Novo Nordisk

NovoCare Patient Assistance Program

Free Novo Nordisk diabetes meds for income-qualified patients. ≤400% FPL for most products; ≤200% FPL for Ozempic (uninsured).

Doctor signature neededUninsured only

What you need to enroll

Your doctor needs to sign part of the application

This program requires a prescriber signature. The easiest path: download the application, bring it to your next appointment, and have the office fax it in for you.

Your copay

Free

Eligible patients pay $0. See the eligibility checklist below to confirm you qualify.

Download form for your doctor

Covered medications

  • Ozempic (semaglutide injection) — uninsured patients only † 0.25/0.5 mg pen·1 mg pen·2 mg pen
  • Xultophy 100/3.6 (insulin degludec + liraglutide) 5 pens x 3 mL/pen
  • Fiasp (insulin aspart) 10 mL vial·FlexTouch (5 pens × 3 mL)·PenFill (5 × 3 mL)
  • Novolin (human insulin) R 10 mL vial·N 10 mL vial·70/30 10 mL vial
  • NovoLog (insulin aspart) 10 mL vial·FlexPen (5 pens × 3 mL)·PenFill cartridge (5 × 3 mL)
  • NovoLog Mix 70/30 10 mL vial·FlexPen (5 pens × 3 mL)
  • Tresiba (insulin degludec) U-100 10 mL vial·U-100 FlexTouch (5 pens × 3 mL)·U-200 FlexTouch (3 pens × 3 mL)
  • NovoPen Echo (device)
  • NovoFine 32G needles (100/box) — only for FlexPen / FlexTouch / Xultophy users
Download form for your doctor

Income tiers by product/insurance: (1) Most Novo Nordisk products: ≤400% FPL. (2) Ozempic UNINSURED: ≤200% FPL only. (3) Ozempic Medicare Part D: NOT ELIGIBLE — Medicare patients should use the Medicare Prescription Payment Plan (MPPP) instead. (4) Medicare patients on Novo Nordisk INSULINS: ≤400% FPL, but if income is below 150% FPL you must provide proof of denial for Part D Extra Help. Uninsured patients in states with high FPL thresholds must provide proof of Medicaid denial before enrollment. Wegovy, Rybelsus, and Victoza are NOT covered by the PAP. Levemir was discontinued by Novo Nordisk in the US on Dec 31, 2024 and is no longer in the PAP. Document ID NNIPAP_11_01012026.

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