Vaccines and GSK Patient Assistance Program
This section provides information about the GSK Patient Assistance Program for patients who need financial assistance with a GSK vaccine. This program does not constitute health insurance.
Do I Qualify?
The GSK Patient Assistance Program
To qualify for the GSK Patient Assistance Program:
For a vaccine, you must:
- Have no third party coverage for Vaccines OR 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
- Be an adult, age 19 or older
- Live in one of the 50 states, District of Columbia or Puerto Rico
- Not be eligible for Puerto Rico's Government Health Plan Mi Salud or have applied and been denied
- Have a household income within program eligibility criteria:
|
Maximum Monthly Gross Income
|
||||
Household Size |
48 states and D.C. |
Alaska |
Hawaii |
Puerto Rico |
|
1
|
$2,683.33
|
$3,352.08
|
$3,087.50
|
$2,000.00
|
|
2
|
$3,629.17
|
$4,535.42
|
$4,175.00
|
$2,500.00
|
|
3
|
$4,575.00
|
$5,718.75
|
$5,262.50
|
$3,000.00
|
|
4
|
$5,520.83
|
$6,902.08
|
$6,350.00
|
$3,500.00
|
|
For each additional person, add
|
$945.83
|
$1,183.33
|
$1,087.50
|
$500.00
|
| Calculate your monthly income limit if you have more than 4 people in your household | ||||
- You must enroll in the GSK Patient Assistance Program through your healthcare provider, who will need to first register with the program. Your healthcare provider will submit your application
-
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