Every manufacturer patient assistance program asks the same basic question — does your household income fall below a set percentage of the federal poverty level — but the percentage itself is different for almost every company, and sometimes different for every drug within the same company's portfolio.
That inconsistency is the single biggest reason patients get discouraged and stop applying. Someone denied by NovoCare's Ozempic tier might not realize they'd sail through Sanofi's insulin program with the same income. This guide puts the actual 2026 numbers side by side so you can see where you stand before spending hours on paperwork for a program you don't qualify for.
One note before the table: income limits are not the only requirement. Every program listed here also requires you to be uninsured, underinsured, or lacking adequate coverage for the specific drug. Meeting the income threshold with full commercial insurance that already covers the medication generally won't get you approved.
Table of Contents
- 2026 Income Limits: Side-by-Side Comparison
- What "% of FPL" Actually Means in Dollars
- Program-by-Program Breakdown
- Medicare-Specific Rules Across Programs
- Decision Tree: Which Program Might Fit You?
- How to Confirm the Current Number Before You Apply
- What Happens If You're Slightly Over the Limit
- Frequently Asked Questions
2026 Income Limits: Side-by-Side Comparison
This is the core table. Figures reflect each manufacturer's own published 2026 guidance where available. Where a program uses different limits by drug category, all published tiers are shown.
| Program | Manufacturer | 2026 Income Limit | Medicare-Specific Rule | Notes |
|---|---|---|---|---|
| Lilly Cares Foundation | Eli Lilly | ~300%–400% FPL (commonly cited) | Reviewed case-by-case; not automatically excluded | Less granular public detail than other four; confirm directly |
| NovoCare PAP | Novo Nordisk | ~200% FPL (Ozempic, uninsured) / up to 400% FPL (other drugs) | ~150% FPL; must not qualify for Extra Help | Threshold varies significantly by specific medication |
| Sanofi Patient Connection | Sanofi | ≤400% FPL | Must show no Part D access to the drug and no Extra Help enrollment | Applies to the main uninsured-patient assistance track |
| AZ&Me (AstraZeneca) | AstraZeneca | ≤300% FPL (Primary/Specialty) / ≤500% FPL (Rare Disease) | Must not be eligible for or enrolled in Extra Help (LIS) | Effective limits confirmed unchanged for 2026 as of Jan 26, 2026 |
| Pfizer RxPathways PAP | Pfizer | ≤300% FPL | Government-insured patients (Medicare/Medicaid/TRICARE/VA) may qualify; commercially insured patients are not eligible | Single flat threshold applies to all PAP products as of 2026 |
Lilly Cares publishes less specific public income detail than the other four programs in this comparison. The 300–400% FPL range shown above reflects how it's commonly described by third-party guides rather than a single figure Lilly states plainly for every product. If Mounjaro or another Lilly medication is what you're applying for, call the foundation directly or check the current application form for the exact number tied to that drug.
What "% of FPL" Actually Means in Dollars
The Federal Poverty Level is a dollar figure set annually by the Department of Health and Human Services, adjusted for household size. Programs describe their income cutoff as a multiple of that figure — 300% FPL, 400% FPL, and so on — rather than a flat dollar number, because the underlying guideline changes every year.
| Household Size | Approx. 200% FPL | Approx. 300% FPL | Approx. 400% FPL |
|---|---|---|---|
| 1 person | ~$31,200 | ~$46,800 | ~$62,400 |
| 4 people | ~$64,400 | ~$96,600 | ~$128,600 |
These are approximations for the lower 48 states and D.C. only. Alaska and Hawaii use higher baseline guidelines, so the same percentage translates to a higher dollar figure in those states. Every program in this comparison publishes its own household-size table — use the manufacturer's current chart rather than back-calculating from these approximate figures when you actually apply.
Program-by-Program Breakdown
Lilly Cares Foundation
Lilly Cares provides free medication — most notably insulin and Mounjaro — to qualifying uninsured or underinsured patients. Reported income thresholds commonly cluster in the 300–400% FPL range, but Lilly's public materials are less specific about exact percentages than Sanofi's, AstraZeneca's, or Pfizer's. Medicare patients aren't automatically excluded, but are reviewed against separate criteria.
NovoCare Patient Assistance Program
NovoCare's PAP applies different income limits depending on the specific Novo Nordisk drug requested. Uninsured patients seeking Ozempic face a lower threshold (around 200% FPL), while other medications in the portfolio, such as Rybelsus and Victoza, use a higher limit closer to 400% FPL. Medicare beneficiaries face a separate, lower threshold and must document that they don't qualify for Extra Help.
Sanofi Patient Connection
Sanofi's main uninsured-patient track uses a single, clearly published limit of 400% FPL across its covered insulin, vaccine and specialty products. Medicare Part D beneficiaries can still qualify if they have no access to the specific product through their plan and aren't enrolled in Extra Help. Not every Sanofi medication is included in the program, so confirming your specific drug is covered is a separate step from checking the income limit.
AstraZeneca AZ&Me
AZ&Me splits its threshold by drug category: 300% FPL for Primary and Specialty medicines, and a more generous 500% FPL for its rare-disease product. AstraZeneca confirmed these limits stayed unchanged heading into 2026. Medicare beneficiaries must not be eligible for or enrolled in Extra Help, and for certain specialty/rare-disease products, Medicare patients who are conditionally approved may be asked to pursue independent nonprofit grants first.
