Committed to Helping You Get Your Genentech Medicine
Knowing what to expect can make all the difference. We can help you
through each step of getting your Genentech medicine.
Frequently Asked Questions
About POLIVY Access Solutions
What is POLIVY Access Solutions?
POLIVY 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 POLIVY
My co-pays for POLIVY are too high. How can you help me?
There may be options to help you get the Genentech medicine your doctor has prescribed. POLIVY Access Solutions can refer you to patient assistance options.
Where can I find information about the Genentech® Access to Care Foundation (GATCF)?
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 POLIVY Access Solutions
How do I enroll in POLIVY Access Solutions?
- You fill out the Patient Consent Form.
- Your doctor fills out the Prescriber Service Form. You do not have to fill out anything on this form.
- Your doctor sends both of these forms to POLIVY Access Solutions.
There are 3 ways to send us the Patient Consent Form:
- Complete it online at Genentech-Access.com/PatientConsent
- Fill out a paper copy and fax or mail it to us (or give it to your doctor to do so)
- Text a picture of the completed form to (650) 877-1111
Why do I need to sign the Patient Consent Form?
The Patient Consent Form lets us discuss your health information with
your doctor and your health insurance plan. We can’t work with you
without a signed Patient Consent Form.
I submitted the Patient Consent Form online or gave the signed Patient Consent Form 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 Prescriber Service Form. This form tells us your doctor wants to treat you with POLIVY. Make sure your doctor has sent us the Prescriber Service Form so you get help from us.
You do not need to fill out anything on the Prescriber Service Form.
I already submitted a PAN form. Do I also need to fill out the Patient Consent Form?
The Patient Consent Form replaces the PAN. The PAN and the Patient Consent Form are valid for 3 years in all states (except Maryland, where it is valid for 1 year).
If your PAN is still valid, you do not need to fill out the Patient Consent Form yet.
My Health Plan Denied Coverage for POLIVY
My health insurance plan will not cover POLIVY. 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 ask if you should file an appeal.
We have resources to help you and your doctor file an appeal.
Does POLIVY Access Solutions send the appeal to my health insurance 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 take several months if you have to appeal several times.
My Insurance Might Change
I am enrolled in POLIVY 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?
The Genentech Patient Foundation gives free Genentech medicine to
people who don't have insurance coverage or who have financial
concerns and to people who meet certain income criteria.
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.