GSK Patient Assistance Program (PAP)* for Prescription Medicines

If You Are Uninsured

This section provides information about the GSK Patient Assistance Program for patients who do not have insurance. This program does not constitute health insurance.

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Eligibility

To qualify for the GSK Patient Assistance Program, you must:

  • Live in the United States or Puerto Rico
  • Have no prescription drug benefits through any insurer/payer/program
  • Not be currently receiving prescription drug coverage through a government Program (excluding Medicare), which includes Medicaid, VA, DOD or TriCare benefits
  • Not be eligible for Puerto Rico's Government Health Plan Mi Salud or have applied and been denied

You must also meet certain household income eligibility requirements as outlined below:

48 States and DC
Household SizeMaximum Annual Gross Income
1$45,180
2$61,320
3$77,460
4$93,600
For each additional person, add$16,140
Calculate your annual income limit if you have more than 4 people living in your household, including yourself.
Alaska
Household SizeMaximum Annual Gross Income
1$56,430
2$76,620
3$96,810
4$117,000
For each additional person, add$20,190
Calculate your annual income limit if you have more than 4 people living in your household, including yourself.
Hawaii
Household SizeMaximum Annual Gross Income
1$51,930
2$70,500
3$89,070
4$107,640
For each additional person, add$18,570
Calculate your annual income limit if you have more than 4 people living in your household, including yourself.
Puerto Rico
Household SizeMaximum Annual Gross Income
1$28,800
2$36,000
3$43,200
4$50,400
For each additional person, add$7,200
Calculate your annual income limit if you have more than 4 people living in your household, including yourself.
  • Assistance is available in Spanish and many other languages: 1-866-728-4368
  • La asistencia está disponible en español y muchos otros idiomas: 1-866-728-4368
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Enrollment

Enrollment in the GSK patient assistance program for a non-vaccine product

  • You can enroll yourself in the GSK Patient Assistance Program. Most patients will enroll by fax or mail. If medicine is needed immediately, you can also enroll by phone.

Enroll by fax or mail

    Enroll by phone (only when medicine is needed immediately)

      Additional enrollment information

        • *

          Subject to eligibility, program terms, and conditions, which are subject to change. Programs do not constitute health insurance.

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        Have private insurance?

        See access and copay assistance programs for certain products.

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        Need help paying for a vaccine?

        Learn about the GSK Patient Assistance Program for Vaccines.

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        Have questions about patient assistance?

        Please take a look at our FAQs.