BAUSCH & LOMB INCORPORATED
Bausch + Lomb Patient Assistance Program
Information last checked July 17, 2026
Contact info
- Phone
- 1-855-770-0424
- Fax
- 1-844-444-0531
- Mailing address
- P.O. Box 991624Louisville, KY 40269
Eligibility
- Patient must be a legal United States resident.
- Must have a valid prescription from a licensed U.S. healthcare professional for a product made available through the Bausch Health PAP.
- Patient must not have insurance coverage for the prescribed Bausch Health product.
- Eligibility for patients with Medicare Part D are determined on case-by-case basis.
- Meet the pre-defined eligibility requirements and total annual household income requirements.
- Income limit, single
- Not published
- Income limit, couple
- Not published
- Medical expenses can be deducted
- Not published
- Social Security number asked for
- Yes
- US citizenship or residency required
- Yes
Not sure where your income falls? See this year's federal poverty guidelines (opens in a new tab).
Application process
- Documents to attach
- Proof of income
- Prescriber license number
- NPI number
- Both DEA and state license numbers
- Who can sign
- Physician
- Application can be faxed
- Yes
- Decision letter sent to
- Provider and patient
Getting the medication
- Patient receives
- Medication
- Shipped to
- Provider or patient
- Supply per shipment
- Not published
- Time to first delivery
- Not published
- Refills
- Not published
- Staying enrolled
- New application every 12 months
- New proof of income every 12 months
Medications covered
- Alrex suspension .2% (loteprednol etabonate ophthalmic suspension)
- Besivance (besifloxacin ophthalmic suspension)
- Lacrisert Ophthalmic insert (hydroxypropyl cellulose opthalmic insert)
- Miebo (perfluorohexyloctane ophthalmic solution)
- Prolensa (bromfenac sodium solution)
- Retisert (fluocinolone acetonide intravitreal implant)
- Visudyne (verteporfin for injection)
- Vyzulta (latanoprostene bunod ophthalmic solution)
- Xiidra (lifitegrast ophthalmic solution)
- Xipere (triamcinolone acetonide injectable suspension)