The Mounjaro Patient Assistance Program: How It Works, Who Qualifies, and How to Apply

Key Takeaways

• The Mounjaro patient assistance program is administered by the Lilly Cares Foundation, a 501(c)(3) charitable program separate from Eli Lilly's commercial operations.
• Eligibility generally requires U.S. residency, no prescription drug insurance coverage for the medication, and household income at or below 400% of the federal poverty level ($63,840 for one person and $132,000 for a family of four under the 2026 guidelines). Whether Mounjaro is on the Lilly Cares medication list in 2026 is disputed: Healthline (March 18, 2026) and NiceRx say it is not covered; rx.com (August 2026) says it is; the foundation's own site sat behind a browser check we could not pass on September 4, 2026. Confirm at lillycares.com or 1-800-545-6962 before you apply.
• If Mounjaro is on the foundation's current medication list, approved patients receive it at no cost for up to 12 months, with annual reapplication required; sources disagreed on that point in 2026, so confirm with the foundation first.
• The Mounjaro Savings Card is a separate program for commercially insured patients without coverage; it can reduce the cost to as low as $25 per month.
• Application requires a prescription, a completed Lilly Cares form signed by the patient and the prescriber, and proof of income.

The short answer

The Mounjaro patient assistance program, where it applies, is run by the Lilly Cares Foundation. Eligible patients are U.S. residents without prescription drug insurance for the medication, with household income at or below 400% of the federal poverty level ($63,840 for one person, $132,000 for four, 2026 HHS guidelines). If Mounjaro is on the foundation's current medication list, approved patients receive it at no cost for up to 12 months, with annual reapplication required; sources disagreed on that point in 2026, so confirm with the foundation first.

Table of contents

1. The 30-second answer
2. Lilly Cares Foundation: what it is and how it differs from the savings card
3. Who qualifies for the Mounjaro patient assistance program
4. The 2026 income limits explained
5. How to apply: step-by-step
6. What happens after you apply
7. The Mounjaro Savings Card: a separate program for insured patients
8. If you are denied: alternatives and appeals
9. Cost of Mounjaro without assistance
10. 2026 income limits, corrected
11. Does Lilly Cares cover Mounjaro in 2026?
12. Application checklist and timeline
13. Denied: $499 fill, card caps, samples
14. Medicare patients
15. FAQ
16. Sources
17. Footer disclaimers

Lilly Cares Foundation: what it is and how it differs from the savings card

Eli Lilly and Company runs two distinct programs to make Mounjaro more affordable.

The Lilly Cares Foundation Patient Assistance Program is a charitable program for patients who cannot afford Mounjaro and have no prescription drug insurance covering it. The foundation is a 501(c)(3) nonprofit, legally separate from Lilly's commercial business, even though Lilly funds and supports it. Whether Mounjaro is on the Lilly Cares medication list in 2026 is disputed: Healthline (March 18, 2026) and NiceRx say it is not covered; rx.com (August 2026) says it is; the foundation's own site sat behind a browser check we could not pass on September 4, 2026. Confirm at lillycares.com or 1-800-545-6962 before you apply.

The Mounjaro Savings Card is a commercial copay assistance program for patients who have commercial (private) insurance but face high copays or whose insurance does not cover Mounjaro. It is not a charity program. Eligible patients can pay as little as $25 for a 1, 2, or 3 month supply.

The two programs serve different populations:

Program	For whom	Who pays	Typical patient cost
Lilly Cares Patient Assistance	Uninsured or medication not covered, income at or below 400% FPL	Lilly Cares Foundation	$0, if Mounjaro is on the foundation's medication list (confirm first)
Mounjaro Savings Card	Commercially insured, high out-of-pocket	Lilly commercial program	As low as $25 per fill

People with government insurance (Medicare, Medicaid, Tricare, VA) are typically excluded from the Mounjaro Savings Card by federal anti-kickback rules. They may still qualify for Lilly Cares if income criteria are met and Mounjaro is not covered by their plan.

