FORTEO Patient Assistance Program
How can this program help me?
The FORTEO Patient Assistance program is for non-Medicare eligible individuals. If you qualify for the program, FORTEO Patient Assistance Program will provide free FORTEO medicine to you via mail order pharmacy.

Do I qualify for FORTEO Patient Assistance Program?
To receive free FORTEO medicine, you must:
  • Not have any prescription insurance.
  • Not be eligible for or enrolled in Medicare.
  • be a United States resident.*
  • Meet the household income guidelines for the program.

What Lilly medicines are available?

NamePrescribing InformationMedication Guide
Forteo® (teriparatide [rDNA origin]) injection Prescribing Information Medication Guide
Please see full prescribing information including Boxed Warning and Medication Guide for FORTEO.

Where do I get my medicine?
A 90-day supply of medicine will be shipped to your home via mail order pharmacy. Prescription refills will be available during your 1-year enrollment period.

How do I apply?
  • Download an application here or request it by calling 1-877-214-3475.
  • You must fill out and mail or fax the completed application, along with proof of income.

Keep a photocopy of your application and your original income documents. If approved, you will be notified by the program and your medication will be shipped to your home via mail order. You will remain enrolled in the program for up to 1 year. To continue receiving free Lilly medicines, you must reapply each year.

For additional information about the FORTEO Patient Assistance Program, call us at 1-877-214-3475.

*Does not include Puerto Rico or the US Virgin Islands