Cialis Prescription Assistance Programs

Cialis: Apply for prescription assistance below

If you are eligible, the programs below can help you afford Cialis. Review the information to see if you qualify. The applications are available in Adobe PDF format and should be mailed directly to the provider of the patient assistance program.

If you have any questions, please call the telephone number for the program (not PharmacyChecker.com) or go to the program website.

Looking for a different medication?

Lilly Cares Foundation Patient Assistance Program

(Program 1 of 2 — Scroll down to see them all )

Provided by: Lilly USA, LLC.
PO Box 13185 La Jolla, CA 92039
TEL: 800-545-6962
FAX: 844-431-6650
Languages Spoken:
English
Program Website
Medications
  • Cialis tablet (tadalafil tablet)
Eligibility Requirements
  • Insurance Status *Contact program for details.
  • Those with Part D Elibible? Varies
  • Income Varies
  • Diagnosis/Medical Criteria Not specified
  • U.S. Residency Required? The patient must also be residing in the US or Puerto Rico
Application
  • Obtaining Call, download or apply online
  • Receiving Faxed
  • Returning The completed application can be faxed or mailed back.
  • Doctor's Action Complete section, sign, attach required documents
  • Applicant's Action Complete section, sign, attach required documents
  • Decision Communicated Patient and Doctor are notified
  • Decision Timeframe Not specified
Medication
  • Amount/Supply Up to 120 day supply
  • Sent To Varies
  • Delivery Time Contact Program for Details
  • Refill Proces Contact program for details.
  • Limit Not specified
  • Re-application New application, new documentation yearly
Additional Information
Please visit www.LillyCares.com or call 800-545-6962 for more information. Additional products may be available. Please contact the program for a complete product listing. Lilly donates products to the Lilly Cares Foundation Patient Assistance Program.
Updated October 2, 2019

If you, your patient or loved one does not qualify for this program or other prescription savings programs, then please search for prices here.

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Rx Outreach Medications

(Program 2 of 2 — Scroll down to see them all )

Provided by: Rx Outreach
PO Box 66536 St. Louis, MO 63166-6536
TEL: 888-796-1234
FAX: 800-875-6591
Languages Spoken:
English, Spanish
Program Website
Medications
  • Cialis tablet (tadalafil tablet)
Eligibility Requirements
  • Insurance Status May have insurance
  • Those with Part D Elibible? Yes
  • Income At or below 400% of FPL
  • Diagnosis/Medical Criteria Not required
  • U.S. Residency Required? The patient must also be residing in the US.
Application
  • Obtaining Call, download or apply online
  • Receiving Faxed, mailed or downloaded from website
  • Returning Fax or E-Prescribe online
  • Doctor's Action Give prescription to patient
  • Applicant's Action Complete section and sign
  • Decision Communicated Medications sent if accepted. If denied patient and doctor notified
  • Decision Timeframe Usually same day
Medication
  • Amount/Supply Varies
  • Sent To Doctor's office or patient's home
  • Delivery Time Not specified
  • Refill Proces Company contacts patient to arrange
  • Limit Only limited by manufacturer's guidelines
  • Re-application New application yearly
Additional Information
Some medications are available for a fee of $20 for up to a 180 day supply. Check the Rx Outreach website for the exact price and most current medication list. Contact Program for Spanish Application(s)/Form(s).
Updated September 17, 2019

If you, your patient or loved one does not qualify for this program or other prescription savings programs, then please search for prices here.

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