Who qualifies for the Mounjaro patient assistance program

Lilly Cares eligibility criteria, as published on the foundation's patient materials:

• U.S. resident. Citizens and lawful residents qualify. Documentation of residency is requested.
• Prescribed Mounjaro by a U.S.-licensed healthcare provider. A prescription is required to apply.
• No prescription drug insurance coverage for Mounjaro. This includes patients who are uninsured, patients whose insurance excludes Mounjaro from formulary, and Medicare Part D patients during the coverage gap (less common since the 2025 Inflation Reduction Act changes).
• Household income at or below 400% of the federal poverty level. This is the key financial criterion. See the 2026 limits in the next section.

Patients who have insurance that covers Mounjaro, even partially, are typically not eligible for Lilly Cares. The program is designed for patients with no other path to affording the medication. If you have a high copay but coverage exists, the Mounjaro Savings Card or independent foundations are the better fit.

Approval is for up to 12 months at a time. Patients reapply annually if continued assistance is needed.

The 2026 income limits explained

The 400% of federal poverty level (FPL) threshold means roughly:

Household size	100% FPL (2026)	400% FPL (Lilly Cares cutoff)
1 person	$15,960	$63,840
2 people	$21,640	$86,560
3 people	$27,320	$109,280
4 people	$33,000	$132,000
5 people	$38,680	$154,720
6 people	$44,360	$177,440

The figures above are the 2026 federal poverty guidelines published by the U.S. Department of Health and Human Services on January 15, 2026 (an earlier version of this table used the 2025 guidelines by mistake); add $5,680 per additional person at 100% and $22,720 at 400%, and note that Alaska and Hawaii use higher guidelines. The 400% multiplier is the Lilly Cares cutoff specifically. Other patient assistance programs use different multipliers (200%, 300%, 500%), so cutoffs vary by program.

Household income for Lilly Cares purposes typically includes wages, self-employment income, retirement income, Social Security, and certain investment income. SNAP, housing assistance, and similar non-cash benefits are not counted. The application asks for documentation, usually the most recent IRS Form 1040 or W-2.

A family of 4 with combined income of $120,000 falls under the $132,000 cap and would meet the income criterion. A single person with income above $63,840 would not.

Higher income patients without insurance coverage for Mounjaro are not necessarily without options. The Mounjaro Savings Card requires commercial insurance, but other paths (manufacturer cash price programs, copay foundations, or alternative therapies) may apply.

How to apply: step-by-step

The application process for the Lilly Cares Mounjaro patient assistance program:

Step 1: Confirm you have a Mounjaro prescription.

Lilly Cares requires an active prescription. If you are exploring whether Mounjaro is appropriate for you clinically, that conversation happens with your provider before you apply for assistance.

Step 2: Download or request the Lilly Cares enrollment form.

The current form is available on the Lilly Cares Foundation website (lillycares.com) or by phone request to the foundation. The form has separate sections for the patient and the prescriber.

Step 3: Patient section.

Fill out demographic information, contact details, residency status, and a household income disclosure. Sign and date.

Step 4: Income documentation.

Attach a copy of one of the following:

• Most recent IRS Form 1040 (federal tax return)
• Most recent W-2 forms for everyone in the household with income
• Recent Social Security or pension benefit statements
• A signed statement of zero income if applicable

The foundation accepts redacted Social Security numbers on tax documents.

Step 5: Prescriber section.

Take the form to your provider. The provider fills in the prescription details (medication, dose, quantity, refills) and signs. This signed form serves as both the application and the prescription for fulfillment.

Step 6: Submit the form.

Submission options:

• Fax to the number listed on the Lilly Cares form
• Mail to the Lilly Cares Foundation address listed on the form
• Some providers can submit electronically through the foundation's portal

Step 7: Wait for a decision.

The foundation typically reviews applications within 7 to 10 business days. Expect a written decision letter. Approved patients receive instructions for receiving the medication shipment.

Step 8: Receive medication.

Approved patients receive Mounjaro shipped to their home or to their provider's office, depending on the program's current logistics. Standard shipments cover 30 to 90 days at a time.

What happens after you apply

Three possible outcomes follow an application:

Approval. You receive a letter or notice confirming enrollment for up to 12 months. Medication shipments begin. You will need to reapply at the end of the 12-month period if continued assistance is needed. Renewal applications are simpler than initial ones and usually only require updated income documentation.

