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Terms and Conditions
Co-pay Program Requirements:
To determine if you are eligible for the Co-pay Program for NUCALA, you and your healthcare provider must complete the enrollment form.
If you are eligible, the Co-pay Program for NUCALA may provide support for your cost share for NUCALA, up to a maximum amount of $11,000 annually. The Co-pay Program for NUCALA is not insurance. GSK reserves the right to rescind, revoke, or amend this program without notice.
You must have a prescription for NUCALA in order to apply for the Co-pay Program for NUCALA.
If you have insurance coverage provided through a state or federal government-funded medical or prescription drug program, including but not limited to Medicare, Medicaid, TRICARE, and Mi Salud, you are not eligible to participate in the Co-pay Program for NUCALA.
If you have prescription drug coverage that is provided by a commercial payer and the commercial payer has opted out of the Co-pay Program for NUCALA, you are not eligible to participate.
You must live in the United States (including the District of Columbia, Puerto Rico and U.S. Virgin Islands).
You should inform program representatives of any changes in insurance coverage during the course of your enrollment in the Co-pay Program for NUCALA. Please note that after 90 days of non-use of an approved and/or activated Co-pay Card, funding will be released back into the program. If you are still receiving the product, you may contact the program and request that funds be reloaded onto the Co-pay Card.