Rituxan

Indicated For

Non-Hodgkin's lymphoma, chronic lymphocytic leukemia, rheumatoid arthritis

About This Medication

# Genentech Patient Foundation Patient Guide: How to Get Rituxan at Low or No Cost ## About This Program The **Genentech Patient Foundation** is a patient assistance program that provides free Rituxan (rituximab) to eligible patients who lack insurance coverage or face financial hardship. Rituxan is a biologic medication used to treat conditions including certain cancers, rheumatoid arthritis, and autoimmune disorders. This guide explains who qualifies, how to apply, and what to expect throughout the process. ## About Rituxan Rituxan is a monoclonal antibody medication manufactured by Genentech that works by targeting specific cells in the immune system. It is prescribed by healthcare providers to treat various conditions, and the cost can be substantial. The Genentech Patient Foundation helps ensure that financial barriers do not prevent patients from accessing this important medication. ## Who Qualifies for This Program? You may be eligible for the Genentech Patient Foundation if you meet one of these criteria: - **Uninsured**: You have no health insurance coverage - **Underinsured with coverage gaps**: You have insurance but it does not cover Rituxan - **High out-of-pocket costs**: Your insurance requires out-of-pocket payments that exceed 7.5% of your household yearly income - **Financial hardship**: You have insurance but cannot afford the cost-sharing requirements for your medication The program is available to patients living in the United States and Puerto Rico who are being treated by a US-licensed physician. **The program does not require or collect citizenship or immigration information.** ## Income Eligibility The Genentech Patient Foundation is designed for patients with financial need. While specific income thresholds are not publicly detailed, the program considers your household size and income when determining eligibility. The program is needs-based, meaning it evaluates your individual financial situation rather than applying a strict income cutoff. If you are unsure whether your income qualifies, you can discuss your situation with a Foundation Specialist by calling **(888) 941-3331** (Monday–Friday, 6 a.m.–5 p.m. PT). ## Insurance Requirements The Genentech Patient Foundation accepts patients with various insurance situations: | Insurance Status | Eligible? | Notes | |---|---|---| | Uninsured | Yes | Full program eligibility | | Commercially insured | Yes | If out-of-pocket costs are high or coverage is denied | | Medicare | Yes | If you meet financial need criteria | | Medicaid | Yes | If you meet financial need criteria | | Insured but denied coverage | Yes | Program may provide support after 1 level of appeal | **Important**: If you have insurance, the program does not provide free medication in cases of administrative errors or standard coverage restrictions (such as step edits), unless your prescribing physician confirms the step edit is not medically appropriate. ## Step-by-Step Application Process ### Step 1: Complete the Patient Consent Form You (or your legally authorized representative) must complete the **Patient Consent Form**, available in English and Spanish. This form collects: - Your personal information (name, date of birth, contact details) - Household size and income information - Insurance status - Authorization for Genentech to contact your healthcare provider and insurance company You can complete this form online through Genentech's website or print and fill it out by hand. ### Step 2: Inform Your Doctor's Office Once you complete the Patient Consent Form, contact your prescribing physician's office and let them know you are applying for assistance from the Genentech Patient Foundation. ### Step 3: Your Doctor Completes the Prescriber Foundation Form Your doctor's office must complete the **Prescriber Foundation Form**, which includes: - Confirmation that Rituxan is medically necessary for your condition - Your diagnosis code(s) - Treatment information - Prescriber attestation **Both the Patient Consent Form and Prescriber Foundation Form are required.** No action can be taken until both forms are received. ### Step 4: Submit Both Forms You have multiple options for submitting your completed forms: - **Online**: If your doctor's office has a registered account with My Patient Solutions, they can submit forms through that portal - **Fax**: Send both forms to **(833) 999-4363** - **Text**: Text a photo of the completed forms to **(650) 877-1111** - **Phone**: Call a Foundation Specialist at **(888) 941-3331** for assistance **Submit both forms together** for faster processing. ## Timeline and What to Expect **Processing Time**: Your application will be processed within **5 business days** of receiving both completed forms. **After Approval**: Once an eligibility determination has been made, both you and your prescriber will be contacted to discuss the application outcome and next steps. **Medication Delivery**: Once approved, Rituxan will be delivered to either: - Your home through the foundation's pharmacy, or - Your prescriber's office or treatment site Your prescriber will help determine the best delivery option for your situation. ## Ongoing Coverage and Reauthorization Once enrolled in the Genentech Patient Foundation, **you will continue to receive free Rituxan as long as you remain eligible**. There is no need to re-enroll each time you need a refill. However, your eligibility may be reviewed periodically, and you should notify the program if your financial situation or insurance coverage changes significantly. ## What If Your Application Is Denied? If your application is denied, you have options: - **Appeal**: You may file an appeal of the decision. You do not need to submit proof of appeal with your application—you can apply while an appeal is pending - **Contact a Specialist**: Call **(888) 941-3331** to discuss your situation and explore other assistance options - **Explore alternatives**: Ask your doctor about other financial assistance programs or lower-cost treatment options ## Important Disclaimers - This program is intended for patients living in the United States and Puerto Rico - You must be treated by a US-licensed physician - The program does not provide free medication in cases of administrative errors or standard coverage restrictions unless your physician confirms medical necessity - Eligibility is based on financial need and insurance status - Always consult with your healthcare provider about your treatment options ## Need Help? If you have questions about the application process or your eligibility, contact a **Foundation Specialist**: - **Phone**: (888) 941-3331 - **Hours**: Monday–Friday, 6 a.m.–5 p.m. PT - **Languages**: English and Spanish support available Foundation Specialists have local knowledge and can help you understand your options and next steps.

Program information last verified: March 25, 2026