Frequently Asked Questions

The Genentech Patient Foundation gives free Genentech medicine to people who don’t have insurance coverage or who have financial concerns and meet eligibility criteria.

Eligible patients may be able to get free Genentech medicine if they:

• Do not have insurance coverage for their Genentech medicine and their household makes less than $150,000* per year
• Have insurance, can’t afford their out-of-pocket costs and meet certain income requirements†

*For all patient types, add $25,000 for each extra person in households larger than 4 people.

†We encourage insured patients to try other financial assistance options before applying for help from the Genentech Patient Foundation, if possible.

Learn more about qualifying for the Genentech Patient Foundation.

A current list of the medications supported by the Genentech Patient Foundation can be found here.

Steps for enrolling into the Genentech Patient Foundation can be found here.

Call a Foundation Specialist at (888) 941-3331, Monday through Friday, 6 a.m.–5 p.m. PT.

Foundation Specialists are your main point of contact at the Genentech Patient Foundation. They are always ready to help walk you through your next steps. They have local knowledge and can tell you the best options for help in your area.

If you meet the Genentech Patient Foundation eligibility criteria, you may be able to get your Genentech medicine for free.

Find out if you are eligible for the Genentech Patient Foundation.

If your insurance does not cover your medicine, it may be because:

• The health insurance plan does not have the Genentech medicine on its list of covered medicines (also known as a “formulary”)
• The health insurance plan includes certain restrictions that limit the ability to receive the prescribed Genentech medicine

Genentech Access Solutions may be able to help explain the insurance plan’s policy

Please note: Some health plans require you to try another medicine before it will approve your Genentech medicine. This is called a “step edit.” If your health plan requires a step edit, you may not be eligible for free medicine from the Genentech Patient Foundation.

If your health insurance plan requires you to use another medicine before you can use a Genentech medicine (also known as a "step edit" or "step therapy"), you must follow your plan requirements before the Genentech Patient Foundation can help you. Certain exceptions apply. To learn more, please call a Foundation Specialist at (888) 941-3331, Monday through Friday, 6 a.m.–5 p.m. PT.

No. You may still apply for help from the Genentech Patient Foundation while you and your doctor file an appeal. You do not need to send us proof of your appeal to get help.

We suggest all patients consider other forms of financial assistance before applying for support from the Genentech Patient Foundation. These may include Genentech co-pay programs and/or independent co-pay assistance foundations.

How much you and the members of your household make each year minus specific deductions. This is also frequently referred to as your Adjusted Gross Income or AGI. If you have questions, please call a Foundation Specialist at (888) 941-3331, Monday through Friday, 6 a.m.–5 p.m. PT.

Some health insurance companies, Pharmacy Benefit Managers, and employers have initiated programs or engaged third party vendors in order to cut their costs. These programs, including Alternate Funding Programs (AFPs), Copay Maximizers, and Copay Accumulators, may pose potential risks to patients by interfering with patients receiving timely treatment and burdening patients with undue stress and unexpected costs when trying to access prescribed medicines.

Under a Patient Assistance Diversion Program (PADP) a patient may be required to pursue a Patient Assistance Program (PAP) in order to shift the cost of the medicine away from the payor and onto the patient. These programs can cause confusion about coverage and benefits and may add stress to patients who are navigating a coverage denial and worry about receiving their prescribed treatment.

Below are three common Patient Assistance Diversion program types:

• Alternate Funding Programs (AFP): AFPs are third party vendors that have partnered with payors or employers. Under a typical AFP, the plan automatically denies claims for the drug prescribed and directs the patient to the plan’s for-profit AFP vendor. The AFP vendor requires the patient to acquire the prescribed drug in a way that shifts coverage costs away from the plan.
• Copay Maximizers: these programs are features of a patient’s insurance plan and may require opt-in by the patient. Maximizer programs set an individual’s monthly copay value based on the maximum co-pay assistance provided by the manufacturer. Their intention is to redirect funds from manufacturer’s assistance programs from patients to payers. Often the copay value that is paid does not count towards the patient’s annual deductible or out-of-pocket maximum.
• Copay Accumulators: these programs are features of a patient’s insurance plan. Accumulator programs set the copay value for specialty medications at an unaffordable rate and ensure that value paid does not count towards the patient’s annual deductibles or out-of-pocket maximums.

If patients who have been denied coverage by an AFP or whose coverage has become unaffordable due to a Maximizer or Accumulator program are accepted into the Foundation program, the health plan and any third party vendors associated will have improperly shifted the cost of their insurance obligation to our non-profit program. This shift of coverage will ultimately have a negative impact on our efforts to support patients who truly need free Genentech medicine and meet Foundation eligibility criteria.

New patients and patients re-applying to the Foundation whose health insurance plans require them to use an AFP vendor or enroll in a Maximizer or Accumulator plan and apply to the Foundation do not meet the Foundation’s eligibility criteria and are therefore denied Foundation assistance. Patients who are currently enrolled will not be affected; however, their eligibility will be re-evaluated during their annual reverification.

There are several programs that may be able to help you get your Genentech medicine. Genentech Access Solutions can help you understand your insurance coverage and can refer you to programs that may be able to help you pay for your medicine.

Patients who are enrolled in the Genentech Patient Foundation will keep getting free medicine as long as they qualify. They do not need to re-enroll.

At Genentech, we believe that each patient should get the medicine their doctor prescribed. We work to get our medicines to those who need them. The Genentech Patient Foundation is just one of the ways we help patients in need.

Learn more about how we help patients.

No, the Genentech Patient Foundation does not collect or require citizenship information.

• Health care providers can order medicines by:

  • Calling a Foundation Specialist at (888) 941-3331
  • Using the Prescriber Foundation Form
  • Using the Product Replacement Form

  Learn more about the Genentech Patient Foundation logistics.

The Genentech Patient Foundation Overview Bifold provides an overview of the Genentech Patient Foundation and its eligibility criteria. You can download a copy for your reference here.

For printed copies to give to your patients and information about other resources, please contact your Genentech Field Reimbursement Manager or visit GenentechPatientFoundation.com.

See the Learn How To Get Our Medicines page for information on which Genentech medicines are eligible for replacement shipments.

While a benefits investigation is not required to receive assistance, the Genentech Patient Foundation may leverage benefit investigations as an internal tool, to support an eligibility decision. We do require health care providers to be aware of and attest to the patient's coverage status prior to enrolling in the Foundation.

Proof of appeal is not necessary to receive assistance. You may still apply for help from the Genentech Patient Foundation while you and your doctor file an appeal if you choose to. Please do not submit additional paperwork with your patient's enrollment, as this may cause delays.

While it is preferred that the Prescriber Foundation Form and Patient Consent Form are sent together, we are still able to review the patient's eligibility if we receive them separately.