Trulicity is one of the most-prescribed GLP-1 medications for Type 2 diabetes, and also one of the most searched terms in patient assistance because of how expensive it is without coverage — often $800 to $1,000 or more a month at retail. It's made by Eli Lilly, which runs its charitable assistance through a separate nonprofit called the Lilly Cares Foundation, not a program with Trulicity's name on it.
That distinction matters for two reasons. First, Lilly Cares sorts every medication into an income-based group, and Trulicity sits in the strictest tier. Second, Lilly Cares handles Medicare very differently than most manufacturer programs — it's actually one of the few paths a Medicare Part D patient has left once a copay card is off the table.
This guide covers exactly what the 2026 Trulicity PAP requires, what changed after a period of tighter eligibility rules, and how it compares to the Trulicity Savings Card for patients who have commercial insurance instead.
What Is Trulicity and Why the PAP Matters
Trulicity (dulaglutide) is a once-weekly injectable GLP-1 receptor agonist approved for adults with Type 2 diabetes, used alongside diet and exercise to help manage blood sugar. It comes in a prefilled, single-dose pen and doesn't require the dose-titration steps some other GLP-1 medications need.
Because it has no generic equivalent and demand for GLP-1 medications has stayed high, patients who lose insurance or never had drug coverage in the first place often face full retail pricing with limited alternatives that work the same way.
Why this matters: Interrupting GLP-1 therapy due to cost can cause blood sugar to rebound and undo months of progress. The PAP exists specifically to prevent patients from having to make that trade-off.
What Is the Lilly Cares Foundation?
Lilly Cares is a separate nonprofit foundation funded by Eli Lilly and Company. It's not the same thing as Lilly's commercial copay cards or its LillyDirect self-pay pharmacy — it's the income-based charity track, and it covers dozens of Lilly medications across multiple therapeutic areas, not just diabetes.
| Program | Who It's For | What It Does |
|---|---|---|
| Lilly Cares Foundation (PAP) | Uninsured/underinsured, income-eligible patients | Provides Trulicity at $0 cost |
| Trulicity Savings Card | Patients with eligible commercial insurance | Reduces monthly copay |
| LillyDirect | Anyone paying cash, regardless of insurance | Set self-pay price, no income test |
General Lilly Cares support: 1-800-545-6962 (Mon–Fri, 8am–6pm ET). Fax: 1-844-431-6650. For the full foundation-wide picture across all Lilly medications, see our Lilly Cares Patient Assistance Program guide.
Trulicity PAP Eligibility at a Glance
You're a strong candidate for the Trulicity PAP if the following apply:
- You are a permanent U.S. resident (including Puerto Rico and the U.S. Virgin Islands) currently prescribed Trulicity.
- You have no prescription drug coverage, or you have Medicare Part D without adequate coverage for Trulicity.
- Your household income falls at or below 300% of the federal poverty level.
- Your prescriber is willing to complete and sign the medical certification section.
You're less likely to qualify if:
- You have commercial insurance that already covers Trulicity — the Trulicity Savings Card is the better fit here.
- Your household income is above the 300% FPL threshold.
- You're enrolled in Medicaid or VA benefits, which Lilly Cares treats as adequate coverage.
- Your application is missing the prescriber's signature or income documentation.
Income Limits for Trulicity Assistance (2026)
Trulicity is a Lilly Cares Group 1 medication, which carries the foundation's strictest income ceiling — 300% of the federal poverty level, compared to 400% for Lilly's insulin products and 500% for many oncology and specialty drugs.
| Household Size | Annual Income Limit |
|---|---|
| 1 Person | ~$47,880 |
| 2 People | ~$64,920 |
| 3 People | ~$81,960 |
| 4 People | ~$99,000 |
| 5 People | ~$116,040 |
| 6 People | ~$133,080 |
| 7 People | ~$150,120 |
| 8 People | ~$167,160 |
Alaska and Hawaii use higher thresholds. For households larger than 8, add roughly $17,040 per additional person to the limit above. Call 1-800-545-6962 for exact figures in those states.
Trulicity vs Other GLP-1 Medications: What's Covered
GLP-1 demand has pushed several manufacturers to change their assistance rules recently, and not every popular medication in this class has a patient assistance path. Here's how Trulicity compares.
| Medication | Manufacturer | PAP Available? | Income Limit |
|---|---|---|---|
| Trulicity | Eli Lilly | Yes — Lilly Cares Group 1 | 300% FPL |
| Mounjaro | Eli Lilly | Not in Lilly Cares | N/A — savings card or LillyDirect only |
| Zepbound | Eli Lilly | Not in Lilly Cares | N/A — savings card or LillyDirect only |
| Ozempic | Novo Nordisk | Yes — Novo Nordisk PAP | 200% FPL, uninsured only |
| Rybelsus | Novo Nordisk | Yes — Novo Nordisk PAP | 400% FPL |
If your prescriber is weighing Trulicity against a competing GLP-1, our Novo Nordisk Patient Assistance Program guide and Mounjaro guide cover those alternatives in detail.
