Genentech Oncology
Co-pay Assistance Program

In order to qualify for the Co-pay Program, patients must meet the following criteria:

• Covered by commercial (also known as private) insurance

• Not a participant in a federal or state-funded healthcare program, including but not limited to Medicare, Medicaid, VA/DoD, TRICARE and Medigap

• Are 18 years of age or older, or have a legal guardian 18 years of age or older to manage the program

• Live in and receive treatment in the United States or U.S. Territories

• Receiving a Genentech Oncology product for an FDA-approved indication

• Not receiving assistance through the Genentech Patient Foundation or any other co-pay charitable organization

Announcing updated program features

• 0

  Income requirements

• ^$5

  Patient pays as little as $5 for their prescribed Genentech Oncology product(s)

• ^$25k

  Annual benefit limit of Co-pay Program is $25,000 per product

• $5 co-pay applies for FDA-approved Genentech combination products

• Retroactive requests for assistance from the Oncology Co-pay Assistance Program may be honored for qualifying patients if the infusion or prescription fill occurred within 180 days prior to enrollment and the patient meets all eligibility criteria at the time of infusion

• Claims must be submitted within 365 days from the date of service (DOS) for consideration

• No physical card needed; patients simply need their Member ID