GSK Co-Pay Assistance Program is a patient assistance program sponsored by GlaxoSmithKline that helps eligible patients pay insurance co-payments or coinsurance for certain GSK medicines. Eligibility is based on household income and insurance status. To apply, applicants may fax a completed application along with income documentation to 1.866.272.9439. Applicants will be notified if they qualify for the Program.
If approved, the Co-pay Assistance Program will pay the patient’s co-payment or coinsurance amount after the patient has paid an amount that can range from $25 to $75 for each fill of the qualifying GSK medicine. The amount of co-payment for which a patient is responsible in the Program depends on the applicant’s household income.
The program provides assistance with co-payments or coinsurance that are up to 50%. Applicants whose co-payments or coinsurance exceeds 50% remain responsible for those amounts.
Applicants must re-apply annually. Additional information about eligibility requirements and how to complete this form can be obtained at www.CARESbyGSK.com or by calling 1.888.ONE.GSKCARES (1.888.663.4752).