I Have
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.

GSK Patient Assistance Program (PAP) Participants who have Medicare Part D:
As a reminder, GSK PAP eligibility is based on a calendar year like Medicare Part D. Therefore, your enrollment in GSK PAP will expire on December 31, 2016 and you will not be able to use GSK PAP until you qualify for the program and re-enroll in the new year. To qualify for GSK PAP in 2017, you will need to meet eligibility requirements, including having spent at least $600 on prescription medicines on or after January 1, 2017.

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
$2,475.00
$3,091.67
$2,847.92
$2,000.00
2
$3,337.50
$4,170.83
$3,839.58
$2,500.00
3
$4,200.00
$5,250.00
$4,831.25
$3,000.00
4
$5,062.50
$6,329.17
$5,822.92
$3,500.00
For each additional person, add
$862.50
$1,079.17
$991.67
$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