Request for more information. If income documentation is unclear or the form is incomplete, the foundation may request additional documents. Respond promptly to keep the application active.

Denial. If you do not meet eligibility criteria, you receive a denial letter explaining why. The most common reasons for denial:

• Household income exceeds 400% FPL
• Insurance coverage exists for Mounjaro
• Missing required documentation
• Application was not signed by the prescriber

A denial does not preclude future applications. If your circumstances change (loss of insurance, change in income), reapply.

The Mounjaro Savings Card: a separate program for insured patients

If you have commercial insurance and your insurance covers Mounjaro but with a high copay, the Mounjaro Savings Card is the right program. Key features:

• Eligibility: Commercially insured patients with type 2 diabetes (Mounjaro's FDA-approved indication). Patients on Medicare, Medicaid, Tricare, or VA coverage are excluded by anti-kickback rules.
• Cost reduction: As low as $25 for a 1, 2, or 3 month supply. Savings are capped at $150, $300 or $450 per fill, $1,950 per calendar year and 13 fills a year, and the current card expires December 31, 2026 (mounjaro.lilly.com, 08/2026).
• Application: Online enrollment at the Mounjaro savings card page, no income verification required.
• Combination rules: Cannot be combined with other discount programs.

A common point of confusion: the Mounjaro Savings Card is for diabetes patients. The companion product Zepbound (also tirzepatide, but FDA-approved for chronic weight management) has its own savings card with different terms. Patients prescribed Mounjaro off-label for weight loss may run into eligibility issues at the pharmacy.

For patients prescribed tirzepatide for weight loss specifically, the Zepbound Savings Card is usually the appropriate program. A pharmacist can confirm which card applies given the indication on the prescription.

For an in-depth treatment of cost paths, see the Mounjaro coupon overview and the Zepbound coupon guide.

If you are denied: alternatives and appeals

A denial from Lilly Cares is not the end of the cost conversation. Several alternatives exist.

Independent copay foundations. Organizations like NeedyMeds, RxAssist, the HealthWell Foundation, the Patient Access Network Foundation, and Good Days have programs that sometimes cover GLP-1 medications. Eligibility varies by program and disease state, and funding cycles open and close.

State pharmaceutical assistance programs. Some states (notably New Jersey, Pennsylvania, New York) run Senior Pharmacy Assistance Programs that may cover diabetes medications including Mounjaro for eligible older residents.

Manufacturer cash price programs. As of September 4, 2026, LillyDirect sells Zepbound KwikPen (the same molecule, labeled for weight management) for $299 at 2.5 mg, $399 at 5 mg and $449 for 7.5 mg and above when refilled within 45 days of the prior fill (otherwise $499 for 7.5 mg and $699 for 10 to 15 mg), posted through December 31, 2026. For Mounjaro itself, Lilly's savings program offers $499 for a 1-month prescription to people whose commercial insurance does not cover it. Neither is charity, but both beat the $1,112.16 list price.

Switching to compounded tirzepatide. Compounded tirzepatide ran a month-one median of $299 across 14 telehealth providers (range $149 to $470) in the Compounded GLP-1 Price Index on September 3, 2026. The clinical considerations are different (compounded medications are not FDA-approved), and the conversation with your provider is appropriate before switching.

Alternative GLP-1 medications. If Mounjaro specifically is not affordable, alternatives like semaglutide (brand or compounded) may be a workable substitute. They are different molecules with different efficacy and side effect profiles, but for many patients either one delivers meaningful clinical benefit.

Appeals. If you believe the denial was based on incorrect information (e.g., the foundation misread your income documentation), you can submit an appeal in writing with corrected documentation. The foundation reviews appeals within 30 days.

Cost of Mounjaro without assistance

For context on what the assistance program saves:

• Retail cash price: list price $1,112.16 per 4-pen fill as of January 2026, and about $1,330 at retail per GoodRx's August 25, 2026 write-up.
• With commercial insurance and Mounjaro Savings Card (eligible patients): As low as $25 per fill.
• With Lilly Cares approval: $0, provided Mounjaro is on the foundation's medication list, which sources disputed in 2026.
• Through Lilly's self-pay prices (September 4, 2026): Mounjaro $499 a month through the not-covered savings tier (commercial insurance that excludes it); Zepbound KwikPen $299 to $449 a month through LillyDirect with the 45-day refill rule.
• Medicare Part D: Mounjaro for diabetes goes through normal Part D cost sharing; the $50 Medicare GLP-1 Bridge (July 1, 2026 to December 31, 2027) covers Zepbound KwikPen, Wegovy and Foundayo, not Mounjaro.

