I Don't Have Insurance

This section provides information about Zejula and Blenrep patient assistance programs for patients who do not have insurance, or whose insurance does not cover the product (please contact program for Functionally Uninsured eligibility process details). This program does not constitute health insurance.

Do I Qualify?

Zejula and Blenrep Patient Assistance Programs

To qualify for the Zejula or Blenrep Patient Assistance Program, you must:

  • Live in one of the 50 states, District of Columbia, Puerto Rico or U.S. Virgin Islands
  • Meet one of these criteria:
    • Uninsured
    • Have private commercial insurance but have no coverage (medical or pharmacy) for the product as demonstrated to the program through the defined Appeals Process criteria (please contact program for details)
  • Not be currently receiving prescription drug coverage through a government Program (excluding Medicare), which includes Medicaid, VA, DOD or TriCare benefits
  • Not be eligible for Puerto Rico's Government Health Plan Mi Salud, or have applied and been denied
  • Meet certain income eligibility requirements. Patients whose income exceeds program eligibility maximum will be provided the opportunity to demonstrate that their eligible medical expenses bring them within the income eligibility criteria (please contact program for details)
Maximum Monthly Gross Income
Household Size
48 states, D.C. and U.S. Virgin Islands
Alaska
Hawaii
Puerto Rico
1
$5,316.67
$6,645.83
$6,116.67
$4,000.00
2
$7,183.33
$8,979.17
$8,262.50
$5,000.00
3
$9,050.00
$11,312.50
$10,408.33
$6,000.00
4
$10,916.67
$13,645.83
$12,554.17
$7,000.00
For each additional person, add
$1,866.67
$2,333.33
$2,145.83
$1,000.00
Calculate your monthly income limit if you have more than 4 people in your household
  • For assistance with the Zejula or Blenrep Patient Assistance Program please call Together with GSK Oncology at 1‑844‑4GSK‑ONC (1‑844‑447‑5662)