INJECTABLES

ViiVConnect financial assistance options for your patients

ViiVConnect Copay Program*

Eligible patients could pay as little as $0 copay for their injectable medication

Enroll your patient in ViiVConnect for additional services, OR visit the ViiVConnect Copay Program site to enroll them directly in the savings program.

You can register and log in to the ViiV Claims Portal for reimbursement claims through the ViiVConnect Copay Program.

After receiving payer reimbursement for an enrolled patient, submit the Explanation of Benefits (EOB) for copay and administration fee reimbursement through one of the following methods:

  • EHR: Your electronic health record (EHR) system
  • Online: ViiVClaims.com
  • Fax: 866-437-8798 
  • Mail: ConnectiveRx, Attn: VC Copay Program, PO Box 1326, Morristown, NJ 07962

If a patient paid out of pocket for an eligible, prescribed ViiV Healthcare medication(s) and did not use the ViiVConnect Copay Program, they can use this form to request reimbursement.

eVoucherRx™

At participating pharmacies, an eVoucher will be automatically applied to qualifying claims without the need for patients to apply for savings cards or coupons. The eVoucherRx™ program is operated by CoverMyMeds®.

ViiV Healthcare Patient Assistance Program (PAP)*§

ViiV Healthcare PAP offers our medications at no cost to patients who qualify

For eligibility criteria, visit viivpap.org or call a ViiV Healthcare Patient Assistance Program representative at 1-844-588-3288, toll free. Monday–Friday, 8 am–8 pm (ET). Language options are available.

*All ViiV Healthcare patient assistance and savings programs are subject to program-specific eligibility and terms and conditions. Savings and assistance programs do not constitute health insurance.

The ViiVConnect Copay Program is subject to eligibility and is not health insurance. Read the full Eligibility Requirements and Restrictions.

The ViiVConnect Copay Program helps your eligible, enrolled consumers with their out-of-pocket costs for ViiV Injectable products. Medicare-eligible patients and those enrolled in some government-funded programs are not eligible for the ViiVConnect Copay Program.

§The ViiV Healthcare Patient Assistance Program is operated by the GSK Patient Access Programs Foundation, an independent, non-profit organization separate from ViiV Healthcare.