To submit a medical co-pay claim you will need:
Please note: You may only submit a claim if the patient is commercially insured and is not participating in any Federal Healthcare Program (including Medicare, Medicaid, TRICARE®, or any other state or federal medical pharmaceutical benefit program or pharmaceutical assistance program).
PP-RC-US-1951 10/2023 ©Lilly USA, LLC 2023. All rights reserved.
TRICARE® is a registered trademark of the Department of Defense (DoD) DHA. All rights reserved.