Novo Nordisk


You must be a citizen of the US or a legal resident.

You cannot have any prescription drug coverage through a private insurance company.

You cannot have any federally funded prescription coverage such as Medicare or Medicaid. If you are in the coverage gap or donut hole of Medicare Part D then you are eligible. You may also be eligible if you have applied for Medicare Extra Help/ Low Income Subsidy (LIS) and been denied.

Your total household income must be at or below 200% of the federal poverty level:

Household Size Total Income
1 $23,340
2 $31,460
3 $39,580
4 $47,700
Each additional person add $8,120

Medications covered by the Patient Assistance Program:

Levemir (insulin detemir [rDNA origin] injection)

                Levemir 10mL vials

                Levemir FlexPen (5x3mL) 1

Novolog (insulin aspart [rDNA origin] injection)

                Novolog 10mL vials

                Novolog FlexPen (5x3mL) 1

                Novolog Mix 70/30 10mL vials

                Novolog Mix 70/30 FlexPen (5x3mL) 1

Novolin (human insulin [rDNA origin])

                Novolin R 10mL vials

                Novolin N 10mL vials

                Novolin 70/30 10mL

NovoFine 30G Needles (100/box)

NovoFine 325 Tip (100/box)

NovoTwist 32G Needle (100/box)

GlucaGen HypoKit (glucagon [rDNA origin] for injection)

GlucaGen Hypokit

Victoza (liraglutide [rDNA origin] injection)

                Victoza 6mg/mL 2x3mL

                Victoza 6mg/mL 3x3mL


Phone: (706) 208 9700   Mail: