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.

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