A benefits investigation will help determine whether your insurance will cover PHESGO and which financial assistance options may be right for you. PHESGO Access Solutions will conduct the benefits investigation. PHESGO Access Solutions works with you, your doctor's office, your health insurance plan, and your specialty pharmacy to help you get your prescribed PHESGO.
To get started:
- Complete the Patient Consent Form, which is available in English and Spanish, below:
- Once you have completed the Patient Consent Form, please inform your doctor's office and let them know that you are applying for assistance with PHESGO Access Solutions. Your doctor will have to complete another form called the Prescriber Service Form. Both forms are required. No eligibility determination will be made until a completed Patient Consent Form and Prescriber Service Form have been received.
What to expect next:
- The request will be processed within 5 business days upon receipt of both required forms
- You and your provider will be contacted to discuss the application outcome and any next steps
Genentech reserves the right to modify or discontinue the program at any time and to verify the accuracy of information submitted.