Merck Vaccine Patient Assistance for Gardasil (HPV Vaccine)
Merck has created a Patient Assistance Program for the Gardasil vaccine because very limited public funding is available in the United States. This private and confidential program provides the vaccine free of charge to eligible adults, primarily the uninsured who, without assistance, could not afford the Gardasil vaccine.
Who May Qualify
You may be eligible for the program if all four of the following conditions apply:
- You are age 19 to 26
- You have no health insurance coverage*
- You make less than $20,240 a year*
- You cannot be claimed as a dependent on another individual's tax return*
*However, Merck recognizes that sometimes exceptions need to be made based on a patient's individual circumstances. Individuals who do not meet these criteria may still qualify for the vaccine program if the patient has special circumstances of financial and medical hardship.
How the Program Works
- 1. If you believe you qualify for the free Gardasil vaccine, download the application or pick one up at UHC's Information Desk. Complete the first page of the application and drop it off at the Information Desk.
- Be sure to download the correct application. You can find the application under "How the Program Works" below the Merck Vaccine Patient Assistance Program on the left side. This application must be submitted and approved prior to each administration of the Gardasil vaccine.
- A new application will need to be completed and submitted to the Merck Vaccine Patient Assistance Program for eligibility assessment prior to your next dose.
- Annette Hraban (Patient Assistance Program Coordinator, Telephone: 472-7479) will fax your application to Merck. If you have any type of insurance, Merck will fax back an attestation form. You will need to come back to UHC and sign this. You will then be notified by Annette of your approval status. There will be an administration injection fee of $6.00 for each dose.
