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.

The NUCALA Co-pay Program helps eligible approved patients with their out-of-pocket costs for NUCALA up to $15,000 for 12 months.

 

If approved, you could pay as little as $0 for NUCALA.

GETTING STARTED

There are 2 ways to get started with the NUCALA Co-pay Program: 

  1. You may work with your doctor to enroll in Gateway to NUCALA to see if you are eligible for the NUCALA Co-pay Program.
  2. You may check to see if you are eligible at www.NUCALACopayProgram.com to sign up for the NUCALA Co-pay Program.

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.

Use your card each time you go to the doctor to get NUCALA.

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
at 1-844-4-NUCALA/1-844-468-2252.

 

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:

WAIT FOR YOUR APPROVAL LETTER

If you’re approved for the NUCALA Co-pay Program, you’ll receive an approval letter with specific instructions, tailored just for you. Make sure to follow those instructions.

Keep your cards handy, and write in your co-pay information once you receive an approval letter.

 

The Co-pay Program can help you save on your NUCALA.

 

Co-pay Program Eligibility:

 

If approved, you could pay as little as $0 for NUCALA.

 

You are not eligible for the program if: 

  • You have a state- or federal government-funded medical or prescription insurance plan such as Medicare, Medicaid, VA, or TRICARE.
  • You are Medicare-eligible (those who are aged 65 or older are deemed Medicare-eligible). 
  • You are enrolled in a commercial health plan that does not permit the use of Co-pay assistance programs.

 

You may be eligible for the program if:

  • You have a commercial medical or prescription insurance plan; or
  • You are uninsured.
         AND
  • You are a resident of the US (including the District of Columbia, Puerto Rico, and the US Virgin Islands).

‡ The NUCALA Co-pay Program helps eligible approved patients with their out-of-pocket costs for NUCALA up to $15,000 for 12 months. Medicare eligible patients, and patients enrolled in government-funded programs, are not eligible for the NUCALA Co-pay Program. Patients must submit an Enrollment Form or complete eligibility check online at www.NUCALACopayProgram.com so their eligibility can be determined. For full Program Terms & Conditions, please visit www.GSKCopayPrograms.com.