What Options Are There?

There may be options to help you afford XOLAIR, no matter what type of health insurance you have.

Referrals to Independent Co-pay Assistance Foundations

If you need help with your co-pay for XOLAIR, XOLAIR 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 XOLAIR Access Solutions at (800) 704-6610 for a referral.

If you would like to contact a foundation directly, you can use the information below:

Patient Access Network Foundation (PANF)
P.O. Box 221858
Charlotte, NC 28222-1858
Toll Free: 1-866-316-PANF (7263)
www.panfoundation.org

The HealthWell Foundation
PO Box 220410
Chantilly, VA 20153-0410
800-675-8416
www.healthwellfoundation.org

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 help you.

Referrals to the Genentech® Access to Care Foundation

The Genentech Access to Care Foundation, or GATCF, can help you receive XOLAIR 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 XOLAIR
  • Underinsured—People who have health insurance (including commercial or government insurance plans), but pay more than a certain amount for XOLAIR 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 XOLAIR?

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.

Download the SMN and PAN

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.

Find Out Which Option May Be Right for You

You can also call XOLAIR Access Solutions at (800) 704-6610 and speak with one of our Specialists.

You’ll have to fill out Sections 5 and 6 of the PAN form to apply for GATCF.

If you have health insurance, you must have already tried other types of patient assistance to qualify for free medicine from GATCF. This includes the XOLAIR Co-pay Card Program 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.

Referrals to the XOLAIR Co-pay Card Program

XOLAIR Access Solutions can refer you to the XOLAIR Co-pay Card Program. It can help you with the out-of-pocket costs of XOLAIR, if you’re eligible.

The XOLAIR Co-pay Card Program 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 XOLAIR Co-pay Card Program, 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 XOLAIRCopay.com for the full list of terms and conditions.

How to Work With XOLAIR Access Solutions

Step 1

Enroll in XOLAIR Access Solutions.

How do I enroll?

Step 2

We work with you, your doctor’s office, your health insurance plan and your specialty pharmacy. We might contact you for more information.

What will we find out?

Step 3

We refer you to patient assistance options.

What options are there?

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.