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LUCENTIS Co-pay Card

The LUCENTIS Co-pay Card Program can 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.

 


 

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
 

 

To enroll in the LUCENTIS Co-Pay Card, call (855) 218-5307 from 9 AM to 8 PM ET, Monday through Friday, or go to www.LucentisCoPayCard.com.

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

Who is LUCENTIS for?

LUCENTIS® (ranibizumab injection) is a prescription medicine for the treatment of patients with wet age-related macular degeneration (wAMD), macular edema following retinal vein occlusion (RVO), and diabetic macular edema (DME).

What important safety information should I know about LUCENTIS?

LUCENTIS is a prescription medication given by injection into the eye, and it has side effects. Some LUCENTIS patients have had detached retinas and serious eye infections. You should not use LUCENTIS if you have an infection in or around the eye or are allergic to LUCENTIS or any of its ingredients. Some LUCENTIS patients have had increased eye pressure before and within 1 hour of an injection. Serious side effects also include inflammation inside the eye and, rarely, problems related to the injection procedure, such as cataracts. Uncommonly, LUCENTIS patients have had serious, sometimes fatal, problems related to blood clots, such as heart attacks or strokes. If your eye becomes red, sensitive to light, or painful, or if you have a change in vision, call or visit your eye doctor immediately. Ask your doctor if you have questions or want more information.

You may report side effects to the FDA at (800) FDA-1088 or www.fda.gov/medwatch. You may also report side effects to Genentech at (888) 835-2555.

For additional safety information, please talk to your doctor and see the LUCENTIS full prescribing information.

LUCENTIS® and the Access Solutions logo are registered trademarks of Genentech, Inc.