Accessing Emgality Enrollment Forms
To obtain Emgality enrollment/prescription forms, you can download the PDF for adults available here. Providers can also visit the Emgality Website or contact an Emgality representative directly at (1-833-364-2548). The Emgality website contains a variety of multimedia resources for healthcare providers and patients to manage treatment with Emgality.
Once you have obtained and accurately completed the Emgality enrollment forms with your patient’s information, the enrollment forms can be faxed to 1-844-431-6650 or submitted to additional appropriate parties. Emgality enrollment forms require information about your patient’s medical history, insurance coverage, treatment history and the reason for prescribing Emgality. For questions about enrollment forms, you can call 1-800-545-6962 to speak to an Emgality representative.
Following submission of your enrollment forms, eligible patients can opt-in to the Lilly Cares Foundation Patient Assistance Program ® for access to resources to help manage their treatment journey with Emgality.
Lilly Cares Foundation Patient Assistance Program ®
The Lilly Cares Foundation Patient Assistance Program is a program offered by Eli Lilly and Company, the manufacturer of Emgality, to provide assistance to eligible patients who are prescribed Lilly medications and have limited or no prescription drug coverage. The program offers free medications to eligible patients who meet certain income and insurance criteria.
To be eligible for the program, patients must be residents of the United States or Puerto Rico, have no prescription drug coverage or be underinsured, have an income at or below 200% of the federal poverty level, and have a valid prescription for a Lilly medication.
The Lilly Cares Foundation Patient Assistance Program provides medications to eligible patients for up to 12 months. Patients must reapply annually to continue receiving assistance.
In addition to providing free medications, the program also offers a variety of resources to help patients manage their health, including educational materials, disease management programs, and assistance with navigating insurance coverage.
Patients can apply for the program online by faxing the completed online form to 703-310-2534 or by calling a toll-free number (1-800-545-6962). The program is intended to help eligible patients access the medications they need to manage their health conditions, regardless of their ability to pay.
Conclusion
As a healthcare provider, it can be challenging and time-consuming to navigate access to Emgality enrollment forms. This blog provides you access with the appropriate enrollment forms and the information to help support patients as you manage their condition.
With the aid of the Lilly Cares Foundation Patient Assistance Program ® , you can gain access to resources and support to help streamline the process of prescribing to ensure that your patients receive the medications they need, when they need them. By utilizing the resources available through the program, you can confirm that your patients receive the best possible care for their migraines.
