Yes, this program is only available to legal residents of the United States and its territories.

Medicare and Medicaid offer drug coverage for their enrolled patients, as well as insurance for general health care.

Patients enrolled in Medicare or Medicaid may be eligible for the Bausch Health Patient Assistance Program for patients who do not have specific product coverage.

Some patients who cannot afford their prescription products and meet certain financial criteria also may be eligible.

For information on Medicare and Medicaid, visit the Centers for Medicare & Medicaid Services website http://www.cms.hhs.gov.

If Medicaid does not cover your prescription and the product is included as part of the Bausch Health Patient Assistance Program, you may be eligible.

We recommend checking our list of included products here, which allows patients to determine if their prescribed product is included.

You can download the application online to print it and complete by hand. Bring the application to your prescriber to complete. Patients with coverage through Medicaid only can also complete the ‘Application for Medicaid-only Patients’ over the phone by calling (833) 862-8727.

Tips to avoid delays:

• Fill out as much of the application online for legibility and to speed up processing
• Be sure all information is completed
• Be sure your prescriber fills out their portion fully and signs the form

Yes, you can submit one application for all applicable products you are prescribed. Your doctor will make the necessary product selections on the application for each product they prescribe to you.

No. In most cases, the program can determine your financial eligibility without providing documentation.

However, in some cases, you may be asked to include a copy of your most recent 1040 or 1040EZ federal tax return or other requested document.

If you have any information that helps us to understand your current financial situation better, please provide those details with your application.

Our policies require us to retain all copies in case we are audited. You can always print copies of all documents before you submit them for review.

Your prescriber must complete their sections of the application and sign where required.

We will review and confirm the information in your application.

It is important to make sure you and your doctor complete all the required information on your application before sending it to the program. If the application has any missing information, it will take longer to review and determine if you are eligible.

You will receive a communication informing you of your eligibility upon completion of the review.

We will keep you informed during the process. Be sure to provide your cell phone number and email – these are the fastest ways for us to provide you with the status of your application.

Note: There is a higher volume of applications received during the re-enrollment period which is November – March. During these months all applications will experience longer processing times. Please make sure that you and the prescriber have completed all the required information and signed the application. If there is any missing information it will delay any decision on eligibility until that information is received.

Please call us at 833-862-8727 to obtain an update on the status of your application.

It will depend on several factors. Call 833-862-8727 to speak with a Program Advocate to discuss whether you will need to reapply.