Selzentry

Indicated For

HIV-1

About This Medication

# ViiV HEALTHCARE Patient Assist Program Patient Guide: How to Get Selzentry (maraviroc) at Low or No Cost Selzentry (maraviroc) is an antiretroviral medication used to treat HIV-1 infection in adults and children who weigh at least 2 kg and are treatment-experienced or have certain CCR5-tropic viruses. The **ViiV Healthcare Patient Assistance Program (PAP)** provides **Selzentry at no cost** to eligible uninsured patients or those with Medicare who meet income limits and other criteria[1][5][6]. ## About Selzentry (maraviroc) **Selzentry**, also known as maraviroc, is a prescription medicine that blocks the CCR5 receptor on CD4 cells, preventing HIV-1 from entering and infecting them. It is typically used in combination with other antiretroviral drugs for patients whose virus uses the CCR5 co-receptor (confirmed by a tropism test). Common side effects include diarrhea, nausea, headache, and rash; serious risks involve liver problems, heart issues, or infections—always consult your doctor[1][6]. This program helps ensure access for those facing financial barriers, as Selzentry can be expensive without coverage. ## Who Qualifies for the Program? To qualify for free **Selzentry** through the ViiV Healthcare PAP, you must meet **all** these criteria: - Live in the 50 U.S. states, District of Columbia, or Puerto Rico (applications for patients under 18 need parent/guardian signature)[1][6]. - Be **uninsured** or have **Medicare Part A, B, D, or Medicare Advantage** (but meet extra requirements like spending $600+ on drugs that year for Part D)[1][5]. - **Not enrolled** in Medicaid, Puerto Rico Government Health Plan, AIDS Drug Assistance Program (ADAP), Alternate Funding Programs, or other federal/state government plans (except Medicare)[1][5]. - Meet **income eligibility** (detailed below)[6]. - Have a valid prescription for **Selzentry** from your doctor[5]. This program is operated by the GSK Patient Access Programs Foundation, separate from ViiV Healthcare, and does not count as health insurance[4]. ## Income Eligibility Breakdown Eligibility is based on **gross household income at or below** these limits for the **48 states and DC** (Alaska and Hawaii may differ—call to confirm). If your income is slightly over, you may qualify by showing high medical expenses[6]. | Household Size | Maximum Annual Gross Income | |---------------|-----------------------------| | 1 | $78,250 | | 2 | $105,750 | | 3 | $133,250 | | 4 | $160,750 | | Each additional person | Add $27,500 | **Notes**: Income includes all household earnings before taxes. Provide proof like tax returns or pay stubs. Up to **500% of Federal Poverty Level** per some sources[5][6]. Contact the program for exact FPL calculations or exceptions. ## Insurance Requirements - **Uninsured patients**: Fully eligible if other criteria met[1]. - **Medicare patients**: Eligible for Part A/B/D/Advantage if you've spent **$600+ on drugs this year** and meet income rules. Medicare Part D enrollees **must apply by mail/fax** first—no same-day phone approval[5]. - **Excluded**: Commercial insurance may direct you to ViiVConnect savings (not PAP); government programs like ADAP/Medicaid disqualify you[1][4]. - First, try ViiVConnect (1-844-588-3288) to check coverage or savings options before PAP[2][3]. ## Step-by-Step Application Process The program offers **multiple application methods**: phone, fax, mail, or download forms[1][5][6]. Here's how: 1. **Get a prescription**: Ask your doctor for **Selzentry** and have them complete the provider section[5]. 2. **Enroll via ViiVConnect first** (recommended): Download/fill the Patient Enrollment/Authorization Form (English/Spanish). Include insurance details if any. Email to info@viivconnectportal.com or fax 1-844-208-7676[3]. An Access Coordinator calls in a few days[3]. 3. **For PAP specifically** (oral meds like Selzentry): - Download the **Oral Medication Enrollment Form** from gskpaf.org/viiv[6]. - Patient and **doctor both sign/date** it. - Attach **proof of income** (e.g., 1040 tax return, W-2s, pay stubs)[5]. - Fax or mail per form instructions[6]. 4. **Call for help**: 1-844-588-3288 (Mon-Fri 8AM-8PM ET, languages available). They can fax/mail apps or enroll same-day for non-Medicare[1][5]. 5. **Doctor involvement**: Providers download forms from viivconnect.com or gskpaf.org[6]. **Required Documents**: - Prescription. - Proof of income. - Insurance cards (front/back) if applicable. - ID/residency proof if requested[3][5]. ## Timeline and Delivery - **Processing**: A few days for ViiVConnect response; PAP varies—non-Medicare may ship same-day via phone enrollment, Medicare by mail/fax takes longer[3][5]. - **Supply**: Up to **90-day supply** per shipment, shipped free to your **home**[5]. - **Refills**: Reauthorization likely required (call for details); track via coordinator[1]. Expect ongoing eligibility checks. ## Alternatives if Denied or Ineligible - **ViiVConnect Savings**: For insured patients, copay as low as $0 (not for Medicare/government programs)[4][7]. Enroll at viivconnect.com or ViiVSavingsProgram.com[7]. - **State ADAP**: If eligible, covers HIV meds[1]. - **RxHope or NeedyMeds**: Search other PAPs[5]. - **Patient Access Network (PAN) Foundation** or generic assistance. - Appeal denial by calling 1-844-588-3288 with more docs[1]. - **Biosimilars/Alternatives**: None listed for Selzentry; discuss CCR5 antagonists or other HIV regimens with your doctor. ## Important Disclaimer This guide is for informational purposes based on available program details as of latest data. **Eligibility, terms, and income limits can change**—always verify by calling **1-844-588-3288** or visiting gskpaf.org/viiv / viivconnect.com. This is **not health insurance** or medical advice. Consult your healthcare provider for treatment decisions. ViiV Healthcare/GSKPAF not liable for errors. For patients under 18, guardian required[1][4][6]. (Word count: 1028)

Program information last verified: March 30, 2026