Trulicity for Medicare Patients
This is where Lilly Cares stands apart from most manufacturer assistance programs. Federal anti-kickback rules block manufacturer copay cards from being used by Medicare beneficiaries — but a charitable foundation like Lilly Cares isn't a copay card, and it can, in specific circumstances, still help.
If your Medicare Part D plan excludes Trulicity entirely, or the out-of-pocket cost is unaffordable even with coverage, you may still qualify. You'll generally need:
- A formulary exclusion letter or denial from your Part D plan showing Trulicity isn't covered
- Proof that you're not eligible for Extra Help (Low Income Subsidy), or that the subsidy doesn't make the drug affordable
- Household income at or below 300% FPL for your household size
Medicare patients: Call 1-800-545-6962 and ask specifically about Medicare Part D formulary exclusion documentation. This is essentially the only manufacturer-connected path to free Trulicity for Medicare beneficiaries — the Trulicity Savings Card cannot be used by federal program enrollees. Our Medicare Part D guide and Extra Help (LIS) explainer cover how those pieces fit together.
Trulicity Savings Card vs Patient Assistance Program
These solve different problems, and applying to the wrong one wastes time.
| Feature | Patient Assistance Program | Trulicity Savings Card |
|---|---|---|
| Best for | Uninsured or underinsured patients | Commercially insured patients |
| Cost | $0 | Reduced monthly copay |
| Income limit | 300% FPL | None |
| Medicare/Medicaid eligible? | Medicare: case-by-case; Medicaid: usually no | No — federal law prohibits |
| Application complexity | Full application with income and prescriber sections | Simple online enrollment, no income proof |
Bottom line: If you have commercial insurance that already covers Trulicity, the savings card is faster and skips income verification entirely. If you're uninsured and under the income limit, the PAP is the better fit because it eliminates the cost completely rather than just reducing it.
The 2026 Supply Update: Applications Reopened
For a period, Lilly Cares required a medical exception request before approving new Trulicity applications, tied to broader supply constraints affecting GLP-1 medications industry-wide. As of 2026, that restriction has been lifted — new applications for Trulicity are being accepted again and no longer require a medical exception request.
If you were told "no" in the past, apply again. Patients who were previously denied or discouraged from applying due to the exception requirement should not assume that's still the case. Standard applications are now processed the same way as any other Group 1 medication.
Insurance Status Requirements
| Insurance Situation | Typically Eligible for the PAP? |
|---|---|
| No health insurance at all | Usually Yes |
| Medicare Part D with Trulicity excluded or unaffordable | Case-by-Case, with documentation |
| Commercial insurance that already covers Trulicity | Usually No — Savings Card instead |
| Medicaid | Generally No — treated as adequate coverage |
| VA Benefits | Generally No — treated as adequate coverage |
Required Documents
| Document | Who Needs It | Purpose |
|---|---|---|
| Completed patient section | Everyone | Identity, household size, income, insurance status |
| Completed prescriber/medical certification section | Everyone | Confirms diagnosis and the exact medication and dose |
| Proof of income | Everyone | Recent tax return or two recent pay stubs |
| Proof of insurance status | Everyone | Insurance card, denial letter, or evidence of no drug coverage |
| Medicare Part D formulary exclusion letter | Medicare applicants | Documents the specific coverage gap for Trulicity |
| Valid prescription | Everyone | Confirms Trulicity and the prescribed dose |
How to Apply, Step by Step
Confirm your household income is at or below 300% FPL
Check your household size against the income limits table above before starting the application.
Get the 2026 application
Apply online at lillycares.com, call 1-800-545-6962 to request a paper form, or ask your prescriber's office if they keep one on hand.
Complete the patient section
Fill in your name, address, household size, income, and current insurance status exactly as it appears on your supporting documents.
Have your prescriber complete their section
Your provider confirms your Type 2 diabetes diagnosis, specifies Trulicity and the dose, and signs the form. This section cannot be left blank.
Attach income and insurance documentation
Include a recent tax return or pay stubs, plus proof of your insurance status — or, for Medicare applicants, the formulary exclusion letter.
Submit by fax or mail and wait for a decision
Fax the completed application to 1-844-431-6650, or mail it to Lilly Cares. You'll receive written notice of approval or denial.
