I Have
Medicare Part D
Medicare Part D
This section provides information about the GSK Patient Assistance Program for patients who have Medicare Part D. This program does not constitute health insurance.
Do I Qualify?
The GSK Patient Assistance Program
To qualify for the GSK Patient Assistance Program:
- Live in one of the 50 states, District of Columbia or Puerto Rico
- Be enrolled in a Medicare Part D Prescription Drug Plan and have spent at least $600 on prescription medicines through your Medicare Part D Prescription Drug Plan during this calendar year
- Not be eligible for Puerto Rico's Government Health Plan Mi Salud or have applied and been denied
- Meet certain income eligibility requirements:
|
Maximum Monthly Gross Income
|
||||
Household Size |
48 states and D.C. |
Alaska |
Hawaii |
Puerto Rico |
|
1
|
$2,512.50
|
$3,137.50
|
$2,887.50
|
$2,000.00
|
|
2
|
$3,383.33
|
$4,227.08
|
$3,889.58
|
$2,500.00
|
|
3
|
$4,254.17
|
$5,316.67
|
$4,891.67
|
$3,000.00
|
|
4
|
$5,125.00
|
$6,406.25
|
$5,893.75
|
$3,500.00
|
|
For each additional person, add
|
$870.83
|
$1,089.58
|
$1,002.08
|
$500.00
|
| Calculate your monthly income limit if you have more than 4 people in your household | ||||
- 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