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1st Rx and Eligible Refills

Eligible* commercially insured XIIDRA® (lifitegrast ophthalmic solution) 5% and MIEBO® (perfluorohexyloctane ophthalmic solution) patients may pay as little as:

$0 COPAY

For all other brands within the Bausch + Lomb portfolio, eligible
commercially insured patients may pay as little as:

$25 COPAY

Exclusively at Walgreens and other participating independent pharmacies

At non-participating
pharmacies, eligible
commercial patients
may pay as little as: $35 COPAY

CLICK TO ACTIVATE CARD

Or activate your coupon by calling 1-877-494-4372
*Terms, conditions and limitations apply. Please see eligibility criteria and terms and conditions below. For questions call: 1-877-494-4372.

LEARN MORE ABOUT THE BAUSCH + LOMB MEDICARE PART D COPAY PROGRAM

Eligible products include:

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 up to six (6) fills per product per patient in a 12-month period, other than MIEBO® (perfluorohexyloctane ophthalmic solution), Xiidra® (lifitegrast ophthalmic solution) 5%, and VYZULTA® (latanoprostene bunod ophthalmic solution), 0.024%. The coupon is valid for up to twelve (12) fills for Miebo, Xiidra, and Vyzulta 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. Patients in Massachusetts and Minnesota may pay as little as $35 copay. For questions, please call 1-877-494-4372.
  • Savings may not be applied to any outstanding deductible or coinsurance a patient may have.
  • 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 where 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, BEPREVE® (bepotastine besilate ophthalmic solution) 1.5%, ALREX® (loteprednol etabonate ophthalmic suspension) 0.2%, and PROLENSA® (bromfenac ophthalmic solution) 0.07%.
  • 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.bauschaccessprogram.com or on the phone by calling 1-877-494-4372.
  • 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: 1-877-494-4372.