Insurance Info: Gateway to NUCALA
Get information about coverage, cost, and assistance.
Understanding your insurance
The cost of NUCALA varies depending on your individual insurance plan. That’s why understanding your insurance is important. If a medicine is covered by an insurance plan, the insurance will generally pay part of the cost, and you pay the remainder out-of-pocket cost — your co-pay. Our Gateway to NUCALA program is here to help you understand your insurance company’s policies for covering NUCALA and estimate what your out-of-pocket cost may be. Information provided by Gateway to NUCALA is not a guarantee of coverage.
NOTE: If you are uninsured and meet certain eligibility requirements, you may qualify for the Patient Assistance Program, which offers free medicines to eligible patients. Patients with Medicare Part D or other insurance can also qualify under certain circumstances.
Investigating cost and coverage
Once you and your doctor have discussed NUCALA, you can choose to use Gateway to NUCALA to understand your insurance company’s policies for covering NUCALA and estimate your cost.Information provided to Gateway to NUCALA is not a guarantee of coverage. Follow these steps:
- Fill out the Patient (green) Section of the Enrollment Form (available in Spanish) and sign it.
If you are eligible, you can apply for the Co-Pay Program Patients in government-funded programs (e.g., Medicare, Medicaid, VA, or TRICARE) are not eligible for the NUCALA Co-pay Program. Medicare eligible patients who are enrolled in certain retiree drug benefit plans are also ineligible for the Co-pay Program (most patients become eligible for Medicare when they reach age 65).
You can check your eligibility by submitting an Enrollment Form to Gateway to NUCALA or by going to www.NUCALACopayProgram.com. For full Program Terms & Conditions, please visit www.GSKCopayPrograms.com. or Patient Assistance ProgramGo to https://www.gskforyou.com/gsk-help/ to see if you're eligible. through the form, too.
- Have your doctor fill out the Prescriber (blue) Sections and sign the form.The signatures on the form give us permission to ask your insurance company about your coverage. Then, have your doctor fax us the form at 1-844-237-3172.
- Your benefits information will be sent to you in the mail. This will tell you your insurance company’s policies for covering NUCALA and estimate your out-of-pocket cost for NUCALA. If you have questions about this information, you can call 1-844-468-2252 or your insurance company.
If you have questions at ANY point in this process, call 1-844-4-NUCALA (1-844-468-2252) to talk to a representative. Representatives are available Monday – Friday, 8 AM – 8 PM ET.
NOTE: If we have any questions about your enrollment form information, a Gateway to NUCALA representative may call you to clarify information. Please look out for any unknown calls that could be coming from those representatives.
If your doctor prefers not to use Gateway to NUCALA, your doctor may be able to help you understand your cost and coverage, OR you may call your insurance company directly to understand their policies on covering NUCALA and ask for an estimated cost.
Using a specialty pharmacy
Specialty pharmacies are different than traditional pharmacies because they focus on certain diseases that require more specialized medications, like NUCALA. If you take NUCALA at home, a specialty pharmacy will be used to ship your medicine directly to your home. If you receive NUCALA in your doctor’s office, your doctor may or may not use a specialty pharmacy.
To fill your prescription, your specialty pharmacy will work through the approval process directly with your insurance company. During this process, your specialty pharmacy will need to call you to discuss important information and collect your co-pay. If you don't return calls from the specialty pharmacy, this will delay your prescription, so make sure to answer unknown calls and check your voicemail for messages that refer to a "prescription" and be sure to call them back. Once you’ve paid your co-pay, NUCALA will be shipped directly to you if you use NUCALA at home, or it will be shipped directly to your doctor if you receive NUCALA in your doctor’s office.
In some cases your doctor may make arrangements for you to receive NUCALA from the doctor's office without using a specialty pharmacy. In those instances, you may need to pay your co-pay to the doctor rather than paying the specialty pharmacy. Be sure to ask your doctor what to expect.
Talk to your doctor to see if adding NUCALA for your severe asthma is right for you.