The retail-to-assistance gap is meaningful. At about $1,330 a month retail, a patient approved by Lilly Cares saves roughly $16,000 a year, and a patient who moves to Lilly's $499 price saves roughly $10,000 a year. The Mounjaro Savings Card is capped at $1,950 a year in savings, which is enough to bring a $175 copay to $25 every month but not enough to cover a large deductible.

The cost picture has been shifting since the IRA Medicare Part D changes took effect in 2025, which capped Part D out-of-pocket spending at $2,000 in 2025 and $2,100 in 2026. The $50 Medicare GLP-1 Bridge that started July 1, 2026 sits outside that cap but excludes Mounjaro (KFF, May 11, 2026). Neither change affects Lilly Cares directly.

2026 income limits for Lilly Cares (400% of the federal poverty guidelines), corrected

The table earlier on this page was labeled 2026 but used 2025 guidelines until September 2026. These are the figures from the HHS 2026 poverty guidelines published January 15, 2026, for the 48 contiguous states and D.C.

Household size	100% FPL (2026)	400% FPL (Lilly Cares cutoff)
1	$15,960	$63,840
2	$21,640	$86,560
3	$27,320	$109,280
4	$33,000	$132,000
5	$38,680	$154,720
6	$44,360	$177,440
7	$50,040	$200,160
8	$55,720	$222,880
Each additional person	add $5,680	add $22,720

Alaska and Hawaii have separate, higher guidelines; use the HHS table for those states. The foundation counts household income, generally documented with a recent tax return, W-2s, Social Security or pension statements, or a signed statement of no income.

Does Lilly Cares cover Mounjaro in 2026? What the foundation's own documents say

This is the question most readers arrive with, and as of September 4, 2026 we cannot give a yes or no. The sources conflict. Healthline (updated March 18, 2026) and NiceRx both state that Mounjaro is not currently covered by Lilly Cares, NiceRx adding that it "may be added in the future." rx.com (August 2026) says it is covered. The foundation's website, including its medication list, sits behind a Cloudflare browser check that our tools could not pass, so we could not read the current list directly. Until you have confirmed it yourself at lillycares.com or by phone at 1-800-545-6962, treat Mounjaro coverage as unconfirmed.

What we could read is the foundation's insurance verification requirements document (PP-AP-US-0681, June 2025), which explains how Lilly Cares treats insured applicants for what it calls Group 4 medications:

• If the plan does not cover the medication at all (excluded, non-formulary, or capped at a dollar amount), the applicant must send both insurance cards, the plan's signed Summary Plan Description or Evidence of Coverage, and the plan-specific formulary.
• If the plan does cover it but denied the claim for another reason, the applicant must send both insurance cards plus the coverage denial and the denied appeal letter.
• Medicare Part D patients applying for a Group 4 self-administered product are exempt from the insurance verification requirement.
• If coverage ended in the last 60 days, a termination letter, employer letter, COBRA offer letter or limited-Medicaid documentation is required.
• Documents go by fax or mail with the application, or within 14 days of a denial letter; decisions come by mail to the patient and by fax to the prescriber.

Those rules tell you what the foundation will ask for if Mounjaro is eligible. They do not tell you whether it is. Ask before you assemble the paperwork.

Application checklist and timeline

Assuming the foundation confirms the medication is covered, this is what a complete application looks like, drawn from the foundation's verification document and the process this page already describes.

Item	Detail
Application form	Patient section and prescriber section, both signed; the prescriber section doubles as the prescription
Proof of income	Most recent federal tax return, W-2s, Social Security or pension statements, or a signed zero-income statement
Proof of residency	U.S. address; the foundation requests documentation
Insurance documents, if insured	Both insurance cards plus either the signed plan document and formulary (drug excluded) or the denial and denied-appeal letters (drug covered but denied), per the Group 4 rules above
Loss-of-coverage proof, if applicable	Termination, employer or COBRA letter dated within the last 60 days
Submission	Fax or mail; supporting documents within 14 days of any denial letter
Decision	Mailed to the patient, faxed to the prescriber; this page's experience is 7 to 10 business days once everything is in
Enrollment length	Up to 12 months, then reapply with updated income documentation

The foundation's document is explicit that incomplete or non-matching paperwork leads to denial or delay, and that submitting everything does not guarantee approval.

