- Download the Maine Continuing Need Program for Maine residents under 18 prescribed Lilly products here: https://assets.ctfassets.net/srys4ukjcerm/5Ai9mMnh8affcuYYSCEGP6/370ab1261d0888f138e0c224216ff7d1/Maine_-_ISPAP_-_Patient_Enrollment_Form_-_MINOR_-_03-2022.pdf or call 1-855-447-8412 to ask for an application to be sent via mail.
- Complete the application and either fax the application and financial documents to 1-833-200-6304 or mail to the address listed on the application.
- You must include copies of your proof of Maine residency, proof-of-income documentation, proof of plan benefit showing you pay out-of-pocket more than $75 for a 30-day supply of insulin.
- Within 10 business days of receiving your application, a decision will be made regarding your eligibility.
- If approved, you will receive a document called “Statement of Eligibility,” good for 12 months. You will take this to your pharmacy in Maine, along with your prescription and proof of residency.
- Your pharmacy may collect a fee of up to $50 for a 90-day supply. If you have questions regarding that fee, you must speak with the pharmacist. Lilly is not responsible for that fee, nor does it receive any part of that fee.
If you do not qualify for Maine Continuing Needs Program, you can call the Lilly Diabetes Solutions Center at 1-833-808-1234. A live representative will have a confidential conversation and present solutions from 9am to 7pm Eastern Monday to Friday.