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BAUSCH + LOMB Access Program |
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VALEANT Patient Assistance Program Application https://www.bauschaccessprogram.com/Portals/69/-/m/BL/United%20States/USFiles/Downloads/Consumer/Pharma/pharma_patient_assistance.pdf |
Patient Assistance Program https://www.bauschaccessprogram.com/Portals/77/-/m/BL/United%20States/Files/Downloads/ECP/Pharma/pharma_patient_assistance.pdf |
highlights of prescribing information https://www.bauschaccessprogram.com/Portals/69/-/m/BL/United%20States/USFiles/Package%20Inserts/Pharma/zirganpackageinsert.pdf |
Management of Epithelial Herpetic Keratitis: An Evidence- ... https://www.bauschaccessprogram.com/Portals/77/-/m/BL/United%20States/Files/Downloads/ECP/Pharma/zirgan/Treament-algorithm.pdf |
bepreve-prescribing-info.pdf https://www.bauschaccessprogram.com/Portals/69/-/m/BL/United%20States/USFiles/Package%20Inserts/Pharma/BEPREVE-Prescribing-Info.pdf |
Alrex® (loteprednol etabonate ophthalmic suspension, 0.2 ... https://www.bauschaccessprogram.com/Portals/77/-/m/BL/United%20States/Files/Package%20Inserts/Pharma/alrex-package-insert.pdf |
ZYLET prescribing information https://www.bauschaccessprogram.com/Portals/77/-/m/BL/United%20States/Files/Package%20Inserts/Pharma/Zylet-package-insert.pdf |
besivance-full-prescribing-info.pdf https://www.bauschaccessprogram.com/Portals/77/-/m/BL/United%20States/Files/Package%20Inserts/Pharma/Besivance-Full-Prescribing-Info.pdf |
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Date: Tue, 14 May 2024 11:59:44 GMT |
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1 st Rx and Eligible Refills Eligible* commercially insured patients may pay as little as: Exclusively at Walgreens and other participating independent pharmacies At non-participating pharmacies, eligible commercial patients may pay as little as: $35 COPAY *Terms, conditions and limitations apply. Please see eligibility criteria and terms and conditions below. For questions call: 1-866-693-4880 Or activate your coupon by calling 1-866-693-4880, or by texting BLSAVINGS to 24109. † By texting BLSAVINGS to 24109, you will receive a link to activate your coupon via SMS. † By texting BLSAVINGS to 24109, you will receive a link to activate your coupon via SMS. 1 msg per enrollment activation. Msg & data rates may apply. For SMS Terms visit https://bauschaccess.copaysavingsprogram.com/sms-terms . For Privacy Policy, https://www.bauschhealth.com/privacy . Eligible products include: Hover over logo to view patient copay details. ✖ Product Website Eligible patients may pay copays as little as: NDC# SIZE COVERED Not Covered 24208-0504-02 24208-0504-05 90-Day Offer 2.5 mL 5 mL 3x2.5 mL $25 $25 $25 $70 $100 NA ✖ Product Website Eligible patients may pay copays as little as: NDC# SIZE COVERED Not Covered 4208-0507-07 5 g $25 $70 ✖ Product Website Eligible patients may pay copays as little as: NDC# SIZE COVERED Not Covered 24208-0602-03 3 mL $25 $70 ✖ Product Website Eligible patients may pay copays as little as: NDC# SIZE COVERED Not Covered 24208-0443-35 3.5 g $25 $70 ✖ Product Website Eligible patients may pay copays as little as: NDC# SIZE COVERED Not Covered 24208-0353-05 24208-0353-10 5 mL 10 mL $25 $25 $70 $100 ✖ Product Website Eligible patients may pay copays as little as: NDC# SIZE COVERED Not Covered 24208-0358-05 24208-0358-10 5 mL 10 mL $25 $25 $70 $100 ✖ Product Website Eligible patients may pay copays as little as: NDC# SIZE COVERED Not Covered 24208-0299-05 24208-0299-10 24208-0299-15 5 mL 10 mL 15 mL $25 $25 $25 $70 $100 $130 ✖ Product Website Eligible patients may pay copays as little as: NDC# SIZE COVERED Not Covered 24208-0535-35 5 mL $25 $70 ✖ Product Website Eligible patients may pay copays as little as: NDC# SIZE COVERED Not Covered 24208-0446-05 5 mL $25 $70 ✖ Product Website Eligible patients may pay copays as little as: NDC# SIZE COVERED Not Covered 24208-0629-02 24208-0629-01 5 mL 10 mL $25 $25 $70 $100 ✖ Product Website Eligible patients may pay copays as little as: NDC# SIZE COVERED Not Covered 24208-0004-01 24208-0004-03 2.5 mL 5 mL $25 $25 $70 $100 ✖ TIMOPTIC® IN OCUDOSE® 0.25% TIMOPTIC® IN OCUDOSE® 0.50% TIMOPTIC® IN OCUDOSE® 0.25% TIMOPTIC® IN OCUDOSE® 0.50% Product Website Eligible patients may pay copays as little as: NDC# SIZE COVERED Not Covered 00187-1498-25 00187-1496-05 60 units 60 units $25 $25 $70 $70 Eligibility Criteria/Terms and Conditions: By using the Bausch + Lomb Access coupon, you confirm that you understand and agree to comply with the following terms and conditions of this offer: This coupon is valid for (6) fills per product per patient in a 12-month period. Reimbursement limitations apply. Patient is responsible for all additional costs and expenses after reimbursement limits are reached, including additional copayment and coinsurance amounts. Patients with high deductible or coinsurance health plans may pay more than $25. For questions, please call 1-866-693-4880. VYZULTA ® (latanoprostene bunod ophthalmic solution), 0.024%, 90-day supply copay offer only