Bausch + Lomb Patient Assistance Program

Funded

About

The Bausch + Lomb Patient Assistance Program offers invaluable support by providing medications such as Miebo, Visudyne, Retisert, and Xipere free of charge to eligible patients. The Bausch + Lomb Patient Assistance Program ensures that uninsured or functionally uninsured US citizens with prescribed medications can access necessary treatment at no cost, reinforcing its commitment to healthcare accessibility.

Insurance requirements: Medicare / Medicaid, Underinsured, Uninsured

Enrollment Forms

Enrollment Form

Program Requirements

•Valid only for residents in the US and Puerto Rico

•Enrollment Required: Yes

•Coverage Required: No

•Needs Based: Yes

•Activation Required: No

Program Details

•Eligible patients may be able to receive medication free of charge

•HCP should submit completed enrollment form via fax to: 8444440531

•For assistance or additional information, call 8557700424, Monday – Friday, 8 AM TO 5 PM ET

Enrollment Forms

Enrollment Form