How to Use the Program

At the doctor's office, clinic or hospital:

Receive your treatment and pay as little as a $5 co-pay for your drug costs.

Your doctor's office sends the LUCENTIS Co-pay Program a copy of the detailed Explanation of Benefits (EOB)*. The EOB may be faxed to (855) 320-0457.

The requirements for reimbursement must include:

  • Name of insurance company
  • Facility name
  • Patient's name
  • Date of Service (DOS)
  • Name of drug or J-code
  • Amount billed, Amount allowed, Patient responsibility, Amount paid to provider

If the EOB does not include any of the above items, additional documentation may be required to process the claim.

The LUCENTIS Co-pay Program verifies your information. After confirmation that program requirements are met, we send your doctor the out-of-pocket (OOP) drug costs for LUCENTIS minus your patient responsibility.
To receive check reimbursement:
  • Complete the Check Request Form and send it to Genentech, along with copies of the detailed EOB and payment receipt. These can be sent via:
  • Fax to (855) 320-0457
  • Upload at
  • Mail to the LUCENTIS Co-pay Program
P.O. Box 2106, Morristown, NJ 07962

*EOBs must be submitted within 365 days from the date of service (DOS) for consideration.

Indication and Important Safety Information

Who is LUCENTIS for?

LUCENTIS® (ranibizumab injection) is a prescription medicine for the treatment of patients with wet age-related macular degeneration (wAMD), macular edema following retinal vein occlusion (RVO), myopic choroidal neovascularization (mCNV), diabetic macular edema (DME), and diabetic retinopathy (DR).

What important safety information should I know about LUCENTIS?

You should not use LUCENTIS if you have an infection in or around the eye or are allergic to LUCENTIS or any of its ingredients. LUCENTIS is a prescription medication given by injection into the eye, and it has side effects. Some LUCENTIS patients have had detached retinas and serious eye infections. If your eye becomes red, sensitive to light, or painful, or if you have a change in vision, call or visit your eye doctor immediately. Some LUCENTIS patients have had increased eye pressure before and within 1 hour of an injection. Uncommonly, LUCENTIS patients have had serious, sometimes fatal, problems related to blood clots, such as heart attacks or strokes. Fatal events were seen more often in patients with DME and DR with LUCENTIS compared with patients who did not receive Lucentis. Although there were only few fatal events which included causes of death typical of patients with advanced diabetic complications, these events may be caused by Lucentis.

Some LUCENTIS patients have serious side effects related to the injection. These include serious infections inside the eye, detached retinas, and cataracts. The most common eye-related side effects are increased redness in the white of the eye, eye pain, small specks in vision, and increased eye pressure. The most common non-eyerelated side effects are nose and throat infections, anemia, nausea and cough. Ask your doctor if you have questions or want more information.

You may report side effects to the FDA at (800) FDA-1088 or You may also report side effects to Genentech at (888) 835-2555.

For additional safety information, please talk to your doctor and see the LUCENTIS full prescribing information.