No matter what type of health insurance your patients have, and even if they have none at all, there may be financial assistance options available. Take a look at the details of some potential programs below.
Use our financial assistance tool to see which programs may be right for your patient.
If you would rather talk through some potential options, call us at 866-4ACCESS (866-422-2377) (6AM-5PM, Monday through Friday).
Genentech Ophthalmology Co-pay Program and Independent Co-pay Assistance Foundations
If your patient has insurance coverage and needs help affording LUCENTIS, these programs may help:
Help with costs for LUCENTIS
With the Genentech Ophthalmology Co-pay Program, eligible patients with commercial insurance could pay as little as $5 per LUCENTIS co-pay. Co-pay assistance is available up to $15,000 per calendar year.
Patients may be eligible if they:
- Have been prescribed a Genentech Ophthalmology treatment for an FDA-approved indication
- Are 18 years of age or older
- Have commercial (private or non-governmental) insurance. This includes plans available through state and federal health insurance exchanges
- Are not receiving assistance through the Genentech Patient Foundation or any other charitable organization for the same expenses covered by the program
- Are not a government beneficiary and/or participant in a federal or state-funded health insurance program (e.g., Medicare, Medicare Advantage, Medigap, Medicaid, VA, DoD, TRICARE)
Help with costs for injections
With the Genentech Ophthalmology Co-pay Program, eligible patients with commercial insurance could pay as little as $5 per injection co-pay for LUCENTIS. Assistance with injection co-pay costs is available up to $1,000 per calendar year.
Patients may be eligible if they:
- Have been prescribed a Genentech Ophthalmology treatment for an FDA-approved indication
- Are 18 years of age or older
- Have commercial (private or non-governmental) insurance. This includes plans available through state and federal health insurance exchanges
- Are not receiving assistance from any charitable organization for the same expenses covered by the program*
- Are not a government beneficiary and/or participant in a federal or state-funded health insurance program (e.g., Medicare, Medicare Advantage, Medigap, Medicaid, VA, DoD, TRICARE)
- Do not live or get treatments in a restricted state (Massachusetts or Rhode Island)
*Patients may use the Genentech Ophthalmology Co-pay Program for their administration costs if they are receiving their treatment from the Genentech Patient Foundation.
The Genentech Ophthalmology Product and Administrative Co-pay Program is valid ONLY for patients with commercial insurance who have a valid prescription for a Food and Drug Administration (FDA)-approved indication of a Genentech medication. Patients using Medicare, Medicaid or any other federal or state government program to pay for their medications are not eligible. To receive co-pay assistance for both drug cost and administration fees, patients must apply for and be enrolled in each type of program benefit, (i.e., drug cost and administration fees).
Under the programs, the patient will pay a co-pay for drug costs and a co-pay for administration costs. After reaching the maximum per treatment or annual limit, the patient will be responsible for all remaining out-of-pocket expenses. The amount of the program’s benefits cannot exceed the patient’s out-of-pocket expenses for the cost of the drug or administration fees associated with the LUCENTIS.
All participants are responsible for reporting the receipt of all program benefits as required by any insurer or by law. The programs are only valid in the United States and U.S. Territories. These programs are void where prohibited by law. The product co-pay program shall follow state restrictions in relation to AB-rated generic equivalents (e.g., MA, CA) where applicable. The administration co-pay program is not valid for Massachusetts or Rhode Island residents. The patient, guardian, prescriber, hospital and any other person using or administering the programs agree not to seek reimbursement for all or any part of the benefit received by the patient through the offer of this program. Genentech reserves the right to rescind, revoke or amend the program without notice at any time. Additional Terms and Conditions apply.
An independent co-pay assistance foundation is a charitable organization providing financial assistance to patients with specific disease states, regardless of treatment. Patients who are commercially or publicly insured, including those covered by Medicare and Medicaid, can contact the foundations directly to request assistance. Eligibility requirements, all aspects of the application process, turnaround times and the type or amount of assistance available (if any) can vary by foundation.
These foundations may be able to help. Please check their websites for up-to-date information.
Organizations for macular and retinal diseases
Advise your patient that these organizations are independent of Genentech and may require the patient to provide personal or financial information directly to the organization to enroll in their respective programs. Genentech cannot share any information the patient has provided to us.
Independent co-pay assistance foundations have their own rules for eligibility. We have no involvement or influence in independent foundation decision-making or eligibility criteria and do not know if a foundation will be able to help your patient. We can only refer your patient to a foundation that supports their disease state. This information is provided as a resource for you. We do not endorse or show preference for any particular foundation. The foundations in this list may not be the only ones that might be able to help your patient.
The financial assistance tool can help your patient to find out if this option may be right for them. Get started.
Genentech Patient Foundation
If your patient has financial difficulty or does not have insurance coverage and needs help affording LUCENTIS, this program may help:
The Genentech Patient Foundation gives free LUCENTIS to people who have been prescribed this medicine and don’t have insurance or that have financial concerns and meet certain eligibility criteria.
Your patient may be eligible if their insurance coverage and income match one of these situations:
- Uninsured patients with incomes under $150,000
- Insured patients without coverage for LUCENTIS with incomes under $150,000
- Insured patients with coverage for a Genentech medicine:
- With unaffordable out-of-pocket costs
- Who have pursued other forms of financial assistance
- With household size and income within certain guidelines
If you have any questions about the criteria, please contact a Foundation Specialist at 888-941-3331 (Mon.–Fri., 6AM–5PM PST), or get started by enrolling below.
