What Options Are There?
Whether you have insurance or not, you might feel concerned about the cost of your treatment. If you are eligible, there is an option to help you pay for your PEGASYS.
You might qualify if you meet the requirements below.
Do you have health insurance?
Is your yearly household income less than $100,000?
Is your yearly household income less than $150,000?
Do you spend 5% or more of the yearly household income on the out-of-pocket costs for your Genentech medicine?
You Might Qualify for Free Medicine From GATCF
To apply, you must enroll in PEGASYS Access Solutions. To do this, you must sign a form called the Patient Authorization and Notice of Release of Information, or PAN.
Be sure to fill out Section 6 of the PAN to apply for help from GATCF.
Your doctor also has to fill out a form. Once we receive both forms, we can find out if you qualify.
Click here to go to the Forms and Documents page to download the SMN and PAN forms.
Other Options May Be Available
You do not appear to qualify for free medicine from GATCF. However, there may be other patient assistance options that might be able to help you.
Call PEGASYS Access Solutions at (888) 941-3331 and speak with one of our Specialists to find out which option may be right for you.
To apply for this program, you must be enrolled in PEGASYS Access Solutions.
If you have health insurance, you must have already tried other types of patient assistance to qualify for free medicine from GATCF. This includes Genentech co-pay cards and support from co-pay assistance foundations. You must also meet specific criteria.
What Can I Expect?
Here is what you can expect as we work with you, your doctor and/or your health insurance plan, if you have one.