TRODELVY ACCESS SUPPORT is a patient access and reimbursement support program. It will help you understand specific coverage and reimbursement guidelines for TRODELVY.
Reimbursement support services include:
- Benefits and coverage
- Out-of-pocket cost assessment
- Patient support programs
- Alternate assistance options
Patient access support includes:
TRODELVY support may vary based on application criteria and is subject to change or discontinuation. Physician office must submit prior authorizations and appeals.
*The TRODELVY Savings Program is not available to patients with any form of government insurance. Patients must meet certain eligibility criteria to qualify for this program. Once enrolled, the patient pays $0 out-of-pocket for TRODELVY with maximum benefit of $25,000 per year.
†Gilead PAP provides TRODELVY free of charge for eligible patients who are uninsured or underinsured. To qualify for assistance, patients must meet certain eligibility criteria.
‡Patients with Medicare or other government insurance who need assistance with cost-share requirements for TRODELVY may be eligible for co-pay or co-insurance assistance through an independent co-pay assistance foundation. Case managers can help patients assess their high-level eligibility for possible coverage for TRODELVY through an independent co-pay assistance foundation. If co-pay assistance needs are identified, the case managers can provide information about any available foundations. The foundation will determine the patient’s eligibility for co-pay or co-insurance assistance based on their own criteria, completely independent of Immunomedics and its agents, and will contact the patient directly regarding the application process. Gilead and its agents make no guarantee regarding reimbursement for any service or item.
The TRODELVY Savings Program provides savings on out-of-pocket expenses of TRODELVY 180-mg single-dose vial, up to $25,000 annually for commercially or privately insured patients. Terms and conditions apply. §
- Patients pay $0 out-of-pocket for TRODELVY, which includes co-pay and co-insurance, up to $25,000 annually
- The program only assists with cost of TRODELVY; patient is responsible for cost-share of treatments and office visits
- This program does not support any claims covered, paid, or reimbursed, in whole or in part, by Medicaid, Medicare, or other federal or state healthcare programs
- See HOW IT WORKS below for simple steps to receive savings
- For additional information, contact TRODELVY ACCESS SUPPORT at 1-844-TRODELVY (1-844-876-3358), option 2
HOW IT WORKS
Your doctor's office or TRODELVY ACCESS SUPPORT can help you determine eligibility and apply. Download the Enrollment Form and then talk to your doctor about the enrollment process.
- Your healthcare provider purchases and administers TRODELVY
- Your healthcare provider submits a claim to your insurance plan
- You and your healthcare provider will receive an Explanation of Benefits, which shows how much your healthcare provider was reimbursed and how much you owe
- If approved, you or your healthcare provider will be reimbursed up to $25,000 annually by the TRODELVY Savings Program. Your healthcare provider may collect any remaining balance from you
§Terms & Conditions
Eligible patients receive up to a maximum benefit of $25,000 per year. This offer is not valid for prescriptions covered by or submitted for reimbursement, in whole or in part, under Medicare (including Medicare Part D), Medicaid, similar federal or state-funded programs (including any state prescription drug assistance programs and the Government Health Insurance Plan available in Puerto Rico), or where otherwise prohibited by law. No claims for reimbursement for TRODELVY units dispensed under the TRODELVY Co-pay/Co-insurance Savings Program may be submitted to any public payor (ie, Medicare, Medicaid, Medigap, Tricare, VA, and DoD). Product dispensed pursuant to program rules and federal and state laws. Gilead reserves the right to rescind, revoke, or amend this offer without notice at any time. Not valid if reproduced. This offer is valid in the United States. Void where prohibited by law.
Gilead Patient Assistance Program (PAP)
The Gilead PAP helps eligible patients who are uninsured or underinsured obtain access to TRODELVY at no cost.
- To determine if you are eligible for the program, your healthcare provider will give you an application to complete and sign
- Your healthcare provider will submit the completed application to TRODELVY ACCESS SUPPORT, and you will be notified by your healthcare provider if you are eligible
Third-party Assistance Referrals
Case Managers are available to provide you with information about other organizations that may be able to help you with co-pays, deductibles, and insurance premiums related to your TRODELVY treatment.
- Call 1-844-TRODELVY (1-844-876-3358), option 2, to speak with a Case Manager