Tarceva

Tarceva® Coupon; Co-Pay Card; Save Up To $4,000; Voucher Program Sponsored By Genentech Oncology

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Description: Save up to $4,000 On Tarceva

Directions: Help Paying for Tarceva. Tarceva Co-Pay Card Program

Please note: This coupon for Tarceva co-pay reduction is only available from your healthcare provider. He should have a supply of these coupons on hand. If not, he must contact his Genentech field representative . If he does not know who the proper representative is, he should call a Tarceva Access solutions specialist at: 888-249-4918 for a detailed explanation of the process.

Certain eligibility limitations apply regarding the coupon for Tarceva:

The maximum they will pay is $4000.
You must use the card within one tear after you activate it.
You need to be 18 years old or older.
Your household income must be less than $100,000.
Your co-pay for Tarceva must be greater than $100.
You must not be a resident of Massachusetts because this program is illegal in Massachusetts.
If any government program pays for your medicines you can no6t use this program.

How it works: You pay the first $100 of your co-pay. Genentech pays 80% of the rest.

Examples:

(A) Your co pay is $200.
You pay the first $100.
Genentech pays 80% of the remaining balance of $100 or $80.
Your total out-of-pocket cost would be $120.

(B) Your co-pay is $150 You pay the first $100.
Genentech pays $80% of the remaining balance of $50 or $40.
Your total out-of-pocket cost would be $110.

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