Pfizer RxPathways
Pfizer uses one flat threshold — 300% FPL — across its entire Patient Assistance Program lineup as of 2026, which makes it the most straightforward of the five to evaluate at a glance. Commercially insured patients are not eligible for the PAP itself, though Pfizer offers separate copay card and uninsured-discount programs for that population. Medicare, Medicaid, TRICARE and VA patients may qualify for the PAP if they meet the income limit.
Medicare-Specific Rules Across Programs
Every program treats Medicare differently enough that "I have Medicare" isn't a yes-or-no answer to eligibility on its own.
| Program | Medicare Treatment |
|---|---|
| Lilly Cares | Case-by-case review, not automatically excluded |
| NovoCare | Separate, lower income threshold; must lack Extra Help |
| Sanofi Patient Connection | Qualifies if no plan access to the drug and not enrolled in Extra Help |
| AZ&Me | Must not be eligible for or enrolled in Extra Help; some specialty tiers require pursuing INO grants first |
| Pfizer RxPathways | Eligible if income limit is met; government insurance alone does not disqualify |
Decision Tree: Which Program Might Fit You?
Which manufacturer makes your drug?
Program is determined entirely by manufacturer, not by disease
Are you uninsured or underinsured for that drug specifically?
Commercially insured patients with coverage for the drug generally don't qualify
Check Extra Help status
Most programs require proof you don't qualify for LIS
Compare income to program's Medicare-specific limit
Often lower than the general uninsured threshold
Check household size
FPL dollar amount changes with household size
Compare income to program's general limit
Usually the higher of the two tiers
Over the limit or denied?
Independent copay foundations don't use these same thresholds
How to Confirm the Current Number Before You Apply
Identify the exact manufacturer, not just the drug class
"GLP-1" or "SGLT2 inhibitor" tells you the drug class, not the program. Check the actual label to confirm whether you need NovoCare, Lilly Cares, AstraZeneca, or another company entirely.
Look up your household size on the manufacturer's current chart
Every program listed here publishes a household-size income table on its own site. Percentages are consistent; dollar amounts update with HHS guidelines, typically each January.
Ask specifically about your medication, not just your manufacturer
Some manufacturers use different limits for different drugs in their own portfolio, as shown with NovoCare above. Confirm the figure tied to your specific prescription.
Confirm whether Medicare changes your threshold
If you have Medicare, ask specifically whether a separate, lower income limit applies, and whether you'll need documentation showing you don't qualify for Extra Help.
What Happens If You're Slightly Over the Limit
1. Recheck your household size calculation. Some applicants undercount dependents or miscalculate gross versus net income, which can push a borderline case over the line unnecessarily.
2. Look at independent copay foundations. Organizations such as the PAN Foundation, the HealthWell Foundation and NeedyMeds operate separately from manufacturer PAPs and sometimes use different, more flexible income criteria.
3. Check state pharmaceutical assistance programs. A number of states run their own low-income or senior drug assistance programs independent of any manufacturer threshold.
4. Ask about manufacturer cash-pay or discount pricing. Several manufacturers, including Pfizer, offer separate reduced cash pricing for uninsured patients regardless of income, distinct from the PAP itself.
Frequently Asked Questions
Among the five compared here, AstraZeneca's AZ&Me rare-disease tier reaches 500% FPL, and Sanofi Patient Connection's main program allows up to 400% FPL.
NovoCare's uninsured Ozempic-specific tier is generally the lowest at around 200% FPL, though NovoCare allows up to 400% FPL for some of its other medications.
Per household. Every program compared here measures annual household income adjusted for household size against Federal Poverty Level guidelines, not individual income alone.
It depends on the program. Most require proof that you don't qualify for or aren't enrolled in Medicare's Extra Help (Low-Income Subsidy), in addition to meeting the income limit, and several apply a separate, sometimes lower, threshold specifically for Medicare beneficiaries.
Yes. Manufacturers can adjust program thresholds at any time, and the underlying Federal Poverty Level guidelines used to calculate dollar amounts typically update every January.
Not necessarily. Most programs also accept underinsured patients — for example, someone whose plan excludes the specific medication — though the exact definition of "underinsured" varies by manufacturer.
For Pfizer RxPathways, yes — commercially insured patients are not eligible for the PAP. Other programs are more flexible if your commercial plan doesn't cover the specific drug you need.
Compared with Sanofi, AstraZeneca and Pfizer, which each publish a single clearly stated percentage, Lilly Cares' public materials describe eligibility in less granular detail. The 300–400% FPL range is a common third-party estimate rather than one figure Lilly states outright for every product.
Each manufacturer sets its own income threshold as a multiple of the Federal Poverty Level, a dollar figure the U.S. Department of Health and Human Services publishes annually and adjusts by household size.
You'd apply separately to each — there's no shared application across manufacturers. If you take medications from two different companies, you generally need two complete applications.
How We Researched This Guide
References
- Pfizer RxPathways — income eligibility requirements
- AZ&Me — frequently asked questions on income limits
- Sanofi Patient Connection — financial eligibility
- Lilly Cares Foundation — eligibility information
- NovoCare — Patient Assistance Program eligibility
- U.S. Department of Health and Human Services — Federal Poverty Guidelines
Related Resources
- NovoCare vs Lilly Cares: Patient Assistance Compared
- Jardiance Patient Assistance Program
- Ozempic Prior Authorization Requirements
- How to Appeal a Prescription Denial
- Medicare GLP-1 Bridge Program
Editorial Policy: Refill Relay medical content is researched using manufacturer patient assistance program pages and Federal Poverty Level guidance from HHS. Because manufacturer PAP income thresholds and FPL dollar figures can change without notice — typically each January — always confirm the current number directly with the program before submitting an application.