*To be eligible for free Genentech medicine from
the Genentech Patient Foundation, insured patients who have coverage
for their medicine must have pursued all other forms of financial
assistance and meet certain financial criteria. Uninsured patients
and insured patients without coverage for their medicine must meet
income requirements.
This ACTEMRA Co-pay Program is valid ONLY for
patients with commercial insurance who have a valid prescription for
a Food and Drug Administration (FDA)-approved indication of a
Genentech medication. Patients using Medicare, Medicaid or any other
federal or state government program to pay for their medications are
not eligible.
Under the program, the patient will pay a co-pay.
After reaching the maximum program benefit, the patient will be
responsible for all out-of-pocket expenses.
All participants are responsible for reporting the
receipt of all program benefits as required by any insurer or by
law. No party may seek reimbursement for all or any part of the
benefit received through this Program. The program is only valid in
the United States and U.S. Territories. This program is void where
prohibited by law and shall follow state restrictions in relation to
AB-rated generic equivalents (e.g., MA, CA) where applicable. The
patient, guardian, prescriber, hospital and any other person using
the program agree not to seek reimbursement for all or any part of
the benefit received by the patient through the offer of this
program. Genentech reserves the right to rescind, revoke or amend
the program without notice at any time. Additional terms and
conditions apply. Please visit https://racopay.com/actemra/terms-and-conditions
for the full list of Terms and Conditions.
§Genentech does not influence or control the operations
or eligibility criteria of any independent co-pay assistance
foundation and cannot guarantee co-pay assistance after a referral
from Genentech Access Solutions. The foundations to which we refer
patients are not exhaustive or indicative of Genentech’s endorsement
or financial support. There may be other foundations to support the
patient’s disease state.
RA=rheumatoid arthritis; SC=subcutaneous.