The Novo Nordisk Patient Assistance Program
Novo Nordisk offers a year round patient assistance program that provides the following medication free of cost to those who meet the eligibility criteria:
There are no fees to participate or apply. Applications can take up to 1-2 days for processing. If approved, the medication will be sent to your healthcare provider’s office where you can pick it up. Delivery of medication can take 10-14 additional days. If you meet the eligibility requirements and are approved, you will receive a letter of approval and be enrolled for 12 months. Medicare patients must submit applications by November 30th of each calendar year and qualified Medicare patients will be enrolled in the program through December 31st of the calendar year. You must reapply annually.
Your healthcare provider must fax or mail the ENTIRE application and all supporting documents on your behalf. Fax to 1-866-441-4190 or mail to: Novo Nordisk Inc. PO Box 370 Somerville, NJ, 08876.
Medications included
Tresiba®
Levemir®
NovoLog®
NovoLog® Mix 70/30
Fiasp®
Novolin® R
Novolin® N
Novolin® 70/30
GlucaGen® HypoKit®
NovoFine® 32G, NovoFine® Plus 32G, and NovoTwist® 32G needles
Eligibility
You are a US citizen or legal resident.
Your total household income is at or below 400% of the federal poverty level. Check FPL guidelines in your area here.
You have no insurance, or you have Medicare
You are not enrolled in and don’t qualify for any other federal, state, or government program such as Medicaid, Low Income Subsidy, or Veterans (VA) Benefits (Exceptions include patients who are Medicaid eligible and have been denied Medicaid)
How to Apply
Visit this webpage, scroll to the bottom, and fill out an application (English / Spanish) linked under step one of “How to Apply.”
Fill out Parts 2 and 3 of the application.
For regular PAP applications: You must include a copy of a valid form of ID and one form of proof of income (copy of the 2 most current pay check stubs or earning statements for all working members of your household, copy of last year’s Federal Income Tax Return (1040), copy of Social Security income, pension, and other income statements, including interest or dividend statements, copy of W-2 or 1099 Form, copy of Unemployment Benefit statement).
COVID-19 Relief
In response to rapid income and health insurance loss during the COVID19 global pandemic, Novo Nordisk is offering a 90 day supply of the following products free of charge to those who meet certain eligibility requirements:
Medications included
Tresiba®
Levemir®
NovoLog®
NovoLog® Mix 70/30
Fiasp®
Novolin®
Victoza®
Rybelsus®
Xultophy®
Eligibility
You are a US citizen or legal resident.
This offer is only available to those who can provide proof of loss of healthcare benefits during the pandemic in addition to meeting all usual PAP requirements as listed in Option 1 on this page. You do not need to provide proof of income for this PAP.
How to Apply
Visit this webpage, scroll to the bottom, and fill out an application (English / Spanish) linked under step one of “How to Apply.”
For COVID-19 Relief application: You must include proof of loss of health insurance benefits (job termination notice, job status change, proof that COBRA benefits are being offered) but you do not need to include any proof of income.
Patients eligible for Medicaid must include a Medicaid Eligibility form.
Patients who are eligible for Medicare Part D must provide proof of Medicaid or Extra Help/LIS denial.
Send your application, ID, and supporting documents to your healthcare provider to complete the application. Your healthcare provider must fax or mail the ENTIRE application and all supporting documents on your behalf. Fax to 1-866-441-4190 or mail to: Novo Nordisk Inc. PO Box 370 Somerville, NJ, 08876.
MY99INSULIN
Novo Nordisk offers a $99 insulin savings card for one month’s supply of any of their products as listed here:
Medications included
NovoLog®
NovoLog® Mix 70/30
Levemir®
Tresiba®
Fiasp®
Novolin® N vial
Novolin® R vial
Novolin® 70/30 vial
Novolin® 70/30 FlexPen®
Insulin Aspart Injection
Insulin Aspart Protamine and Insulin Aspart Injectable Suspension
Eligibility
You must have a valid prescription for the medication.
You do not need health insurance. You can currently be enrolled in a health insurance plan, but you must not seek reimbursement from any health benefit plan for the medications purchased with this savings card (i.e. run the RX without insurance)
You must redeem the offer in the United States.
You may not combine this offer with any other savings cards or coupons.
See full eligibility requirements here.
How to Apply
You can get your card on this webpage by filling out your name and checking the mandatory acknowledgement boxes.
You will then be able to print, download, or email your card. Medicare Part D beneficiaries must apply by calling 1-888-910-0446.
This card is capped at three vials or two boxes of pens per month. The card is valid for one calendar year.
NovoCare Savings Card
Novo Nordisk also offers savings cards for the following medications:
Medications included
Novolog®
Fiasp®
Tresiba®
NovoLog® Mix 70/30
Ozempic®
Rybelsus®
Eligibility
You must have a valid prescription for the medication.
You must be enrolled in, and must seek reimbursement from or submit a claim for reimbursement to, a commercial insurance plan.
You must redeem the offer in the United States.
Anyone using Medicaid, Medicare, Medigap, VA, DOD, TRICARE, or any similar federal or state health care program is not eligible.
See full eligibility requirements here.
How to Apply
To apply for any of the savings cards, click on your medication on this webpage and fill out the questionnaire.
Once finished, you will have the opportunity to print, download, or email your savings card.
Present your savings card when picking up your prescription at the pharmacy.
Still need assistance?
Request Aid
Common Questions about Patient Assistance
No. Each patient assistance program has its own set of eligibility requirements. Many are fairly restrictive. If you find out which manufacturer makes your insulin, you can check out our page on them. We have information on Eli Lilly, Novo Nordisk, Sanofi, and Mylan.
No. If you need emergency assistance, seek help at your local emergency room, or call 9-1-1. If you incur medical debt from an emergency hospital stay, fill out our request aid form.
Patient Assistance programs vary in the time they take to respond back. Often times additional documentation must be submitted after an initial review. You can review the guidelines for the patient assistance program you need help from here: Eli Lilly, Novo Nordisk, Sanofi, and Mylan.
Yes! This is not always a quick process but we have people that can help you apply for patient assistance programs. Fill out our request aid form here for help.