[Roche](https://www.gene.com/good/giving/corporate-giving)

Rolling (applications accepted year-round)

Free Genentech medicines for eligible patients; coverage duration as long as eligibility is maintained.

Provides free Genentech medicines to eligible U.S. patients facing insurance or financial barriers.

Both patient and prescriber forms are required; U.S. residency and treatment by a U.S.-licensed physician are necessary.

--- ## Description The Genentech Patient Foundation offers free access to Genentech medicines for eligible patients who are uninsured, underinsured, or experiencing financial hardship. The program aims to ensure that financial or insurance barriers do not prevent access to necessary, prescribed Genentech treatments. Comprehensive support is provided throughout the application process, including assistance for both patients and healthcare providers. The foundation covers a wide range of Genentech medicines and strives for inclusivity regardless of race, citizenship/immigration status, age, disability, gender identity, or sexual orientation. --- ## Due Dates - Applications are accepted on a rolling basis throughout the year; there are no fixed deadlines. --- ## Funding Amount - Eligible patients receive Genentech medicines at no cost. - Coverage is maintained as long as the patient continues to meet eligibility criteria. - There is no set limit on duration or quantity, provided ongoing eligibility. --- ## Eligibility Applicants must meet **all** of the following criteria: - **Residency & Treatment:** Must be living in the United States and receiving treatment from a physician licensed in the U.S. - **Insurance & Financial Status:** Must fall into one of these groups: 1. **No insurance:** Household income under $150,000 for 1–4 people (add $25,000 for each additional person). 2. **Has insurance, but it does not cover Genentech medicine:** Same income limits as above. 3. **Has insurance that covers Genentech medicine, but out-of-pocket maximum exceeds 7.5% of yearly income:** Same income limits apply. - **Participating Medicines:** Must be prescribed a Genentech medicine covered by the Foundation ([see current list](https://www.gene.com/patients/patient-foundation/our-participating-medicines)). - **Exclusions:** Patients whose insurance/employer requires them to apply to a Patient Assistance Program (PAP) as a prerequisite for coverage (such as via Alternate Funding Programs, Copay Maximizers, or Accumulators) are not eligible. - **No citizenship/immigration status required:** The Foundation does not collect or require this information. --- ## Application Process 1. **Complete the Patient Consent Form** - Available [online](https://genentech-pps.my.site.com/digitalconsent/s/?source=gene&preferredLanguage=en) or as a [PDF](https://www.genentech-access.com/content/dam/gene/accesssolutions/pdfs/patient-consent-form/Genentech-Access-Solutions-Patient-Consent_Form.pdf). - Must be filled out by the patient or their legally authorized representative. 2. **Prescriber Foundation Form** - Must be completed by the treating healthcare provider. - Available [online](https://genentech-pps.my.salesforce-sites.com/enroll/#!/public-enroll/eligibility) or as a [PDF](https://www.gene.com/download/pdf/Genentech_Patient_Foundation_Prescriber_Foundation_Form.pdf). 3. **Submission** - Submit forms online, by fax ([833-999-4363](tel:8339994363)), or by texting a photo to [650-877-1111](tel:6508771111). - Both forms are required for processing. - Processing typically occurs within 5 business days after receipt of both forms. 4. **Assistance** - Foundation Specialists are available for questions and can assist in multiple languages. 5. **Renewal** - No need to re-enroll annually; continued eligibility ensures ongoing access. --- ## Additional Information - The Foundation provides a [full list of covered medicines](https://www.gene.com/patients/patient-foundation/our-participating-medicines). - Patients are encouraged to explore other financial assistance options before applying, such as Genentech co-pay programs or independent foundations. - The Foundation does not require proof of appeal if insurance coverage is denied. - The program is designed to be inclusive and confidential. --- ## External Links - [Genentech Patient Foundation Main Page](https://www.gene.com/patients/patient-foundation) - [Eligibility Criteria](https://www.gene.com/patients/patient-foundation/see-if-you-qualify) - [List of Participating Medicines](https://www.gene.com/patients/patient-foundation/our-participating-medicines) - [Apply for Help](https://www.gene.com/patients/patient-foundation/apply-for-help) - [FAQs](https://www.gene.com/patients/patient-foundation/patient-foundation-faqs) - [Patient Consent Form (Online)](https://genentech-pps.my.site.com/digitalconsent/s/?source=gene&preferredLanguage=en) - [Prescriber Foundation Form (Online)](https://genentech-pps.my.salesforce-sites.com/enroll/#!/public-enroll/eligibility) - [Overview Brochure (PDF)](https://www.gene.com/assets/frontend/downloads/pdf/Genentech-Patient-Foundation-Overview-Bifold.pdf) - [Audio Brochure](https://soundcloud.com/genentechsound/gpf-overview-bifold-audio-recording?si=8e19a98259874a50b626962690edc38c&utm_source=clipboard&utm_medium=text&utm_campaign=social_sharing) --- ## Contact Information | Contact Type | Details | |--------------------------|-------------------------------------------| | Foundation Specialist | (888) 941-3331 (Mon–Fri, 6 a.m.–5 p.m. PT) | | Fax | (833) 999-4363 | | Text (form submission) | (650) 877-1111 | | Online Contact | [Contact Form](https://www.gene.com/good/giving/contact-us) | ---

Genentech Patient Foundation

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