Genentech Patient Foundation

Funded

About

The Genentech Patient Foundation offers a generous assistance program providing free medication such as Xolair, Rituxan, Pulmozyme, Lucentis, and numerous others to qualified patients. With no cost for eligible participants, the Genentech Patient Foundation ensures ongoing access to vital drugs without the need for re-enrollment, making healthcare more accessible for uninsured and underinsured patients facing financial hardships.

Insurance requirements: Commercially insured, Medicare / Medicaid, Underinsured, Uninsured

Enrollment Forms

Enrollment Form

Program Requirements

•Valid only for residents in the US and Puerto Rico

•Enrollment Required: Yes

•Coverage Required: No

•Needs Based: Yes

•Activation Required: No

Program Details

•For patients who meet eligibility criteria, program provides one year of medication free of cost

•HCP can submit the completed Patient Consent and Prescriber Foundation form online via their registered My Patient Solutions account, or via fax to 8339994363

•Both the Patient Consent Form and Prescriber Foundation Form are REQUIRED

•Patients who are enrolled in the Genentech Patient Foundation will keep getting free medicine as long as they qualify. They do not need to reenroll

•For assistance or additional information, please call 8889413331, Monday through Friday, 6 a.m.–5 p.m. PT

Enrollment Forms

Enrollment Form