ACCESS PASSPORT PROGRAM

ACCESS PASSPORT PROGRAM

ACCESS PASSPORT PROGRAM

  • You send scripts to your local Walgreens or a participating independent pharmacy
  • Patients can also take the prescription directly to one of these pharmacies
  • Give patients a card with program details and a savings coupon to be user for new prescriptions and refills
  • Once coupon card applies to all products within the Bausch + Lomb Access Program
  • Patient must activate the coupon card via internet or by phone before going to the pharmacy
  • Patient must answer a handful of questions to activate the coupon card
  • Patient needs only a Bausch + Lomb Access coupon and a valid insurance card when picking up a prescription at Walgreens or a participating independent pharmacy

ACCESS PASSPORT PROGRAM

Istalol logo Lotemax logo Prolensa logo Zylet logo Alrex logo Bepreve logo Besivance logo Lacrisert logo Timoptic logo Lotemax logo

ACCESS PASSPORT PROGRAM

ACCESS PASSPORT PROGRAM

Eligibility Criteria 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 offer is only valid for patients with commercial insurance and uninsured cash-pay patients.
  • 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
  • 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 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 any person that 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 ora minor.
  • You must present this coupon along with your prescription to participate in this program. You must activate this coupon before using by calling 1-855-280-0580 or visiting www.activatethecard.com/valeant/opht.
  • This coupon is good for use only with the products identified at Bausch.com/accessprogram. No other purchase is necessary.
  • This offer cannot be redeemed at government-subsidized clinics.
  • The coupon is good for a limited number of fills only. For a complete listing of the maximum number of fills for each product for which this offer applies, please review the program terms and conditions, which are posted at Bausch.com/accessprogram.
  • Reimbursement limitations apply. Patient is responsible for all additional costs and expenses after reimbursement limits are reached.
  • 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.
  • You understand and agree to comply with the terms and conditions of this offer as set forth above.
  • For questions call: 1-855-280-0580.

ACCESS PASSPORT PROGRAM

What is the purpose of the Bausch + Lomb Program at Walgreens

Walgreens is a well-known and respected retailer with more than 8,200 locations in the United States. The alignment will allow patients access to Bausch + Lomb products at a consistent, affordable price. This may help to minimize pharmacy callbacks.

What if I don't have a Walgreens near me?

Ninety percent of our scripts are covered within the Walgreens network. We are looking at areas where coverage is low or absent to align with independent pharmacies. PROLENSA® and LOTEMAX® GEL Part D patients can go to any pharmacy.

How will I know where the Walgreens are located in my area?

You will be provided with a map and list of locations by zip code. Please become familiar with Walgreens in your area so you can provide information to your patients.

Does this card take the place of current Bausch + Lomb coupon card programs?

Yes, for commercial and cash patients, these cards would replace the current programs. Part D for LOTEMAX® GEL and PROLENSA® will continue with current programs and coupons and will expire December 31, 2016.

What if a patient goes to another pharmacy, such as CVS?

The current coupons will continue to work at all pharmacies until April 30, 2016. On May 1, 2016, all commercial and cash patients must go to Walgreens for the discount program.

Can the card be used more than one time?

A patient can use the card up to 6 times. If more than 6 fills are needed, another card is required.

What happens if a patient doesn't have a coupon?

Just like our current programs, patients are required to have a coupon, so make sure to emphasize this to patients. Coupons will be available at Walgreens and online at Bausch.com/accessprogram.

What will patients really pay?

Most eligible insured commercial patients will pay no more than $35. Most eligible uninsured patients will pay no more than $60.