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LUCENTIS Co-pay Card

The LUCENTIS Co-pay Card Program may be able to help reduce the out-of-pocket costs for the medication LUCENTIS. If you have commercial or private insurance and meet other eligibility requirements, this program can help regardless of your income level.

 

Some health plans might not accept a co-pay card. Please contact your insurance provider to find out if your plan allows the use of co-pay cards.

 

To find out if you qualify for this program or to get a co-pay card, call (855) 218-5307 or click Get Started.

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Qualified Patients

To qualify for this program, you must:

  • Be treated with LUCENTIS for
    • Neovascular (Wet) Age-related Macular Degeneration (AMD)
    • Macular Edema following Retinal Vein Occlusion (RVO)
    • Diabetic Macular Edema (DME)
  • Have “commercial” or “private” insurance
    • You must not be covered in part or full by any state or federally funded programs, such as Medicare or Medicaid, Medigap, Medicare Advantage, Managed Medicaid, Veterans Affairs (VA), Department of Defense (DOD), or TRICARE
  • Live in the United States or Puerto Rico
  • Not be receiving help from the Genentech® Access to Care Foundation, or GATCF, or other co-pay foundations for LUCENTIS

 


 

What the card covers

The LUCENTIS Co-Pay Card can cover some of the out-of-pocket costs for LUCENTIS. This may also be called “co-pay,” “co-insurance” or “uncovered expense.”

 

 
Card covers Your co-pay or co-insurance after the first $5, up to the card monthly limit
You pay The first $5 of your LUCENTIS co-pay or co-insurance, plus anything after the card limit is reached
Card limit
  • $5000 if your household income is less than $100,000
  • $1500 if your household income is more than $100,000
 

 

Learn More About
Lucentis
  • LEARN about treatment with LUCENTIS
  • LEARN HOW the LUCENTIS Co-pay Card can help with the out-of-pocket costs for LUCENTIS
  • Form Patient Authorization and Notice of Release of Information

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