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What is Bridges to Access?
Bridges to Access, GlaxoSmithKline’s patient assistance program
for non-oncology medicines, provides GSK prescription medicines to
eligible low-income patients without prescription drug benefits.
What are the eligibility criteria?
Patients must meet all of the following guidelines to qualify for Bridges to Access:
Be a United States resident
Have no prescription drug benefits through any insurer/payer/program*
*Patients eligible for but not enrolled in Medicare Part D
may be eligible for Bridges to Access if they do not qualify for
the
Part D Low Income Subsidy (LIS).
Patients with incomes under 135% of the Federal Poverty Guidelines
will be required to apply for LIS, and provide proof of denial.
Have gross monthly household income at or below:
The following table represents 250% of the 2008 Poverty Guidelines.
Please call 1-888-825-5249 for more information.
- 48 Contiguous States and District of Columbia
Size of Family Unit |
Monthly Gross Income |
1 |
$2,166.67 |
2 |
$2,916.67 |
3 |
$3,666.67 |
4 |
$4,416.67 |
For each additional
person, add |
$750.00 |
- Alaska
Size of Family Unit |
Monthly Gross Income |
1 |
$2,708.33 |
2 |
$3,645.83 |
3 |
$4,583.33 |
4 |
$5,520.83 |
For each additional
person, add |
$937.50 |
- Hawaii
Size of Family Unit |
Monthly Gross Income |
1 |
$2,491.67 |
2 |
$3,354.17 |
3 |
$4,216.67 |
4 |
$5,079.17 |
For each additional
person, add |
$862.50 |
What is an Advocate?
For the purpose of Bridges to Access, an Advocate is any non-family
member who:
- has a relationship in the delivery of healthcare services to
the patient, and
- agrees to help the patient enroll and manage ongoing participation
in Bridges to Access
Usually this is a physician, physician assistant, pharmacist,
pharmacist technician, nurse, social worker or someone who works
in the healthcare office or facility where the patient is being
treated.
A patient must have an Advocate in order to enroll in Bridges to Access.
What are the roles and responsibilities
of an Advocate?
An Advocate is responsible for the following:
- helping patients obtain, complete, and sign the one-page enrollment
form;
- contacting Bridges to Access by phone to enroll
patients;
- sending in documentation after telephone enrollment
is complete;
- ordering product refills
for patients if patients require assistance;
- helping patients re-enroll
after a year, if needed;
- informing GSK of any prescription, address or income changes,
and
- helping patients with other Bridges to Access issues.
To become an Advocate, simply call 1-866-PATIENT or click Register
as An Advocate and attest tot he roles and responsibilities.
Advocates will be issued a personal six-digit identification number for
program usage.
How do patients enroll in Bridges to
Access?
Patients must have an Advocate (see above) to help complete and sign the
one-page enrollment
form. Once the enrollment form is completed and signed, the
Advocate calls 1-866-728-4368, M-F 8AM - 8PM ET, to enroll the patient
by phone. Bridges to Access will make an immediate eligibility determination.
If the patient is eligible, the Advocate completes the Bridges
to Access Patient Voucher and gives to the patient to take to any
local retail pharmacy along with their prescription(s). See
First Retail Pharmacy
Fill – First 60 Days for more information.
The Advocate sends the enrollment form, mail order prescription
(if needed), and income documentation to: Bridges to Access,
PO Box 29038, Phoenix,
AZ 85038-9038.
Do not mail the enrollment form, prescription or any other documentation
until directed after the enrollment phone call.
See Enrollment Process/Timeline
for more information.
How do Advocates and patients download
or request enrollment forms?
Advocates :
After signing onto this website. Advocates
may:
- download a form on-demand, or
- request forms be mailed.
Additionally, Advocates may call 1-866-PATIENT to request:
- a single form by fax, or
- a packet of ten forms by mail.
Patients:
Patients may obtain forms by:
IMPORTANT: Each enrollment form has a unique 9-digit
identification number that serves as the patient’s Bridges
to Access identification number for as long as the patient remains
in the program. Each patient will need an original numbered enrollment
form. Forms may not be photocopied.
How do eligible patients fill initial
prescriptions and refills?
Bridges to Access distributes products through two methods. The first
prescription is dispensed through a local retail pharmacy and refills
are dispensed through mail order pharmacy.
First Prescription:
Retail Pharmacy Distribution -
Products are initially distributed through a local retail pharmacy
to allow eligible patients to fill prescriptions immediately
after telephone enrollment.
An eligible patient presents the Bridges to Access Patient Voucher
and the prescription(s) to the pharmacy. Patients may receive up
to a 60-day supply of medicine for a $10 co-pay per prescription
per fill.
Refills:
Mail Order Pharmacy - If assistance
is needed after the initial 60-day period, the Advocate should send
in a separate prescription with the enrollment form and documentation.
The first refill will be sent automatically to the shipping address
indicated on the enrollment form. Later refills must be requested
by calling 1-866-PATIENT. Refills should be requested three weeks
before the next refill is needed. |