Denied or ineligible: the $499 Lilly fill, the 2026 savings card caps and free samples

If the foundation says no, or says Mounjaro is not on its list, these are the Lilly-published fallbacks as of September 4, 2026.

Option	Price	Conditions
Mounjaro Savings Card	As little as $25 for a 1-, 2- or 3-month fill	Commercial insurance that covers Mounjaro; savings capped at $150, $300 or $450 per fill, $1,950 per year, 13 fills per year; U.S. or Puerto Rico; 18 and up; no Medicare, Medicaid, VA or TRICARE; expires December 31, 2026
Not-covered savings tier	As low as $499 for a 1-month prescription	Commercial insurance that does not cover Mounjaro; GoodRx (August 25, 2026) quotes the card's limits as $647 a month and $8,411 a year
Free samples	$0	Four 2.5 mg single-use pens, a one-month starter, supplied to prescribers by Lilly when available; ask your prescriber (Healthline, March 18, 2026)
Zepbound KwikPen via LillyDirect	$299 (2.5 mg), $399 (5 mg), $449 (7.5 mg and up with a refill within 45 days; otherwise $499 to $699)	Weight-management prescription; through December 31, 2026
Compounded tirzepatide	Median $299 in month one, range $149 to $470 across 14 providers	FormBlends price index, September 3, 2026; FormBlends' current price is on the product page and in that index

Questions about the card go to 833-807-MJRO (833-807-6576).

Medicare patients: Part D covers Mounjaro for diabetes, the $50 Bridge does not, and the Lilly Cares Part D rule

Three Medicare facts as of September 4, 2026. First, Part D plans can cover Mounjaro for type 2 diabetes under normal formulary rules, with a $2,100 out-of-pocket cap for 2026. Second, the Medicare GLP-1 Bridge that runs from July 1, 2026 through December 31, 2027 offers Wegovy, Zepbound KwikPen and Foundayo for $50 a month with prior authorization, and Mounjaro is not among them (KFF, May 11, 2026); a Medicare patient who wants tirzepatide for weight management should ask about Zepbound KwikPen under the Bridge. Third, the Lilly Cares verification document exempts Medicare Part D patients who apply for a Group 4 self-administered product from the insurance verification paperwork, which is the foundation's way of saying Part D enrollees are not shut out the way they are from the commercial savings card. Whether Mounjaro is currently a Lilly Cares product remains the open question above.

FAQ

What is the Mounjaro patient assistance program?

A charitable program run by the Lilly Cares Foundation that provides Lilly medications at no cost to U.S. patients without prescription drug insurance for them and with household income at or below 400% of the federal poverty level ($63,840 for one person in 2026). Approval is for up to 12 months at a time. Whether Mounjaro is currently on the foundation's list is disputed between sources in 2026, so confirm with the foundation before applying.

How do I apply for Mounjaro patient assistance?

Download the Lilly Cares enrollment form from lillycares.com, complete the patient section, attach income documentation (typically your most recent IRS Form 1040), have your provider complete the prescriber section, and submit by fax, mail, or electronic portal. Decisions typically come within 7 to 10 business days.

Who qualifies for the Lilly Cares program?

U.S. residents with a Mounjaro prescription, no prescription drug insurance covering Mounjaro, and household income at or below 400% of the federal poverty level. The 400% FPL cutoff is $63,840 for a single person and $132,000 for a family of four under the 2026 HHS guidelines.

Is the Mounjaro Savings Card the same as patient assistance?

No. The savings card is a copay assistance program for commercially insured patients. The Lilly Cares program is a charitable program for uninsured or no-coverage patients. They serve different populations and have different rules.

Can Medicare patients use Mounjaro patient assistance?

