See where Lilly PatientOne services fit in the reimbursement process.

STEP 1

Your diagnosis is made and your treatment is prescribed.

You See Your Doctor You See Your Doctor

STEP 2

Your coverage is verified by your doctor’s office, your financial responsibility (co-pay or coinsurance) is determined, or a prior authorization (preapproval) is submitted if needed.

Lilly PatientOne offers benefits investigation and prior-authorization guidance that may help your doctor confirm coverage for your prescribed Lilly Oncology medication. If your coverage is denied, we can work with your doctor's office to understand appeal requirements and assist in following up on the progress of the appeal with your insurance company on your behalf.

You provide your insurance information
You provide your insurance information
You receive treatment

STEP 3

Once your coverage is confirmed, you’ll see your doctor to begin treatment. The office will file a claim with your insurance company or will work with you if your medicine will be filled through a specialty pharmacy.

  • If you’re covered, your doctor or pharmacy will receive payment
  • If you have a co-pay or coinsurance, your doctor or pharmacy will bill you for your out-of-pocket costs

    If these costs are higher than you can afford, Lilly PatientOne can help you find financial assistance options if they are available.

  • If you are not covered, or your claim is denied after all appeals have been exhausted, there may be other options your doctor will discuss with you, including options under the Patient Protection and Affordable Care Act

    If you qualify, the Lilly Cares Foundation, Inc., a separate nonprofit organization, provides Lilly Oncology medications at no cost to eligible patients. Learn more at LillyCares.com.

You receive treatment

Applying for Lilly PatientOne services does not guarantee coverage or assistance in any way. While we make every effort to help you navigate complex insurance processes, it is up to you and your doctor to file for prior authorizations and denied claim appeals.