Annual Reauthorization**: Lilly Cares enrollment lasts for 12 months. After 12 months, you must reapply with updated financial documentation to continue receiving assistance. **Medicare Part D Patients**: If you have Medicare Part D, you can begin reapplying for the upcoming year starting October 15. You are encouraged to reapply by December 31. ## What If Your Application Is Denied? If your application is denied, contact Lilly Cares at 1-800-545-6962 to: - Understand the reason for denial - Ask if you can reapply with additional information - Discuss alternative options or resources - Learn about other assistance programs that may help ## Changing Healthcare Providers If you change doctors or healthcare facilities while enrolled in Lilly Cares: - Your new healthcare provider must submit the "Healthcare Provider" section of the application - They must include a signed consent form - They must submit a new prescription for Zyprexa Relprevv - Contact Lilly Cares at 1-800-545-6962 for guidance ## Important Reminders - Keep your contact information current with Lilly Cares - Notify the program if your insurance status changes - Plan ahead for reauthorization before your 12-month enrollment period ends - Contact Lilly Cares immediately if you have questions about your prescription or shipment ## Contact Information **Lilly Cares Patient Assistance Program** - Phone: 1-800-545-6962 - Fax: 1-844-431-6650 - Mailing Address: PO Box 501847, San Diego, CA 92150 - Website: lillycares.com ## Disclaimer This guide provides general information about the Lilly Cares program for Zyprexa Relprevv. Program eligibility, requirements, and procedures may change. For the most current and complete information, visit the official Lilly Cares website or contact the program directly. This information is not a guarantee of eligibility or approval. Always consult with your healthcare provider about your treatment options and medication assistance programs.

Program information last verified: March 30, 2026