You will need a valid prescription and proof of househould income. What are the restrictions?Most people without insurance and with limited incomes will qualify. What are the benefits?You can receive your medication at no cost. You can find the form on the program website. How do I apply?Ask your doctor to help you submit an application. Keep in mindYou may still qualify if you have insurance that does not fully cover you perscription cost. What are the restrictions?Go to the program website and follow the instructions on the page based on your medication. What are the benefits?Go to the program website and follow the instructions on the page based on your medication. How do I apply?Call 1-84 to check if you are eligible and sign up. Program Name:Genetech Access to Care Foundation The following program is available for this drug. ET, Monday through Friday (except major holidays) For questions about OCREVUS, please call (844. there may be other options for co-pay assistance. You’ll need to apply through each program, either online, over the phone, or with your doctor's help. Are not receiving assistance through the Genentech Patient Foundation or any other charitable organization for the same. Eligibility is often based on income, insurance or Medicare status, and other factors. By completing this form you can: Instructions for. Many programs are available from federal and state governments, non-profits, manufacturers, and other organizations to help you get the drugs you need at a reduced cost. Patient Foundation, sign and date the Physician Certification. The program is for commercially insured patients only. How much can I save?Your out-of-pocket cost may be reduced to as little as $5 per prescription, with a maximum yearly savings of $20,000.Your out-of-pocket cost may be reduced to as little as $5 per infusion, with a maximum yearly savings of $1,500. charitable assistance programs (such as Genentech Patient Foundation) are not eligible. How do I get the discount?Register online to download and print a card. This OCREVUS Co-pay Program is valid ONLY for patients with. When you’re ready to use this coupon, simply present the coupon to your pharmacist with a valid prescription for your medication. These programs are free but may have some rules or restrictions, so you’ll want to review carefully. Many manufacturers offer programs that will reduce your out-of-pocket costs for this prescription.
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