Pharmaceutical patient assistance programs — looking for input

I'm trying to navigate the manufacturer patient assistance programs (PAPs) for GLP-1 medications and finding the process overwhelming. Can we compile what's actually available?

My situation: 62 years old, Medicare Part D, A1C of 7.1 (type 2 diabetic), BMI 39. My Part D plan covers Ozempic but my monthly copay is $312 until I hit the catastrophic threshold. I make about $38,000/year and after rent, utilities, and other medications, I simply cannot afford $312/month.

I've heard Novo Nordisk has an assistance program but the website is confusing and I can't tell if I qualify. Has anyone actually gotten free or reduced-cost medication through these programs?

Maria, I help patients navigate PAPs professionally. Here's the current landscape:

Novo Nordisk PAP (for Ozempic, Wegovy, Rybelsus):

• Income limit: generally ≤ 400% Federal Poverty Level ($62,400 for individual in 2026)
• Must have Medicare or be uninsured — commercial insurance patients generally don't qualify
• Must have been denied or have inadequate coverage
• If approved: medication provided FREE for 12 months (renewable)
• Application: NovoCare.com or call 1-866-310-7549

Lilly Cares PAP (for Mounjaro, Zepbound):

• Income limit: ≤ 400% FPL
• Similar requirements — Medicare or uninsured
• If approved: medication provided FREE
• Application: LillyPricingInfo.com or 1-800-545-6962

At $38,000/year, you're well under the 400% FPL threshold. You should absolutely qualify. The application requires proof of income (tax return or pay stubs) and a prescription from your doctor.

I got approved for the Novo PAP for Ozempic in October 2025. Here's what the process actually looked like:

1. Downloaded application from NovoCare.com (4 pages)
2. My doctor filled out the prescription section
3. I provided proof of income (2024 tax return)
4. Mailed the application (can also fax)
5. Got a call 12 days later saying I was approved
6. Medication shipped directly to my home via FedEx, cold-packed
7. 90-day supply at a time, auto-ships quarterly

Total cost to me: $0. Not even shipping. I've received 3 shipments so far without any issues.

The one downside: it took about 3 weeks from application to first shipment. If you're currently on the medication, make sure you have enough to bridge the gap. If you're starting fresh, plan for the wait time.

Diane, Jim — thank you SO much. I had no idea the income limit was that high. I was assuming it was for people near the poverty line only.

I'm going to download the application tonight. Quick question: my doctor currently prescribes Ozempic 1mg. Do they need to write a new prescription for the PAP, or can they use my existing one?

Also — if I get free Ozempic through the PAP, does it affect my Part D coverage for other medications? I also take metformin and lisinopril through Part D.

Your doctor will need to complete the prescription section on the PAP application form — it's essentially a new prescription specifically for the program. Your existing pharmacy prescription can continue as a backup.

Regarding your Part D: No, receiving medication through a PAP does NOT affect your Part D coverage for other drugs. The PAP operates completely outside of your insurance. Your metformin and lisinopril will continue through Part D as normal.

One thing to note: medication received through a PAP does NOT count toward your Part D out-of-pocket spending. So if you're getting Ozempic free through the PAP, those costs won't help you reach the catastrophic coverage threshold faster. For some patients this matters; for you, it probably doesn't since you're trying to reduce spending, not hit OOP max faster.