When Something Is Not Covered It Is

An employee learned today a medication he urgently needs is not covered by his group health plan.

What is he to do? A diabetic, he needs Lucentis to prevent from going blind. That’s pretty scary.

The good news is he probably qualifies for a patient financial assistance program.

The Lucentis website explains:

No matter what type of health insurance you have, you may have options to help you afford your medicine. These options may be available to you even if you have no insurance at all.

The Genentech Patient Foundation gives free LUCENTIS to people who have been prescribed this medicine and don’t have insurance or that have financial concerns and meet certain eligibility criteria.

You may be eligible if your insurance coverage and income match one of these situations:

  • Uninsured patients with incomes under $150,000
  • Insured patients without coverage for LUCENTIS with incomes under $150,000
  • Insured patients with coverage for a Genentech medicine:
    • With unaffordable out-of-pocket costs
    • Who have pursued other forms of financial assistance
    • With household size and income within certain guidelines

Genentech reserves the right to modify or discontinue the program at any time and to verify the accuracy of information submitted.

Use our financial assistance tool to see which programs may be right for you.

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EDITOR’S NOTE: If he doesn’t qualify for financial assistance (highly unlikely) there is another risk transfer strategy that will solve his problem.