Is your patient insured?
Does the patient's insurance cover his or her Genentech medicine?
Does your patient have commercial insurance?What does this mean?
Has your patient already been referred to the Genentech BioOncology Co-pay Card and is either ineligible or no longer receiving assistance?
Has your patient already been referred to an independent co-pay assistance foundation and is either ineligible or no longer receiving assistance?
Is the patient 18 years of age or older?
Your Patient Might Qualify for a Referral to the Genentech BioOncology Co-pay Assistance Program
If eligible commercially insured patients need assistance with their out-of-pocket costs, POLIVY Access Solutions can refer them to the Genentech BioOncology Co-pay Assistance Program.*
*This Genentech BioOncology Co-pay Assistance 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.
Under the Program, the patient will pay a co-pay. After reaching the maximum Program benefit, the patient will be responsible for all out-of-pocket costs.
All participants are responsible for reporting the receipt of all Program benefits as required by any insurer or by law. No party may seek reimbursement for all or any part of the benefit received through this Program. This Program is void where prohibited by law. Genentech reserves the right to rescind, revoke, or amend the Program without notice at any time. Additional eligibility criteria apply. See full terms and conditions at CopayAssistanceNow.com.
Your Patient Might Qualify for a Referral to an Independent Co-pay Assistance Foundation
For eligible patients with commercial or public health insurance, POLIVY Access Solutions offers referrals to independent co-pay assistance foundations.*
*Genentech does not influence or control the operations or eligibility criteria of any independent co-pay assistance foundation and cannot guarantee co-pay assistance after a referral from POLIVY Access Solutions. The foundations to which we refer patients are not exhaustive or indicative of Genentech’s endorsement or financial support. There may be other foundations to support the patient's disease state.
Your Patient Might Qualify for a Referral to the Genentech Patient Foundation
The Genentech Patient Foundation provides free Genentech medicine to people who don't have insurance coverage or who have financial concerns and to people who meet certain income criteria.*
*To be eligible for free Genentech medicine from the Genentech Patient Foundation, insured patients who have coverage for their medicine must have exhausted all other forms of patient assistance (including the Genentech BioOncology Co-pay Assistance Program and support from independent co-pay assistance foundations) and must meet financial criteria. Uninsured patients and insured patients without coverage for their medicine must meet different financial criteria.
Does Your Patient Have Commercial Insurance?
POLIVY Access Solutions can refer eligible patients to the Genentech BioOncology® Co-pay Assistance Program* for help with the OOP cost associated with POLIVY.
Does Your Patient Have Insurance?
If eligible publicly or commercially insured patients have difficulty paying for their co-pay, co-insurance, or other OOP costs, POLIVY Access Solutions can refer them to an independent co-pay assistance foundation supporting their disease state.†
Does Your Patient Have No Insurance or Have Financial Concerns?
The Genentech Patient Foundation helps people affected by serious medical conditions get the POLIVY they have been prescribed. People who do not have health insurance, who have health insurance that does not cover their POLIVY, or who can’t afford their OOP costs may get free medicine.‡