Herceptin hylecta Prescription Assistance Programs

Herceptin hylecta: Apply for prescription assistance below

If you are eligible, the programs below can help you afford Herceptin Hylecta. Review the information to see if you qualify. The applications are available in Adobe PDF format and should be mailed directly to the provider of the patient assistance program.

If you have any questions, please call the telephone number for the program (not PharmacyChecker.com) or go to the program website.

Looking for a different medication?

Genentech Access Solutions

(Program 1 of 2 — Scroll down to see them all )

Provided by: Genentech USA, Inc.
1 DNA Way, Mail Stop #858a South San Francisco, CA 94080-4990
TEL: 866-422-2377
FAX: 866-480-7762
Languages Spoken:
English, Spanish
Program Website
Medications
  • Herceptin Hylecta (trastuzumab-hyaluronidase-oysk)
Eligibility Requirements
  • Insurance Status Determined case by case
  • Those with Part D Elibible? Determined case by case
  • Income Based on FPL
  • Diagnosis/Medical Criteria Varies
  • U.S. Residency Required? Must be treated by US licensed healthcare provider
Application
  • Obtaining Call, download or apply online
  • Receiving Faxed, emailed, mailed or downloaded
  • Returning Fax, mail or submit online (Note: faxed prescriptions are only valid if faxed directly from a prescriber's office)
  • Doctor's Action Will be discussed with patient and Doctor after request is received
  • Applicant's Action Patient or patient representative signs authorization form
  • Decision Communicated Patient and Doctor are notified
  • Decision Timeframe Varies
Medication
  • Amount/Supply Varies
  • Sent To Varies
  • Delivery Time Contact Program for Details
  • Refill Proces Doctor/Doctor's office must contact company
  • Limit One year
  • Re-application Contact program for details.
Additional Information
Call for most recent medications as the list is subject to change.
Updated May 3, 2019

If you, your patient or loved one does not qualify for this program or other prescription savings programs, then please search for prices here.

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Genentech Patient Foundation

(Program 2 of 2 — Scroll down to see them all )

Provided by: Genentech USA, Inc.
None
TEL: 888-941-3331
FAX: 833-999-4363
Languages Spoken:
English, Spanish, Others By Translation Service
Program Website
Medications
  • Herceptin Hylecta (trastuzumab-hyaluronidase-oysk)
Eligibility Requirements
  • Insurance Status Uninsured or Underinsured with no prescription coverage for needed medication
  • Those with Part D Elibible? Contact program for details.
  • Income Income Guidelines published on Program Website
  • Diagnosis/Medical Criteria Medically appropriate condition/diagnosis
  • U.S. Residency Required? Must be treated by US licensed healthcare provider
Application
  • Obtaining Call or download
  • Receiving Faxed or downloaded from website
  • Returning The completed application should be faxed back from the doctor's office.
  • Doctor's Action Complete section and sign
  • Applicant's Action Complete section and sign
  • Decision Communicated Patient and Doctor are notified
  • Decision Timeframe Varies
Medication
  • Amount/Supply Amount requested is sent
  • Sent To Patient's home, unless otherwise noted
  • Delivery Time Varies
  • Refill Proces Varies per medication
  • Limit Not specified
  • Re-application Not specified
Additional Information
The Genentech Access to Care Foundation is now the Genentech Patient Foundation. Eligibility determined on a case-by-case basis. Call for most recent medications as the list is subject to change.
Updated April 16, 2019

If you, your patient or loved one does not qualify for this program or other prescription savings programs, then please search for prices here.

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