Follow these simple steps to apply:
If you cannot print the application you can call us at 833-862-8727, 8 AM to 5 PM ET to have one mailed or emailed to you
We will review and confirm the information in your application and provide a response.
If approved, you are eligible to receive your Bausch Health prescription product(s) at no cost to you for up to one year.*
There is no maximum benefit limit. You may be able to reapply to the program annually if you continue to meet eligibility requirements and have a valid prescription.