AREXVY
Generic: Respiratory Syncytial Virus Vaccine, Adjuvanted
Manufacturer: GSK · Program: GSK Vaccines Patient Assistance Program
Apply for assistanceFree to apply. Service from $40/month, payable only when your application is ready to submit.
Eligibility Criteria
Insurance Requirement
No third party coverage for Vaccines; Medicare patients not eligible
Residency
Live in the United States or Puerto Rico; not eligible for Puerto Rico's Government Health Plan Mi Salud or denied
Income Threshold
Up to 300% FPL
Individual Income Limit
$43,740/year
Must be uninsured or underinsured
Program Information
Processing Time
2–4 weeks
Delivery Method
shipped to patient, physician office, or participating pharmacy
Application Method
Multiple
Reauthorization
Required, annual
Typically Required Documents
ProvisionRX prepares and organizes all required documentation as part of your enrollment management. This list is provided for informational purposes.
- Completed application form
- Prescriber registration
- Patient Health and Allergy Information Form
- Vaccine Dose Authorization Request Form
Indicated for
Prevention of lower respiratory tract disease caused by RSV in adults 60+
About This Medication
GSK Vaccines Patient Assistance Program Patient Guide: How to Get AREXVY (Respiratory Syncytial Virus Vaccine, Adjuvanted) at Low or No Cost
The GSK Vaccines Patient Assistance Program provides AREXVY, a vaccine to protect adults aged 60 and older against respiratory syncytial virus (RSV), at no cost to eligible patients who lack vaccine coverage and meet other criteria.[1][2][3] This guide explains eligibility, the application process, and next steps in simple terms to help you access this important vaccine.
About AREXVY
AREXVY is an adjuvanted RSV vaccine approved for adults 60 years and older to prevent lower respiratory tract disease caused by RSV, a common virus that can lead to serious illness like pneumonia in older adults.[1][2] RSV season typically peaks in fall and winter, and vaccination is recommended by health experts for at-risk seniors. The vaccine is a single dose administered by intramuscular injection, typically in the upper arm. Common side effects include pain at the injection site, fatigue, headache, and muscle pain, which usually resolve within a few days. Always discuss with your healthcare provider if AREXVY is right for you, especially if you have allergies or immune conditions.[1][7]
Who Qualifies?
To qualify for free AREXVY through the program, you must meet these key requirements:
- Be 18 years or older (though AREXVY is primarily for those 60+).[2][7]
- Live in the United States or Puerto Rico (not eligible if enrolled in or approved for Puerto Rico's Mi Salud plan).[2]
- Have no third-party insurance coverage for vaccines (e.g., no private insurance, Medicaid, or other payer covering vaccines).[1][2][4]
- Not be on Medicare (Part D or otherwise; Medicare patients are ineligible).[1][4]
- Meet income guidelines based on federal poverty level (FPL), as outlined below.[2]
Important: This is a charitable program run by the independent GSK Patient Access Programs Foundation, not health insurance. It's designed for uninsured patients facing financial hardship.[3]
Income Eligibility Breakdown
The program has specific income limits based on household size and annual gross income. These are typically set at around 400-500% of the federal poverty level but confirm exact current thresholds by calling the program.[2] Here's a clear table of maximum annual gross incomes:
| Household Size | Maximum Annual Gross Income |
|---|---|
| 1 | $47,880 |
| 2 | $64,920 |
| 3 | $81,960 |
| 4 | $99,000 |
| Each additional person | Add $17,040 |
Notes: Income includes wages, Social Security, pensions, etc. Provide proof like tax returns, pay stubs, or benefit statements. Limits may update annually; verify with the program at 1-866-728-4368.[2] If your income exceeds these, you may not qualify.
Insurance Requirements
A strict rule: You must have no third-party coverage for vaccines. This means:
- No private health insurance paying for vaccines.
- No Medicaid, CHIP, or other government programs covering shots.
- Medicare patients are not eligible—this includes Parts B, D, or Advantage plans.[1][2][4]
Your doctor will verify this during application. If you gain coverage later, notify the program immediately, as it may affect eligibility.[1]
Step-by-Step Application Process
You cannot apply alone—your healthcare provider (doctor or prescriber) must handle enrollment. Here's how it works:
-
Talk to your doctor: Discuss AREXVY and confirm it's medically appropriate. Ask them to register with the program first at **www.gskpatientassistanceprogramportal.com**.[1][2][8]
-
Gather documents: Your provider needs:
- Completed GSK Vaccines Application (English/Spanish available).[2]
- Prescriber registration confirmation.[1]
- Patient Health and Allergy Information Form.[2]
- Vaccine Dose Authorization Request Form for AREXVY.[2][7]
- Proof of income (e.g., 2025 tax return, W-2s, pay stubs).[2]
- Proof of no insurance (e.g., denial letter or statement).[1]
-
Submit application: Provider faxes to 1-855-474-3063, mails to PO Box 220590, Charlotte, NC 28222-0590, or submits online via portal.[1][2]
-
Call for help: Contact 1-866-728-4368 (Mon-Fri 8am-8pm ET) for forms, questions, or Spanish assistance.[1][2]
Keep copies of everything—originals aren't returned.[4]
Timeline and Delivery
Processing time varies but aim for approval before your appointment. Once approved, you're eligible for vaccine doses up to 12 months.[1][2] The vaccine ships free to your doctor's office or sometimes directly to you—your provider confirms.[1][4] Administer only after approval to avoid issues. Reauthorization is required annually or for additional doses via the Dose Authorization Form.[2][7]
Alternatives if Denied or Ineligible
If denied (e.g., income too high, have coverage):
- Check GSKForYou.com for other support like copay cards (if insured).[3]
- Explore vaccines.gov or state health departments for low-cost RSV shots.
- Contact NeedyMeds.org or RxAssist.org for similar programs.[9][10]
- Ask your doctor about retail pharmacy discounts or free clinics.
- No biosimilars for AREXVY, as it's a unique adjuvanted vaccine.[ ]
Disclaimer
This guide is for informational purposes based on publicly available program details as of 2026 and is not medical or legal advice. Eligibility, terms, and income limits can change—always verify directly with GSK at 1-866-728-4368 or gskpaf.org. GSK makes no guarantees of approval. Consult your healthcare provider for personalized guidance. Program does not constitute health insurance.[1][2][3]
Program information last verified: March 30, 2026
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