Zostavax Patient Assistance Programs

Zostavax: Apply for prescription assistance below

If you are eligible, the programs below can help you afford Zostavax. Review the information to see if you qualify. The applications are available in Adobe PDF format and should be mailed directly to the provider of the patient assistance program.

If you have any questions, please call the telephone number for the program (not PharmacyChecker.com) or go to the program website.

Looking for a different medication?

Merck Vaccine Patient Program Assistance

(Program 1 of 1 — Scroll down to see them all )

Provided by: Merck & Co., Inc.
None
TEL: 800-293-3881
FAX: 800-528-2551
Languages Spoken:
English, Spanish, Others By Translation Service
Program Website
Medications
  • Zostavax (zoster vaccine live)
Eligibility Requirements
  • Insurance Status Determined case by case
  • Those with Part D Elibible? Contact program for details.
  • Income At or below 400% of FPL
  • Diagnosis/Medical Criteria Must be 19 yr old or older
  • U.S. Residency Required? Must be a legal resident of the United States or its territories
Application
  • Obtaining Call or download
  • Receiving Faxed, mailed or downloaded from website
  • Returning The application must be faxed back from the doctor's office prior to administration of the vaccine in order to qualify.
  • Doctor's Action Complete section and sign
  • Applicant's Action Complete section and sign
  • Decision Communicated Doctor notified
  • Decision Timeframe Same Day
Medication
  • Amount/Supply Not specified
  • Sent To Doctor's office
  • Delivery Time Not specified
  • Refill Proces New application
  • Limit Not specified
  • Re-application Varies
Additional Information
Decision Timeframe: Made within 10 minutes, if information is complete. For vaccines that are multidoses, the process must be repeated for each dose. The Gardasil vaccine is only available for patients age 19-26. The Zostavax vaccine is only available for patients age 50 and older. Individuals who don't meet the insurance criteria may still qualify for the Merck Patient Assistance Program if they attest that they have special circumstances of financial hardship, and their income meets the program criteria.
Updated November 8, 2018

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