Incruse Ellipta

Indicated For

COPD, chronic bronchitis, emphysema

About This Medication

# GSK Patient Assistance Program Guide: How to Get Incruse Ellipta at Low or No Cost ## About This Guide If you've been prescribed Incruse Ellipta (umeclidinium) to help manage your COPD, chronic bronchitis, or emphysema, but you're concerned about the cost, you're not alone. This guide explains how GlaxoSmithKline's Patient Assistance Program can help you afford this medication at little to no cost. ## What Is Incruse Ellipta? Incruse Ellipta is a prescription inhalation powder that contains umeclidinium, a long-acting muscarinic antagonist (LAMA). It works by relaxing the muscles around your airways to help you breathe more easily. Most patients use it once daily. ## About the GSK Patient Assistance Program GlaxoSmithKline (GSK), the manufacturer of Incruse Ellipta, offers a patient assistance program to help uninsured and underinsured patients access their medications at reduced or no cost. The program provides free medication to eligible patients who cannot afford it, even if they have no insurance. ## Who Can Apply? You may qualify for the GSK Patient Assistance Program if you: - Are a U.S. resident - Have a valid prescription for Incruse Ellipta from your doctor - Are uninsured or underinsured (your insurance doesn't adequately cover the medication) - Meet the income eligibility requirements (see table below) - Cannot afford your medication out of pocket **Important Note:** This program typically does not cover patients with government insurance (Medicare, Medicaid, or VA benefits). However, you may be eligible for other programs—see the alternatives section below. ## Income Eligibility Your eligibility depends on your household income. Below is a general guideline for 2024: | Household Size | Maximum Annual Income | |---|---| | 1 | Varies* | | 2 | Varies* | | 3 | Varies* | | 4 | Varies* | | 5 | Varies* | | 6 | Varies* | | Each additional person | Varies* | *Income thresholds vary and are updated regularly. Contact GSK directly at (866) 728-4368 to confirm current limits for your household size. Income is typically calculated as your gross household income before taxes. You'll need to provide proof of income. ## Insurance Requirements The program is designed for: - **Uninsured patients** with no health insurance coverage - **Underinsured patients** whose insurance plans have high copays, deductibles, or don't cover Incruse Ellipta **Exception:** Patients with government insurance (Medicare, Medicaid, Veterans Affairs) are typically not eligible for this program. If this applies to you, see the "What If I'm Denied?" section below for alternatives. ## Documents You'll Need Before you apply, gather these documents: 1. **Valid Prescription** - An original or recent prescription from your doctor for Incruse Ellipta 2. **Proof of Income** - Recent tax returns, pay stubs, W-2 forms, or a signed statement of income 3. **Proof of Residency** - A utility bill, lease agreement, or government-issued ID showing your current address 4. **Proof of Insurance Status** - If uninsured, a signed statement confirming this; if underinsured, documentation from your insurance company showing denial of coverage or high out-of-pocket costs 5. **Photo ID** - A government-issued ID for verification ## How to Apply: Step-by-Step Instructions ### Step 1: Verify Your Eligibility Call the GSK Patient Assistance Program at **(866) 728-4368** to confirm you meet income and insurance requirements. A program representative can answer your questions and let you know what documents to prepare. ### Step 2: Complete the Application You can apply in multiple ways: - **Online**: Visit https://gskforyou.com/programs/patient-assistance-program/ to complete an online application - **By Phone**: Call (866) 728-4368 and speak with a representative who can guide you through the process - **By Mail**: Request a paper application and mail it with required documents (ask for the mailing address when you call) ### Step 3: Submit Your Documents Include all required documents with your application. Make copies for your records. If applying by phone, you may be asked to mail documents afterward. ### Step 4: Wait for Approval The program typically processes applications within **2-4 weeks**. You'll receive a notification by mail or phone regarding approval status. ### Step 5: Receive Your Medication If approved, Incruse Ellipta will be shipped directly to you at your home or to your doctor's office, whichever you prefer. There is no cost to you for approved medications. ## Timeline & What to Expect - **Application Processing**: 2-4 weeks - **Notification**: By mail or phone - **Medication Delivery**: Shipped at no cost to your home or physician's office - **Duration**: Typically covers a 12-month period - **Reauthorization**: Required annually—you'll need to reapply each year to continue receiving free medication ## Additional Cost-Saving Options Even if you're not eligible for the assistance program, GSK offers other ways to save: ### GSK Savings Card If you have insurance or prefer to use a commercial pharmacy, the Incruse Ellipta savings card may reduce your copay. Visit **https://incruse.com** to learn more or download a card. ## What If My Application Is Denied? If your application is denied, you have several options: 1. **Review the reason** - Call (866) 728-4368 to understand why you were denied 2. **Appeal the decision** - Ask if you can provide additional documentation to reconsider your application 3. **Explore alternatives**: - **Medicaid**: If you have low income, you may qualify for state Medicaid (different from the federal program) - **Medicare Extra Help**: If you're on Medicare with limited income, this program helps with prescription costs - **Charity organizations**: Groups like the American Lung Association or Patient Advocate Foundation may have emergency funds - **State pharmaceutical assistance programs**: Many states offer programs for residents who can't afford medications - **Your doctor's samples**: Ask your physician if they have free samples of Incruse Ellipta - **Savings card**: Use the Incruse savings card to reduce your out-of-pocket cost - **NeedyMeds.org**: Search this nonprofit database for additional assistance resources ## Important Reminders - **Keep your prescription active**: Visit your doctor annually to renew your prescription - **Plan ahead for reauthorization**: Since you must reapply each year, start the process 4-6 weeks before your current assistance expires - **Report changes**: If your income or insurance status changes significantly, let the program know - **Don't stop taking your medication**: If your assistance is delayed, ask your doctor or pharmacist about temporary options ## Legal Disclaimer This guide provides general information about the GSK Patient Assistance Program and is not medical advice. Program eligibility, income limits, and requirements are subject to change. Always verify current program details directly with GSK by calling (866) 728-4368 or visiting https://gskforyou.com/programs/patient-assistance-program/. This program is offered by GlaxoSmithKline and is subject to program terms and conditions. Consult your healthcare provider before starting or stopping any medication. ## Contact Information **GSK Patient Assistance Program** - **Phone**: (866) 728-4368 - **Website**: https://gskforyou.com/programs/patient-assistance-program/ - **Hours**: [Call for current hours] **Incruse Ellipta Savings Card** - **Website**: https://incruse.com

Program information last verified: March 25, 2026