What Options Are There?
There may be options to help you afford your Genentech medicine, no
matter what type of health insurance you have.
If you need help with your co-pay for your Genentech medicine, PERJETA Access Solutions can refer you to an independent co-pay assistance foundation.
An independent co-pay assistance foundation is a charitable
organization that gives financial assistance for medicines.
Call PERJETA Access Solutions at (888) 249-4918 for a referral.
If you would like to contact a foundation directly, you can use the information below:
Independent co-pay assistance foundations have their own rules for
eligibility. We cannot guarantee a foundation will help you. We only
can refer you to a foundation that supports your disease state. This
information is provided as a resource for you. We do not endorse or
show financial preference for any particular foundation. The
foundations in this list are not the only ones that might be able to
The Genentech Access to Care Foundation, or GATCF, can help you receive your Genentech medicine free of charge, if you qualify.
GATCF helps people who are:
- Uninsured—People who do not have insurance
- Rendered uninsured—People whose health insurance does not cover their Genentech medicine
Underinsured—People who have health insurance (including
commercial or government insurance plans), but pay more than a
certain amount for their medicines each year
Other eligibility criteria must be met to qualify for free medicine from GATCF. 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 your yearly household income on the out-of-pocket costs for your Genentech medicine?
You Might Qualify for Free Medicine From GATCF
To apply for GATCF, you’ll need to complete the PAN form and your doctor’s office will need to complete the SMN form.
Be sure to fill out Sections 5 and 6 on the PAN form.
Other Options May Be Available
You do not appear to qualify for free medicine from GATCF. However, other patient assistance options may be available to help you.
You can also call PERJETA Access Solutions at (888) 249-4918 and speak with one of our Specialists.
You’ll have to fill out Sections 5 and 6 of the PAN form to apply for
If you have health insurance, you must have already tried other
types of patient assistance to qualify for free Genentech medicine
from GATCF. This includes the Genentech BioOncology Co-pay Card and
support from independent co-pay assistance foundations. You must
also meet financial criteria. If you do not have insurance, you must
meet different financial criteria.
PERJETA Access Solutions can refer you to the Genentech BioOncology Co-pay Card. It can help you with the out-of-pocket costs of your Genentech medicine, if you’re eligible.
The Genentech BioOncology Co-pay Card helps patients with commercial
health insurance. This might be a plan you get through your employer
or one you purchased through a Health Insurance Marketplace like
HealthCare.gov. To qualify, you must also meet other criteria.
In order to be eligible for the Genentech BioOncology Co-pay Card,
the patient must have commercial insurance, must not have Medicare,
Medicaid or other government insurance, and must meet other
eligibility criteria. They also must agree to the rules set forth in
the terms and conditions for the program. Please visit CopayAssistanceNow.com for the full list of
terms and conditions.
How to Work With PERJETA Access Solutions
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.