AREXVY

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: 1. **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] 2. **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] 3. **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] 4. **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