Each of the two big GLP-1 makers runs a programme that gives medicine free to people on low incomes, and in 2026 each covers exactly one GLP-1 injection. Novo Nordisk's Patient Assistance Program covers Ozempic, for uninsured people only. Eli Lilly's charity, the Lilly Cares Foundation, covers Trulicity. Neither covers the weight-management drugs, Wegovy and Zepbound, or Mounjaro, Rybelsus, Victoza, Saxenda or the Foundayo tablet. Searches for a "Mounjaro patient assistance program" or a "Zepbound patient assistance program" lead to guides that say otherwise; the makers' own lists are the record, and this page reads them.
Documents read on 9 October 2026: Novo Nordisk's PAP page on NovoCare and its 2026 product list (form NNIPAP_11_01012026), the Lilly Cares Foundation application (CMAT-02998, edition 12/2025, income table on 2026 guidelines), and the 2026 federal poverty guidelines from the Department of Health and Human Services. This page reports their terms; it does not suggest a drug, a programme or a course of action for anyone.
The two programmes side by side
| Novo Nordisk Patient Assistance Program | Lilly Cares Foundation | |
|---|---|---|
| GLP-1 medicines on the 2026 list | Ozempic injection only (marked "available for uninsured patients ONLY") | Trulicity only |
| Not on the list | Wegovy, Rybelsus, Victoza, Saxenda | Mounjaro, Zepbound, Foundayo |
| Insurance accepted | No insurance, or Medicare — but not for Ozempic if the Medicare enrollee has drug coverage | No insurance, Medicare Part D, or Medicare Part B with no supplemental cover |
| Commercial insurance | Not eligible | Not eligible for Trulicity's group |
| Income line for the GLP-1 | At or below 200% of the federal poverty level (uninsured, Ozempic) | At or below 300% of the federal poverty level (Group 1) |
| Also excluded | Medicaid or Medicare Extra Help enrollees or eligibles (a denial letter is required), VA benefits | Medicaid, full Extra Help, VA benefits |
| Enrolment length | 12 months uninsured; to the end of the calendar year on Medicare | Generally 12 months; to the end of the calendar year with Medicare Part D |
| Fee | None | None |
Novo's page also states that "some medicines will no longer be a part of the Patient Assistance Program for 2026" and links the product list; it does not say which ones left. The list itself is the only way to tell what remains, and it shows that every Novo GLP-1 other than the Ozempic injection is absent. Xultophy, a fixed combination of insulin degludec and liraglutide, is on the list under "combination product" — it is an insulin-containing diabetes product, not a stand-alone GLP-1.
The income lines in dollars
Both programmes write their limits as a percentage of the federal poverty level. Lilly prints the dollar table on its application; Novo points to a third-party site for the guideline. The table below converts both with the 2026 guidelines HHS publishes for the 48 contiguous states ($15,960 for one person, rising by $5,680 per person). The Novo column is glp1ledger's arithmetic; the Lilly columns are the foundation's own printed figures, which match the same multiplication.
| Household | Novo PAP, Ozempic (200%) | Lilly Cares, Trulicity (300%) | Lilly Cares, insulins (400%) |
|---|---|---|---|
| 1 | $31,920 | $47,880 | $63,840 |
| 2 | $43,280 | $64,920 | $86,560 |
| 3 | $54,640 | $81,960 | $109,280 |
| 4 | $66,000 | $99,000 | $132,000 |
Two details change who fits. Lilly's limit is on "annual adjusted household income", and it tells people in Alaska, Hawaii or households of five or more to call for their figure, because HHS publishes higher guidelines for those two states. Novo uses a different line for its other medicines: total household income at or below 400% of the poverty level for everything except Ozempic, which has the lower 200% ceiling.
What Novo changed for Ozempic
Novo's page carries a separate note for Ozempic patients. It says most Medicare prescription plans cover Ozempic and that "Medicare beneficiaries with prescription drug coverage will no longer be eligible to receive Ozempic through the Patient Assistance Program". Uninsured patients keep access, at the 200% income line. For Medicare patients on Novo insulins, the line stays at 400%, and the page says the programme no longer requires Part D patients to spend $1,000 out of pocket before applying.
The reason the product list marks Ozempic "uninsured only" is that change. A Medicare enrollee whose plan covers Ozempic pays the plan's cost-sharing instead; for that, Novo's page points to the Medicare Prescription Payment Plan, which spreads a year's prescription costs across the plan year rather than reducing them.
What Lilly Cares requires beyond income
The Lilly Cares application sets four conditions for Trulicity's group, all of which must be met:
- a qualifying Lilly medicine prescribed by a US healthcare provider;
- permanent residence in the United States, Puerto Rico or the US Virgin Islands;
- household income under the table above;
- no Medicaid, full Low-Income Subsidy ("Extra Help") or VA benefits, and either no insurance, Medicare Part D, or Medicare Part B without supplemental cover such as Medigap, Medicare Advantage or a former employer's plan.
The application adds a rule aimed at employers and insurers rather than patients: anyone whose plan requires them to apply to Lilly Cares as a condition of coverage — the arrangements the foundation calls "alternative funding programs" — is not eligible, even if everything else fits.
Why the weight drugs are missing
Neither document explains its list. What can be said from the records is narrower:
- Medicare Part D cannot pay for a drug used only for weight loss, which is why the Medicare question for Wegovy and Zepbound runs through their other approved uses; the coverage rules are set out on GLP-1 insurance coverage, and the routes for people paying cash on the cheapest GLP-1 without insurance.
- Both makers instead sell the weight drugs at self-pay prices: Novo through NovoCare Pharmacy, Lilly through LillyDirect, with vials and pens at fixed monthly prices. Those are discounts on a purchase, not free medicine, and they are not income-tested.
- The savings cards are a third, separate route for people with commercial insurance — the opposite population to these programmes. The terms for each are on the Ozempic savings card, the Wegovy savings card, the Mounjaro savings card and the Zepbound savings card.
What this page cannot tell you
- Lists change. Novo's list carries a 1 January 2026 form number and Lilly's application an edition date of December 2025; either maker can add or withdraw a medicine during the year, and both say they may change or end their programmes without notice.
- Approval is case by case. Meeting the printed criteria does not guarantee enrolment; both programmes ask for income documents and contact the prescriber.
- Other programmes exist. State pharmaceutical assistance schemes, charity pharmacies and independent foundations are outside this page, which covers only the two manufacturers' own programmes.
Whether any of these routes fits a particular person's situation is a question for their prescriber, pharmacist or a benefits counsellor.
Sources
- Novo Nordisk, "Patient Assistance Program (PAP)", novocare.com/diabetes/help-with-costs/pap.html, read 2026-10-09: eligibility for 2026, the Ozempic and Medicare notes, income lines, documents, enrolment length FAQ.
- Novo Nordisk, "Novo Nordisk Patient Assistance Program (PAP) Available Products", form NNIPAP_11_01012026, PAP_Product_List.pdf, read 2026-10-09.
- Lilly Cares Foundation, Patient Assistance Program application, CMAT-02998 12/2025, lilly_cares_application.pdf, read 2026-10-09: eligibility, income table (2026 guidelines), Groups 1–4, enrolment terms. (The foundation's web pages returned an access error to this site's request; the application PDF opened.)
- U.S. Department of Health and Human Services, ASPE, "2026 Poverty Guidelines", aspe.hhs.gov, read 2026-10-09.