Bausch Health Patient Assistance Program

Funded

About

The Bausch Health Patient Assistance Program offers vital support in obtaining medications such as Zyclara, Aplenzin, Xifaxan, and others without cost for those who qualify. The Bausch Health Patient Assistance Program is dedicated to individuals who lack insurance coverage or have been denied commercial insurance, providing them with access to necessary prescriptions through the Bausch Health PAP for up to one year.

Insurance requirements: Commercially insured, 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

•Provides assistance and access to individuals in need of products made available through the Bausch Health PAP

•Eligible patients may be able to receive product through this program at no cost for up to one year from date of approval

•All applications are reviewed on a casebycase basis; income verification required

•Patient may be able to reapply to the program annually if patient continues to meet eligibility requirements and have a valid prescription

•Patient and physician can apply online, or print and download application after answering eligibility questions

•Fax the completed application form and any requested documentation to 8447050160 or MAIL: BAUSCH HEALTH PATIENT ASSISTANCE PROGRAM, P.O. Box 991624, Louisville, KY 40269

•For questions, call 8338628727, 8 AM to 5 PM ET

Enrollment Forms

Enrollment Form