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
$2,512.50
$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