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Get started with enrollment
Together with BENLYSTA offers a range of assistance options at no cost to you. After your doctor has prescribed BENLYSTA, you can choose how you want to enroll in the program. Follow the steps below to begin!
Start enrollment in three easy steps
Choose an option below
Start online or download—whatever works best for you.
Complete and sign
Sign as marked or provide your digital signature.
Review and submit
Make sure all required fields are completed by you.
Enroll in the Copay Program
By enrolling in the BENLYSTA Copay Program, eligible commercially insured patients can get support from a Patient Navigator—and possibly pay as little as $0* per dose for BENLYSTA.
*Subject to program maximums. See full Terms and Conditions.
Download and print
If you are enrolling in Together with BENLYSTA with your doctor, you can download and print an enrollment form, which will guide you and your doctor through the steps. Once the form is received and your enrollment is processed, you’ll gain access to the appropriate services.
Additional information about Together with BENLYSTA
We are here to help!
For more information about enrollment, or if you need help with the process, reach out to your Patient Navigator at 1-844-225-5894 (844-Call-TwGSK).
Monday–Friday: 8:00 AM – 8:00 PM ET