Using the Program

For Intravenous (IV) Product Patients Under the Medical Benefit

For a physician's office or hospital

  • Practice completes a one-time registration by calling (855) MY-COPAY (855-692-6729). (Please note: This registration is for the practice only). At the time of enrollment, we also can:
    • Give you a password for the Provider Portal so you can manage all co-pay patients associated with your practice online
    • Link multiple providers in your practice to your account
  • Patient, caregiver or practice applies on behalf of the patient.
  • Practice administers infusion.
  • Practice faxes a copy of the patient's detailed EOB to (877) 885-2607. Co-pay amount minus the patient out-of-pocket responsibility is loaded onto the card after verification.
  • Claims must be submitted within 365 days from the date of service (DOS) for consideration

For providers without a credit card terminal

Before treatment

  • Provider confirms patient's enrollment in the program online or by phone at (855) MY-COPAY (855-692-6729).
  • Patient downloads the Check Request Form from the Forms section.
  • After treatment

  • Patient completes the Check Request Form and sends it to Genentech, along with copies of the detailed EOB and receipt illustrating payment, via:
    • Fax: (877) 885-2607
    • Mail to:
        Oncology Co-pay Assistance Program
        P.O. Box 2106
        Morristown, NJ 07962
  • A check is issued to the recipient indicated on the Check Request Form:
    • Check reimbursements take 7 to 10 business days, provided all documentation received is complete
  • Claims must be submitted within 365 days from the date of service (DOS) for consideration

For Oral Product Patients Under the Pharmacy Benefit

For a specialty pharmacy (SP)

  • SP completes a one-time registration by calling (855) MY-COPAY (855-692-6729). (Please note: This registration is for the SP only). During this call, we also can provide a password for the Provider Portal so they can manage all co-pay patients associated with their SP online.
  • Patient, practice or pharmacy applies on behalf of the patient.
  • Practice sends prescription to SP and informs the patient the oral product is being shipped by SP.
  • Patient gives the SP the RxBIN, Member ID, Group Number and PCN when SP calls to collect co-pay.
  • SP collects the patient's OOP costs using the RxBIN, Member ID, Group Number and PCN.

For a community/retail pharmacy

  • Practice completes a one-time registration by calling (855) MY-COPAY (855-692-6729). (Please note: This registration is for the practice only). During this call, we also can give you a password for the Provider Portal so you can manage all co-pay accounts associated with your practice online
  • Patient or practice applies on behalf of the patient.
  • Practice sends prescription to selected community/retail pharmacy and informs the patient the Genentech Oncology product has been ordered at a community/retail pharmacy.
  • Patient brings the RxBIN, Member ID, Group Number and PCN to the community/retail pharmacy to pick up the Genentech Oncology product.
  • Community/retail pharmacy collects the patient's OOP cost by using their RxBIN, Member ID, Group Number and PCN.

For SPs or community/retail pharmacies without a credit card terminal

  • SP confirms patient's enrollment in the program online or by phone at (855) MY-COPAY (855-692-6729).
  • Patient completes the Check Request Form found in the Downloadable Forms section and sends it to Genentech, along with copies of the detailed EOB and receipt illustrating payment, via:
    • Fax: (877) 885-2607
    • Mail to:
        Oncology Co-pay Assistance Program
        P.O. Box 2106
        Morristown, NJ 07962
  • A check is issued to the recipient indicated on the Check Request Form:
    • Check reimbursements take 7 to 10 business days, provided all documentation received is complete
  • Claims must be submitted within 365 days from the date of service (DOS) for consideration