Your healthcare provider may need to give you antibiotic medicines if you develop fever while your white blood cell count is low. If your white blood cell count is too low, your healthcare provider may need to lower your dose, give you a medicine to help prevent low blood cell count with future doses of TRODELVY, or in some cases may stop TRODELVY. Your healthcare provider should check your blood cell counts during treatment. Low white blood cell count (neutropenia) which is common and can sometimes be severe and lead to infections that can be life-threatening or cause death.Gilead and its agents make no guarantee regarding reimbursement for any service or item. The foundation will determine the patient's eligibility for co-pay or coinsurance assistance based on their own criteria, completely independent of Gilead and its agents, and will contact the patient directly regarding the application process. If co-pay assistance needs are identified, the case managers can provide information about any available foundations. Case managers can help patients assess their high-level eligibility for possible coverage for TRODELVY through an independent co-pay assistance foundation. *Patients with Medicare or other government insurance who need assistance with cost-share requirements for TRODELVY may be eligible for co-pay or coinsurance assistance through an independent co-pay assistance foundation. If you have questions, call a TRODELVY ACCESS SUPPORT Case Manager at 1-844-TRODELVY (1-84), option 2. If you have government insurance, like Medicare, Medicaid, or VA, you will have access to TRODELVY ACCESS SUPPORT Case Managers who can provide you with information about third-party organizations that may be able to help with co-pays, deductibles, and insurance premiums related to your TRODELVY treatment. This offer is valid in the United States. Gilead reserves the right to rescind, revoke, or amend this offer without notice at any time. Product dispensed pursuant to program rules and federal and state laws.

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). 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.

Once enrolled, the patient may pay $0 out-of-pocket for TRODELVY with maximum benefit of $25,000 per year.Įligible patients receive up to a maximum benefit of $25,000 per year. Patients must meet certain eligibility criteria to qualify for this program. *The TRODELVY Savings Program is not available to patients with any form of government insurance. Your healthcare provider may collect any remaining balance from you If approved, you or your healthcare provider will be reimbursed up to $25,000 annually by the TRODELVY Savings Program.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 for the cost of TRODELVY.Your healthcare provider submits a claim to your insurance plan.Your healthcare provider purchases and administers TRODELVY.Your healthcare provider's office or TRODELVY ACCESS SUPPORT can help you apply.ĭownload the Patient Enrollment Form and then talk to your healthcare provider about the enrollment process: 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.The Program only assists with cost of TRODELVY patient is responsible for cost-share of treatments and office visits.Patients may pay as little as $0 out-of-pocket for TRODELVY, which includes co-pay and coinsurance, up to $25,000 annually.If you are commercially or privately insured, the TRODELVY Savings Program* offers you savings on out-of-pocket expenses of TRODELVY 180-mg single-dose vials, up to $25,000 annually.

Gilead co pay card