Enrollment Process for the Genentech Patient Foundation
Get started with enrollment by following the steps below.
Option 1: Submit forms online
If your practice has a registered account for My Patient Solutions, you can get started by logging into your account.
Don't have an account?
Your patient is required to complete the Patient Consent Form. You can either upload their Patient Consent Form as part of your application or have your patient submit the form via fax, text or e-submit.
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An online tool to help you enroll patients in Genentech Ophthalmology Access Solutions and manage your service requests at your convenience.
Option 2: Print forms and fax or text
Step 1: Print one of the Patient Consent Forms below for your patient to complete.
Step 2: Print and complete the Prescriber Foundation Form below.
Step 3: Submit the completed forms via fax or text.
- Send via fax to 833-999-4363
- Text a photo of the form to 650-877-1111
Both forms are required. We must have both the Patient Consent Form and the Prescriber Foundation Form before we can help you.
What to expect next:
- The request will be processed within five business days upon receipt of both required forms.
- Your office will be contacted to discuss the application outcome and any next steps.
Genentech reserves the right to modify or discontinue the program at any time and to verify the accuracy of information submitted.
Not sure which programs may be able to help? We'll walk you through some potential options with the financial assistance tool.
Helpful Resources for Your Practice
Find information and resources for benefits investigations, billing and coding and more.
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Commercial insurance: An insurance plan you get from a private health insurance company. This can be insurance from your job, from a plan you bought yourself or from a Health Insurance Marketplace (for example, from HealthCare.gov). Medicare and Medicaid are not considered commercial insurance.
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Public insurance: A health insurance plan you get from the federal or state government. This includes Medicare, Medicaid, TRICARE and DoD/VA insurance.
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For example, a household size of 1 with income of less than $75,000 may meet the criteria for assistance. Add $25,000 for each additional person in the household. There is no maximum number of people you may add.
Terms and Conditions
The Genentech Ophthalmology Product and Administration Co-pay Program is valid ONLY for patients with commercial (private or non-governmental) insurance who have a valid prescription for a Food and Drug Administration (FDA)-approved indication of a Genentech medication. Patients using Medicare, Medicaid, Medigap, Veterans Affairs (VA), Department of Defense (DoD), TRICARE or any other federal or state government funded program (collectively, “Government Programs”) to pay for their medications and/or administration services are not eligible. The programs are not valid if the costs are eligible to be reimbursed in their entirety by private insurance plans or other programs.
Under the programs, the patient will pay a co-pay. After reaching the maximum program benefit, the patient will be responsible for all remaining out-of-pocket expenses. The amount of the program’s benefits cannot exceed the patient’s out-of-pocket expenses for the cost of the drug or administration fees associated with LUCENTIS. The program benefit will reset every January 1st. These programs are not health insurance or a benefit plan. The programs do not obligate use of any specific product or provider. The drug co-pay program is not available or valid for patients receiving free product from the Genentech Patient Foundation. The administration co-pay program is valid for patients receiving free product from the Genentech Patient Foundation. The product and administration programs are not valid for patients receiving assistance from any other charitable organization for the same expenses covered by the programs. The co-pay benefit cannot be combined with any other rebate, free trial or similar offer for the medication or administration of the product. No party may seek reimbursement for all or any part of the benefit received through these programs.
The programs may be accepted by participating pharmacies, physician offices or hospitals. Once a patient is enrolled, the programs will not honor claims with date of service or medication dispensing that precede program enrollment by more than 180 days. Claims must be submitted within 365 days from the date of service unless otherwise indicated. Use of these programs must be consistent with all relevant health insurance requirements. Participating patients, pharmacies, physician offices and hospitals are responsible for reporting the receipt of all program benefits as required by any insurer or by law. Program benefits may not be sold, purchased, traded or offered for sale.
The patient or their guardian must be 18 years or older to receive program assistance. The programs are only valid in the United States and U.S. Territories. The programs are void where prohibited by law. The product co-pay program shall follow state restrictions in relation to AB-rated generic equivalents (e.g., MA, CA) where applicable. The administration co-pay program is not valid for Massachusetts or Rhode Island residents. Eligible patients will be automatically re-enrolled in the program on an annual basis. Eligible patients will be removed from the program after 3 years of inactivity (e.g., no claims submitted in a 3-year timeframe). Program eligibility and automatic re-enrollment are contingent upon the patient’s ability to meet all the requirements set forth by the programs. Healthcare providers may not advertise or otherwise use the programs as a means of promoting their services or Genentech’s products to patients. Genentech reserves the right to rescind, revoke or amend the program without notice at any time.
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LUCENTIS [package insert]. South San Francisco, CA: Genentech, Inc; 2018.
LUCENTIS [package insert]. South San Francisco, CA: Genentech, Inc; 2018.
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Campochiaro PA, et al; BRAVO Investigators. Ophthalmology. 2010;117:1102-1112.
Campochiaro PA, et al; BRAVO Investigators. Ophthalmology. 2010;117:1102-1112.
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Data on file. South San Francisco, CA: Genentech, Inc.
Data on file. South San Francisco, CA: Genentech, Inc.
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Brown DM, et al; CRUISE Investigators. Ophthalmology. 2010;117:1124-1133.
Brown DM, et al; CRUISE Investigators. Ophthalmology. 2010;117:1124-1133.
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