Sometimes. Medicare patients are excluded from the commercial Mounjaro Savings Card by anti-kickback rules. They may still qualify for Lilly Cares if their plan does not cover Mounjaro and their income falls under 400% FPL.

How long does Lilly Cares enrollment last?

Up to 12 months per approval. Patients reapply annually if continued assistance is needed. Renewal applications are simpler than initial ones.

What if I am denied for Mounjaro patient assistance?

Consider independent copay foundations (NeedyMeds, RxAssist, HealthWell, PAN Foundation), state pharmaceutical assistance programs, manufacturer cash price programs (LillyDirect for Zepbound), or alternative therapies including compounded tirzepatide or semaglutide. You can also appeal a denial in writing with corrected documentation.

Does the program cover Mounjaro for weight loss?

Only if Mounjaro is on the foundation's medication list at all, which Healthline (March 18, 2026) and NiceRx say it is not and rx.com (August 2026) says it is; we could not settle it against lillycares.com on September 4, 2026. Lilly's commercial programs are diabetes-only for Mounjaro. For tirzepatide prescribed for weight management the product is Zepbound, which has its own savings card and LillyDirect pricing.

Can I get Mounjaro patient assistance if I have a high-deductible plan?

A high-deductible plan that covers Mounjaro is still insurance coverage for purposes of Lilly Cares eligibility. The assistance program is for patients with no coverage, not for patients with high cost-sharing. The Mounjaro Savings Card is the more relevant program for that scenario.

How much money will Mounjaro patient assistance save me?

Mounjaro's list price is $1,112.16 per 4-pen fill (January 2026) and retail runs about $1,330 per GoodRx (August 2026). Lilly Cares approval would reduce that to $0, roughly $16,000 a year, if Mounjaro is on the foundation's list; confirm that first. The next-best fallbacks are Lilly's $499 price and compounded tirzepatide at a $299 median (FormBlends price index, September 3, 2026).

What income documents does Lilly Cares accept?

Most recent IRS Form 1040, W-2 forms for household income earners, Social Security benefit statements, pension statements, or a signed statement of zero income. Redacted Social Security numbers on tax documents are accepted.

Is the program available to international residents?

No. Lilly Cares is for U.S. residents only. International patients should check the manufacturer's regional patient assistance programs in their country, which operate separately.

Does Eli Lilly have a patient assistance program for Mounjaro?

Eli Lilly funds the Lilly Cares Foundation, a 501(c)(3) that supplies certain Lilly medicines free to U.S. patients with household income at or below 400% of the poverty level ($63,840 for one person in 2026). Whether Mounjaro is on the foundation's list in 2026 is disputed: Healthline (March 18, 2026) and NiceRx say no, rx.com (August 2026) says yes. Confirm at lillycares.com or 1-800-545-6962 before applying.

Does Mounjaro have a patient assistance program for Medicare patients?

Medicare enrollees are excluded from the commercial Mounjaro Savings Card, but the Lilly Cares verification document explicitly exempts Medicare Part D patients applying for a Group 4 self-administered product from its insurance paperwork, so Part D patients can apply if the medication is on the foundation's list and income is at or below 400% FPL. The $50 Medicare GLP-1 Bridge (from July 1, 2026) covers Zepbound KwikPen, not Mounjaro (KFF, May 11, 2026).

How long does Mounjaro patient assistance take?

In this page's experience, 7 to 10 business days once the foundation has a complete application, with the decision mailed to you and faxed to your prescriber. The foundation's own verification document warns that missing or mismatched documents cause denial or delay, and asks for supporting paperwork within 14 days of any denial letter. Approval, when granted, lasts up to 12 months before reapplication.

My insurance denied Mounjaro; can I get it through patient assistance?

Possibly. Lilly Cares treats an insured applicant two ways: if the plan excludes the drug entirely, you send both insurance cards, the signed plan document and the formulary; if the plan covers it but denied you, you send the denial letter and the denied appeal letter. Income must be at or below 400% FPL. Whether Mounjaro is on the list must be confirmed with the foundation first, and Lilly's $499 not-covered price is the fallback.

