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Help for Uninsured Patients

The Genentech® Access to Care Foundation (GATCF) was established to help patients who are uninsured—or who have been denied coverage for XOLAIR® (omalizumab) by their health plans. GATCF might be able to help those patients receive XOLAIR treatment if they meet specific financial and medical criteria.





Is my patient eligible?

For your patient to be eligible for help from GATCF, certain specific criteria must be met:

  • Your patient must have no health insurance or the health plan has denied coverage for XOLAIR
  • Your patient’s annual household adjusted gross income must be $100,000 or less (special consideration can be given to patients with unique circumstances)
  • Your patient must meet medical criteria determined by the GATCF Clinical Advisory Board





How do I get started?

To apply to GATCF, the following forms must be completed and submitted in addition to the Statement of Medical Necessity (SMN) form and Patient Authorization and Notice of Release of Information (PAN) form.


  • Insurance attestation: required for each of your patient's insurance plans and serves as proof that the patient's insurance will not cover the prescribed Genentech therapy
  • Confirmation of infusion or injection: should be completed after each infusion or injection of an office-administered product


These forms can be submitted online via My Patient Solutions or downloaded from our Forms and Documents Center.

When completing the SMN, be sure to complete all sections of the form.





Only the information requested on these forms is required. Providing additional documents or information will delay processing.


Once we receive your patient’s information, XOLAIR Access Solutions will contact the patient within 24 hours with further instructions. This might include verifying financial eligibility.


Additional GATCF program details:

  • Patients are eligible for free medicine for 1 year and must reapply annually
  • Patient assistance support may be given before treatment or up to 1 year post-treatment
  • GATCF assists with the cost of XOLAIR only, not the administration costs