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Financial Assistance Options
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.
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Use our financial assistance tool to see which programs may be right for your patient.
If your patient has insurance coverage and needs help affording PHESGO, these programs may help:
Genentech Oncology Co-pay Assistance Program
With the Genentech Oncology Co-pay Assistance Program, eligible patients with commercial insurance could pay as little as $5 per treatment for PHESGO. Co-pay assistance of up to $25,000 is provided per calendar year.
Patients may be eligible if they:
- Have a valid prescription for PHESGO for an FDA-approved use
- Reside in the United States or U.S. Territories
- Are over the age of 18, or have a Legally Authorized Person over the age of 18 to manage the program
- Have commercial (private or non-governmental) insurance. This includes plans available through state and federal health insurance exchanges
- Are not currently receiving PHESGO from the Genentech Patient Foundation
- Are not currently receiving assistance from any other charitable organization for any of their out-of-pocket costs that are covered by the Genentech Oncology Co-pay Assistance Program
- Are not using a state or federal healthcare plan to pay for their medication. This includes, but is not limited to, Medicare, Medicaid and TRICARE
The 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 medicine. Patients using Medicare, Medicaid or any other federal or state government program (collectively, “Government Programs”) to pay for their Genentech medicine are not eligible.
Under the Program, the patient may pay a co-pay. The final amount owed by a patient may be as little as $0 for the Genentech medicine (see Program specific details). The total patient out-of-pocket cost is dependent on the patient’s health insurance plan. The Program assists with the cost of the Genentech medicine only. It does not assist with the cost of other medicines, procedures or office visit fees. After reaching the maximum annual Program benefit amount, the patient will be responsible for all remaining out-of-pocket expenses. The Program benefit amount cannot exceed the patient’s out-of-pocket expenses for the cost associated with the Genentech medicine.
All participants are responsible for reporting the receipt of all Program benefits as required by any insurer or by law. The Program is only valid in the United States and U.S. Territories, is void where prohibited by law and shall follow state restrictions in relation to AB-rated generic equivalents (e.g., MA, CA) where applicable. No party may seek reimbursement for all or any part of the benefit received through the Program. The Program is intended for the patient. Only the patient using the Program may receive the funds made available through the Program. The Program is not intended for third parties who reduce the amount available to the patient or take a portion for their own purposes. Patients with health plans that redirect Genentech Program assistance intended for patient out- of-pocket costs may be subject to alternate Program benefit structures. Genentech reserves the right to rescind, revoke or amend the Program without notice at any time.
Additional terms and conditions apply. Please visit the Co-pay Program website for the full list of Terms and Conditions.
Independent Co-pay Assistance Foundations
An independent co-pay assistance foundation is a charitable organization providing financial assistance to patients with specific disease states, regardless of treatment. Patients 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.
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.
If your patient has financial difficulty or does not have insurance coverage and needs help affording PHESGO, this program may help:
Genentech Patient Foundation
The Genentech Patient Foundation gives free PHESGO 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 PHESGO 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
Genentech reserves the right to modify or discontinue the program at any time and to verify the accuracy of information submitted.
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.
Not sure which programs may be able to help your patients? 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. 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.