We Are Here for You
Your treatment journey is unique. Life events, including changes in your income and insurance, may affect your financial situation.
KADCYLA Access Solutions is here to help. See below for answers to frequently asked questions.
Frequently Asked Questions
About KADCYLA Access Solutions
What is KADCYLA Access Solutions?
KADCYLA Access Solutions is a program for people who have been prescribed KADCYLA. We can help you get the KADCYLA you need.
I Am Concerned About Paying for KADCYLA
My co-pays for KADCYLA are too high. How can you help me?
If you are worried about paying for KADCYLA, we might be able to help. If you are eligible, there are several options to help you pay for your medicine.
Enrolling in KADCYLA Access Solutions
How do I enroll in KADCYLA Access Solutions?
1. You sign and date a form called the Patient Authorization and Notice of Release of Information, or PAN form.
The PAN form lets KADCYLA Access Solutions discuss your case with your doctor and your health insurance plan. You can complete the PAN form in 1 of 2 ways:
- Fill out the PAN and submit it online
- Print the form, sign it and give it to your doctor’s office to send to us
Remember: although this is the only form you need to complete to enroll in KADCYLA Access Solutions, your doctor needs to complete another form.
To print and sign the form, visit Forms and Documents.
2. Your doctor fills out a form called the Statement of Medical Necessity, or SMN.
The SMN is a form filled out and submitted by your doctor. You do not have to fill out any information on this form.
This form tells us your doctor wants to treat you with KADCYLA.
3. Both forms must be submitted for you to be enrolled in KADCYLA Access Solutions.
If you have signed a printed version of the PAN form, you can give it to your doctor to send with the SMN form. If you have completed the online version of the PAN form, you can just ask your doctor if he or she has submitted the SMN to make sure you are enrolled.
Why do I need to sign the PAN form?
The Patient Authorization and Notice of Release of Information, or PAN form, allows KADCYLA Access Solutions to discuss your case with your doctor and your health insurance plan. We cannot work with you without a signed PAN form.
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 Statement of Medical Necessity, or 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.
My Health Plan Denied Coverage for KADCYLA
My health insurance plan will not cover KADCYLA. What do I do?
You and your doctor’s office can file an appeal to your health insurance plan. 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’s office while the appeal is prepared. Then you or your doctor’s office has to file the appeal directly with the plan.
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 Changed
I am enrolled in KADCYLA Access Solutions and my health insurance plan has changed. What do I do next?
When your health insurance plan changes, be sure to tell your doctors and KADCYLA Access Solutions. We can help you find out what your new health insurance plan covers and refer you to financial assistance options, if needed.
I no longer have a health insurance plan. What should I do?
If you do not have health insurance, you might qualify for the Genentech® Access to Care Foundation, or GATCF. GATCF helps qualified patients who meet certain criteria receive KADCYLA free of charge.