applies if each of the three 2.5mL bottles is covered by the patient’s commercial insurance. This offer is only valid for eligible patients with commercial insurance and not covered patients. Not Covered Patients” are defined as those patients who have no health insurance or who have commercial insurance, but the drug is not covered on the plan’s formulary or has an NDC block, prior authorization, step edit or other restriction that has not been met. This offer is not valid for any person who is 65 years of age or older without commercial insurance. You must be 18 years of age or older to redeem this offer for yourself or a minor. This offer is not valid for any person eligible for reimbursement of prescriptions, in whole or in part, by any federal, state, or other governmental programs, including, but not limited to, Medicare (including Medicare Advantage and Part A, B, and D plans), Medicaid, TRICARE, Veterans Administration or Department of Defense health coverage, CHAMPUS, the Puerto Rico Government Health Insurance Plan, or any other federal or state health care programs. This coupon shall be applied only toward the cost of an eligible prescription product and not toward ancillary services or treatment costs. You agree not to seek reimbursement for all or any part of the benefit received through this offer and are responsible for making any required reports of your use of this offer to any insurer or other third party who pays any part of the prescription filled. This offer is good only in the United States of America (including the District of Columbia, Puerto Rico, Guam and the U.S. Virgin Islands) at retail pharmacies owned and operated by Walgreen Co. (or its affiliates) and other participating independent retail pharmacies. This offer is not valid in Massachusetts or Minnesota or where otherwise prohibited, taxed, or otherwise restricted. This offer is not valid for redemption in the States of California and Massachusetts or by any resident of the States of California or Massachusetts with regard to any product for which a therapeutically equivalent generic product is available including, but not limited to, ISTALOL® (timolol maleate ophthalmic solution) 0.5%, LOTEMAX® (loteprednol etabonate ophthalmic suspension) 0.5%, LOTEMAX® (loteprednol etabonate ophthalmic Gel 0.5%), TIMOPTIC® in OCUDOSE® (timolol maleate ophthalmic solution) 0.5%, 0.3mL, and BEPREVE® (bepotastine besilate ophthalmic solution) 1.5%. You must present this coupon along with your prescription to participate in this program. You must activate your coupon before use. Please activate online at www.blsavings.com , on the phone by calling 1-866-693-4880 , or by texting BLSAVINGS to 24109 to activate via SMS. By texting BLSAVINGS to 24109, you will receive a link to activate your coupon via SMS. 1 message per enrollment activation. Message and data rates may apply. The full terms can be viewed at https://bauschaccess.copaysavingsprogram.com/sms-terms . For Privacy Policy, visit https://www.bausch.com/privacy/ . This coupon is good for use only with the products identified herein. No other purchase is necessary. This offer cannot be redeemed at government-subsidized clinics. This coupon and offer are not health insurance. The selling, purchasing, trading, or counterfeiting of this coupon is prohibited by law. Void if reproduced. This offer is not valid with other offers. This coupon has no cash value. No cash back. Bausch + Lomb reserves the right to rescind, revoke, terminate, or amend this offer at any time, without notice. When you use this coupon, you are certifying that you understand and agree to comply with the program rules, regulations, eligibility requirements, and terms and conditions. For questions call: 1-866-693-4880. Privacy Policy Legal Notice ®/TM are trademarks of Bausch & Lomb Incorporated or its affiliates except Zirgan is a registered trademark of Laboratoires Théa Corporation used under license. ©2024 Bausch + Lomb. PORT.0018.USA.21 V5.0 Unsubscribe Do Not Sell or Share My Personal Information Do Not Target Limit the Use of My Sensitive Personal...
Domain Name: BAUSCHACCESSPROGRAM.COM Registry Domain ID: 1997242116_DOMAIN_COM-VRSN Registrar WHOIS Server: whois.markmonitor.com Registrar URL: http://www.markmonitor.com Updated Date: 2023-12-24T10:47:36Z Creation Date: 2016-01-25T02:10:41Z Registry Expiry Date: 2025-01-25T02:10:41Z Registrar: MarkMonitor Inc. Registrar IANA ID: 292 Registrar Abuse Contact Email: abusecomplaints@markmonitor.com Registrar Abuse Contact Phone: +1.2086851750 Domain Status: clientDeleteProhibited https://icann.org/epp#clientDeleteProhibited Domain Status: clientTransferProhibited https://icann.org/epp#clientTransferProhibited Domain Status: clientUpdateProhibited https://icann.org/epp#clientUpdateProhibited Name Server: NS1.MARKMONITOR.COM Name Server: NS2.MARKMONITOR.COM Name Server: NS3.MARKMONITOR.COM Name Server: NS4.MARKMONITOR.COM Name Server: NS5.MARKMONITOR.COM Name Server: NS6.MARKMONITOR.COM Name Server: NS7.MARKMONITOR.COM DNSSEC: unsigned >>> Last update of whois database: 2024-05-17T20:02:06Z <<<