Juluca

Indicated For

HIV-1

About This Medication

# ViiVConnect Patient Guide: How to Get Juluca at Low or No Cost ## About This Program ViiVConnect is ViiV Healthcare's patient assistance program designed to help eligible patients access their HIV medications, including Juluca (dolutegravir/rilpivirine), at reduced or no cost. Juluca is a complete one-tablet, once-daily oral HIV treatment that combines two antiretroviral medications. ViiVConnect offers two main pathways to assistance: the ViiVConnect Savings Card Program for commercially insured patients and the ViiV Healthcare Patient Assistance Program (PAP) for uninsured patients. ## Who Qualifies for ViiVConnect Eligibility depends on your insurance status and income level. ViiVConnect serves two distinct patient populations: **For the ViiVConnect Savings Card Program (Commercially Insured Patients):** - You have active commercial insurance that covers Juluca - You are a resident of the United States, including Puerto Rico - You are NOT enrolled in Medicare, Medicaid, Veterans Affairs, TRICARE, or other government-funded insurance plans - You are willing to pay a reduced copay (potentially $0) for your prescription **For the ViiV Healthcare Patient Assistance Program (Uninsured Patients):** - You are uninsured or have spent $600 or more on medications in the current year with Medicare Part D - You meet income eligibility requirements (see income table below) - You are a resident of the United States, District of Columbia, or Puerto Rico - You have a medically appropriate HIV diagnosis - You are not enrolled in AIDS Drug Assistance Program (ADAP), Medicaid, or other state/federal government-funded health plans (with limited Medicare exceptions) ## Income Eligibility Requirements For the ViiV Healthcare Patient Assistance Program, your household income must be at or below **500% of the Federal Poverty Level**. The following table shows the maximum annual gross income limits for the 48 states and Washington DC: | Household Size | Maximum Annual Gross Income | |---|---| | 1 person | $78,250 | | 2 people | $105,750 | | 3 people | $133,250 | | 4 people | $160,750 | | Each additional person | Add $27,500 | If your income exceeds these limits, you may still qualify by demonstrating that your eligible medical expenses bring you within the income eligibility criteria. Contact the program directly to discuss your situation. ## Insurance Requirements **If you have commercial insurance:** You are eligible for the ViiVConnect Savings Card Program, which helps reduce your out-of-pocket costs. Your commercial insurance must actively cover Juluca for you to participate in this program. **If you have Medicare:** You may be eligible for the ViiV Healthcare Patient Assistance Program if you have Medicare Part A, B, D, or Medicare Advantage and meet other program requirements. However, you are NOT eligible for the ViiVConnect Savings Card Program. **If you have Medicaid or other government insurance:** You are generally not eligible for ViiVConnect programs, with limited exceptions for ADAP or PrEP DAP insurance that covers your medication. **If you are uninsured:** You can apply for the ViiV Healthcare Patient Assistance Program, which offers medications at no cost to qualifying patients. ## How to Apply **Step 1: Determine Your Program** Decide whether you qualify for the Savings Card Program (commercially insured) or the Patient Assistance Program (uninsured). Visit viivpap.org or call 1-844-588-3288 (Monday–Friday, 8 am–8 pm ET) to confirm your eligibility. **Step 2: Gather Required Documents** You will need: - A valid prescription for Juluca from your healthcare provider - Proof of income (recent tax return, pay stubs, or benefit statements) - Proof of residency (utility bill or lease agreement) - Insurance information (if applicable) **Step 3: Complete Your Application** For the Savings Card Program, visit myviivcard.com to check eligibility and request a card online. For the Patient Assistance Program, you can: - Call 1-844-588-3288 to request an application by phone, fax, or mail - Download an application from viivpap.org - Work with your healthcare provider to submit the application **Step 4: Submit Your Application** Complete the application form, sign it, and attach proof of income. Submit according to the instructions provided (by mail, fax, or online portal). **Step 5: Receive Your Assistance** Once approved, you will receive your Savings Card (for commercially insured patients) or your medications will be provided at no cost (for uninsured patients). ## Timeline and Delivery While specific processing times are not publicly detailed, most patient assistance programs process applications within 5-10 business days. Your healthcare provider or the program representative can provide more specific timeline information when you apply. For the Savings Card Program, you can use your card at participating pharmacies to pick up prescriptions in-store or by mail. If your pharmacy does not accept the card, you can request reimbursement of your copay costs. For the Patient Assistance Program, medications are typically shipped directly to you or your healthcare provider. ## What If Your Application Is Denied? If you are denied for ViiVConnect, consider these alternatives: - **Review your eligibility:** Contact the program to understand why you were denied and whether you can provide additional documentation - **Explore other assistance programs:** Ask your healthcare provider about other patient assistance programs or community resources - **Contact your state's AIDS Drug Assistance Program (ADAP):** If you have HIV, ADAP may provide medications at no or low cost - **Request a rebate:** If you paid out of pocket for Juluca without using ViiVConnect, you may be able to request a rebate by submitting a form to the program ## Important Disclaimers ViiVConnect programs are subject to program-specific eligibility requirements and terms and conditions. These programs do not constitute health insurance. Income limits and eligibility criteria are subject to change. Always verify current requirements by visiting viivpap.org or calling 1-844-588-3288. This guide is for informational purposes and should not replace professional medical or financial advice. Consult with your healthcare provider or a program representative for personalized guidance.

Program information last verified: March 30, 2026