Terms and Conditions
The OCREVUS Product and Administration Co-pay Program is valid ONLY for patients with commercial (private or non-governmental) insurance who have a valid prescription for a Food and Drug Administration (FDA)-approved indication of a Genentech medication. Patients using Medicare, Medicaid, Medigap, Veterans Affairs (VA), Department of Defense (DoD), TRICARE or any other federal or state government funded program (collectively, "Government Programs") to pay for their medications and/or administration services are not eligible. The programs are not valid if the costs are eligible to be reimbursed in their entirety by private insurance plans or other programs.
Under the programs, the patient will pay a co-pay. After reaching the maximum program benefit, the patient will be responsible for all remaining out-of-pocket expenses. The amount of the program's benefits cannot exceed the patient's out-of-pocket expenses for the cost of the drug or administration fees associated with OCREVUS. The program benefit will reset every January 1st. These programs are not health insurance or a benefit plan. The programs do not obligate use of any specific product or provider. The drug co-pay program is not available or valid for patients receiving free product from the Genentech Patient Foundation. The administration co-pay program is valid for patients receiving free product from the Genentech Patient Foundation. The product and administration programs are not valid for patients receiving assistance from any other charitable organization for the same expenses covered by the programs. The co-pay benefit cannot be combined with any other rebate, free trial or similar offer for the medication or administration of the product. No party may seek reimbursement for all or any part of the benefit received through these programs.
The programs may be accepted by participating pharmacies, physician offices or hospitals. Once a patient is enrolled, the programs will not honor claims with date of service or medication dispensing that precede program enrollment by more than 180 days. Claims must be submitted within 365 days from the date of service unless otherwise indicated. Use of these programs must be consistent with all relevant health insurance requirements. Participating patients, pharmacies, physician offices and hospitals are responsible for reporting the receipt of all program benefits as required by any insurer or by law. Program benefits may not be sold, purchased, traded or offered for sale.
The patient or their guardian must be 18 years or older to receive program assistance. The programs are only valid in the United States and U.S. Territories. The programs are void where prohibited by law. The product co-pay program shall follow state restrictions in relation to AB-rated generic equivalents (e.g., MA, CA) where applicable. The administration co-pay program is not valid for Massachusetts or Rhode Island residents. Eligible patients will be automatically re-enrolled in the program on an annual basis. Eligible patients will be removed from the program after 3 years of inactivity (e.g., no claims submitted in a 3-year timeframe). Program eligibility and automatic re-enrollment are contingent upon the patient's ability to meet all the requirements set forth by the programs. Healthcare providers may not advertise or otherwise use the programs as a means of promoting their services or Genentech's products to patients. Genentech reserves the right to rescind, revoke or amend the program without notice at any time.