Ready to apply?
Call Lilly Cares at 1-800-545-6962 (Monday–Friday, 8am–6pm ET), or apply online and let your prescriber's office know a medical certification is needed.
Go to Lilly Cares → See Required DocumentsDecision Tree: Is the PAP Right for You?
Step 1: Do you have commercial insurance that already covers Trulicity?
✔ Yes → Use the Trulicity Savings Card instead.
✖ No → Continue to Step 2.
Step 2: Are you enrolled in Medicaid or VA benefits?
✔ Yes → Lilly Cares generally won't apply; those are treated as adequate coverage.
✖ No → Continue to Step 3.
Step 3: Is your household income at or below 300% FPL, and do you have a prescriber willing to sign the medical certification?
✔ Yes → You're a strong PAP candidate — start the application.
✖ No → If income is the only barrier, check LillyDirect cash pricing or an independent disease-specific foundation instead.
How Long Approval Takes
| Situation | Typical Timeframe |
|---|---|
| Complete first-time application | 2–4 weeks |
| Renewal application | 1–3 weeks |
| Missing documents or incomplete fields | Additional 2–3 weeks after resubmission |
If your refill is delayed once enrolled, call 1-800-545-6962 with your enrollment ID ready.
How Trulicity Is Delivered
Approved Trulicity typically ships to your prescriber's office, not your home. Your doctor's office coordinates pickup or delivery to you from there — this is a meaningful difference from manufacturer programs that mail directly to patients.
Plan ahead for pickup. Call your prescriber's office when you have 2–4 weeks of medication remaining to request a refill, rather than waiting until you're out.
Renewing Your Enrollment
Enrollment lasts about 12 months. Since Trulicity is a maintenance medication most patients need indefinitely, missing your renewal window can create a gap in supply.
- Submit your renewal about 30 days before your enrollment period ends.
- Provide updated income documentation, even if your income hasn't changed.
- Confirm your prescriber's office still has your case on file, since renewal also requires a new signature.
- If your prescriber switches you to a different medication, you'll need a brand-new application — approval doesn't automatically carry over.
Pros and Cons of Using the PAP for Trulicity
Pros
- Medication cost drops to $0 for approved patients
- One of the few paths to free medication for Medicare Part D patients
- New applications reopened in 2026 with no medical exception hurdle
- Covers Trulicity alongside other Lilly medications under one foundation
- Renewal is generally faster than the initial application
Cons
- 300% FPL income limit is stricter than many other manufacturer PAPs
- Medicaid and VA benefits patients are generally excluded
- Requires a prescriber signature you have to coordinate
- Medication ships to your provider's office, not your home
- Annual reapplication with fresh documentation
Common Mistakes That Delay Applications
- Assuming the past medical exception requirement still applies and not applying at all
- Applying while enrolled in Medicaid or VA benefits without realizing these typically disqualify you
- Prescriber section left blank or unsigned
- Income documentation that doesn't match the household size listed
- Medicare applicants skipping the formulary exclusion letter
- Renewal submitted after the enrollment period already lapsed
Nearly all of these are simple paperwork or timing issues. Confirming your insurance situation and gathering documentation before you apply avoids the most common holdups.
Real Patient Scenarios
Scenario: Uninsured patient, previously denied during the exception period
A patient applied for Trulicity assistance in 2024 and was told a medical exception request was required, then didn't hear back and gave up. Since new applications reopened without that requirement in 2026, reapplying through the standard process is now the right move.
Scenario: Medicare patient with a formulary gap
A Medicare Part D enrollee finds Trulicity isn't on their plan's formulary and the off-formulary cost is unaffordable. With a formulary exclusion letter attached to the application, and income under $47,880, this patient is a strong candidate for Lilly Cares — a path a copay card could never offer them.
Scenario: Commercially insured, high copay
A patient with employer insurance is prescribed Trulicity but faces a high monthly copay. Because they have commercial coverage, the Trulicity Savings Card — not Lilly Cares — is the faster, more appropriate option.
What to Do If You're Denied
| Reason for Denial | Next Step |
|---|---|
| Income slightly above threshold | Check LillyDirect self-pay pricing or an independent disease-specific foundation |
| Missing documentation | Resubmit with all required documents attached |
| Existing adequate coverage | Use the Trulicity Savings Card instead, if commercially insured |
| Enrolled in Medicaid or VA benefits | These are treated as adequate coverage; explore state pharmaceutical assistance programs instead |
Our Drug Price Checker and GoodRx vs. Inside Rx comparison are useful next steps if the PAP isn't a fit, along with our broader prior authorization guides if your insurance requires approval before covering Trulicity at all.