To apply for Lilly Cares Cymbalta assistance, gather these documents: A completed application form, your most recent prescription for Cymbalta, and proof of income for the past three months (pay stubs, tax returns, or a benefits statement).
Income verification is critical. Acceptable forms include W-2s, pay stubs showing year-to-date earnings, or your most recent tax return. Self-employment income requires a profit and loss statement.
Ensure your prescription clearly shows your name, the medication (Cymbalta), dosage, and the prescribing physician’s information. A copy of your insurance card is also needed, even if you lack coverage or have a high deductible.
For those with a High deductible insurance plan or no insurance, additional documentation might be requested. The program may ask for supporting financial documentation to verify income limitations. Prepare to provide bank statements or other relevant financial records.
Keep all documents organized. Submit clear, legible copies. Lilly Cares will review your application promptly after receiving the needed paperwork. Contact Lilly Cares directly if you have questions about specific requirements or acceptable documentation.