Related guides

• How Mounjaro's Patient Assistance Program Works in 2026: Eligibility, Application Process, and What to Do If You Don't Qualify
• Mounjaro Patient Assistance Program: The Complete Protocol to Get Tirzepatide for $25 Per Month (or Free if You Qualify)
• What Is Zepbound For? The FDA-Approved Indications, How Tirzepatide Works, and Who Actually Qualifies
• How to Get Zepbound for $25: Every Legitimate Path to the Savings Card, Patient Assistance, and Compounded Alternatives
• Can Anyone Take Ozempic? FDA Approvals, Off-Label Use, and Who Actually Qualifies
• Who Qualifies for Ozempic: The FDA-Approved Criteria, Off-Label Prescribing Standards, and What Actually Gets Covered

Sources

1. Lilly Cares Foundation. Patient Assistance Program eligibility and enrollment materials. Accessed 2026.
2. U.S. Department of Health and Human Services, ASPE. 2026 poverty guidelines, January 15, 2026. https://aspe.hhs.gov/poverty-guidelines
3. Eli Lilly and Company. Mounjaro (tirzepatide) prescribing information, revised 08/2026. https://pi.lilly.com/us/mounjaro-uspi.pdf
4. U.S. Food and Drug Administration. Mounjaro (tirzepatide) approval letter and label. 2022.
5. Inflation Reduction Act of 2022, Public Law 117-169, Medicare Part D out-of-pocket cap provisions.
6. Centers for Medicare and Medicaid Services. Anti-kickback statute and prescription drug copay assistance guidance.
7. NeedyMeds. Patient assistance program directory. Accessed 2026.
8. Frias JP, et al. Tirzepatide versus Semaglutide Once Weekly in Patients with Type 2 Diabetes (SURPASS-2). N Engl J Med. 2021;385:503-515.
9. U.S. Department of Health and Human Services, ASPE. 2026 poverty guidelines, January 15, 2026. https://aspe.hhs.gov/poverty-guidelines
10. Lilly Cares Foundation. Insurance verification requirements (PP-AP-US-0681, June 2025), seen September 4, 2026. https://www.lillycares.com/assets/pdf/insuranceverification.pdf
11. Healthline. Does Mounjaro offer a patient assistance program, updated March 18, 2026. https://www.healthline.com/health/drugs/mounjaro-patient-assistance-program
12. NiceRx. Mounjaro patient assistance program, seen September 4, 2026. https://www.nicerx.com/blog/mounjaro-patient-assistance-program/
13. Eli Lilly. Mounjaro savings and coverage (card caps, $499 not-covered price), 08/2026, seen September 4, 2026. https://mounjaro.lilly.com/savings-coverage
14. GoodRx. How much is Mounjaro without insurance (list price, retail, not-covered card caps), August 25, 2026. https://www.goodrx.com/mounjaro/how-much-is-mounjaro-without-insurance
15. Eli Lilly. Zepbound coverage and savings (KwikPen self-pay prices), seen September 4, 2026. https://zepbound.lilly.com/coverage-savings
16. KFF. What to know about the BALANCE model and the Medicare GLP-1 Bridge, May 11, 2026. https://www.kff.org/medicare/what-to-know-about-the-balance-model-for-glp-1s-in-medicare-and-medicaid/
17. FormBlends. Compounded GLP-1 Price Index, data as of September 3, 2026. https://formblends.com/report/data/compounded-glp1-price-index

Footer disclaimers

Platform Disclaimer. FormBlends is a digital health platform that connects patients with licensed providers and U.S.-based pharmacies. We do not manufacture, prescribe, or dispense medication directly. All clinical decisions are made by independent licensed providers.

Compounded Medication Notice. Compounded semaglutide and tirzepatide are not FDA-approved. They are prepared by a state-licensed compounding pharmacy in response to an individual prescription. Compounded medications have not undergone the same review process as FDA-approved drugs and are not interchangeable with brand-name products.

Results Disclaimer. Individual results vary. Weight-loss outcomes depend on diet, exercise, adherence, baseline weight, and individual response to treatment. Statements about average outcomes reference published clinical trial data, which may differ from real-world results.

Trademark Notice. Mounjaro, Zepbound, and LillyDirect are registered trademarks of Eli Lilly and Company. FormBlends is not affiliated with, endorsed by, or sponsored by Eli Lilly or the Lilly Cares Foundation.