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 copay and assistance programs are subject to program specific eligibility and terms and conditions. Copay and assistance programs do not constitute health insurance.
†The ViiVConnect Copay Program helps eligible, enrolled consumers with their out-of-pocket costs. Read the full Eligibility Requirements and Restrictions 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.