Committed to Helping You Get Your Genentech Medicine
Knowing what to expect can make all the difference. We can help walk
you through each step of getting your Genentech medicine and assist
you along the way.
Frequently Asked Questions
About KADCYLA Access Solutions
What is KADCYLA Access Solutions?
KADCYLA Access Solutions is a resource for people who take a
Genentech medicine. We connect you to the medicine you need.
I Am Concerned About Paying for KADCYLA
My co-pays for KADCYLA are too high. How can you help me?
There may be options to help you get the Genentech medicine your doctor has prescribed. KADCYLA Access Solutions can refer you to patient assistance options.
Getting My Medicine
How long will it take to get my medicine?
You might not be able to get your Genentech medicine right away.
First, your doctor’s office or specialty pharmacy will have to check
to make sure your health insurance plan covers your medicine. This is
called a “benefits investigation.” They also might have to send some
more information before your plan covers your medicine. This is called
a “prior authorization.”
Enrolling in KADCYLA Access Solutions
How do I enroll in KADCYLA Access Solutions?
- You fill out a form called the PAN.
- Your doctor fills out a form called the SMN. You do not have to fill out anything on this form.
- Your doctor sends both of these forms to KADCYLA Access Solutions.
There are 2 ways to fill out the PAN form:
- You can fill out the form online
- You can download and print it to fill out a paper copy
Why do I need to sign the PAN form?
The PAN form lets us discuss your health information with your doctor
and your health insurance plan. We can’t work with you without a
I submitted the PAN online or gave the signed PAN to my doctor. Is there anything else I need to do to enroll?
You do not need to do anything else, but your doctor does. He or she needs to submit a form called the SMN. The SMN tells us your doctor wants to treat you with KADCYLA. Make sure your doctor has sent us the SMN so you get help from us.
You do not need to fill out anything on the SMN form.
My Health Plan Denied Coverage for KADCYLA
My health insurance plan will not cover KADCYLA. What do I do?
If your health insurance plan will not cover your Genentech medicine,
you and your doctor’s office can file an appeal. Contact your doctor
to find out if filing an appeal is right for you.
We have resources to help you and your doctor file an appeal.
Does KADCYLA Access Solutions send the appeal to my health insurance care plan?
We have resources to help you and your doctor file an appeal. You or
your doctor’s office has to file the appeal directly with your health
How long does an appeal take?
This depends on your health insurance plan. You should ask your plan directly about its process. Sometimes the appeals process is quick. However, it can also take several months if you have to appeal several times.
My Insurance Might Change
I am enrolled in KADCYLA Access Solutions and my health insurance plan has changed. What do I do next?
If your insurance changes while you’re taking your Genentech
medicine, call us. We can help you understand your new coverage.
I no longer have a health insurance plan. What should I do?
GATCF helps people who don't have health insurance. It also helps
people who have health insurance but have trouble paying for their
Genentech medicine. If you qualify for GATCF, you could receive your
medicine for free.
It is your and your doctor's responsibility to complete and submit
all required paperwork to your health insurance plan. Genentech
cannot guarantee your plan will cover any treatments.
PAN=Patient Authorization and Notice of Request
for Transmission of Health Information to Genentech Access Solutions
and Genentech® Access to Care Foundation.
SMN=Statement of Medical Necessity.