NUCALA Co-pay Program
Pay as little as $0 for NUCALA*
* Eligibility restrictions and program maximums apply. See below for more eligibility information and www.GSKCopayPrograms.com for complete Program Terms and Conditions.
HOW TO USE THE CO-PAY PROGRAM
Once you have been approved for the Co-pay Program, how you use the Co-pay Program may be different depending on how you signed up and how you pay for your medicine. If you pay a specialty pharmacy directly, follow the green instructions below. If you pay your doctor for your medicine and signed up for the Co-pay Program using the Gateway Enrollment Form, follow the red instructions below. If you pay your doctor for your medicine and signed up using the www.NUCALACopayProgram.com website, follow the blue instructions below.
† See eligibility requirements below.
With A Specialty Pharmacy
After you’ve been approved by your insurance company, the specialty pharmacy will call you monthly to arrange the delivery of your medicine and collect your co-pay. When they call, follow the 2 steps below to pay your co-pay with the NUCALA Co-pay Program.
Provide the Rx Bin, Rx Group, and Member ID numbers on your monthly $25 Voucher to the specialty pharmacy.
Once complete, your remaining out-of-pocket cost for that month will be automatically loaded onto the Virtual Debit Card.
Provide the number on your Virtual Debit Card to the specialty pharmacy. The Virtual Debit Card will pay for the remaining co-pay amount.*
*Up to program maximum.
You will receive a new text or email in real time, each time your Virtual Debit Card has successfully been loaded.
It will be especially important that you answer this call from the specialty pharmacy and then save the phone number into your contacts, so that it may be easier to recognize when it’s time to refill your prescription.
At Your Doctor’s Office
If you and your doctor have worked together to complete a Gateway Enrollment Form:
Refer to your approval letter to understand how to activate your card with your doctor by using an Explanation of Benefits (EOB) from your insurance company.
OR, if you have registered directly online at www.NUCALACopayProgram.com:
Upload an Explanation of Benefits (EOB) to www.NUCALACopayProgram.com. (This may take up to 7 days to review, so make sure to complete in advance.)
After review of your EOB, you will receive a reimbursement check in the mail.
YOUR CARD INFORMATION
Use this to help identify where your card information is located. If you have
questions or need assistance along the way, please contact Gateway to NUCALA
WHAT ARE THESE CARDS?
These are your NUCALA Co-pay
Program Voucher and Debit cards.
Once you receive your approval letter, write your co-pay information in a safe place for quick reference.
The Debit Card can help you save on the remaining balance on your NUCALA Co-pay.
If a specialty pharmacy asks
for your Voucher Card: