Bausch + Lomb is committed to providing copay assistance on your LOTEMAX® SM prescription
Eligible Commercially Insured Patients May Pay As Little As*:
EXCLUSIVELY AT WALGREENS
Most Eligible Patients Pay No More Than*:
Discounted $60 copay available for eligible uninsured patients*.
Size: 5g in a 10 mL bottle Eligible Fills: 6
How to activate your coupon before heading to the pharmacy
Eligible Commercially Insured & Uninsured Patients*
Eligible Medicare Part D Patients*
Activate your Medicare Part D coupon in three simple steps:
- ACTIVATEPrint coupon: Call 1-866-686-0130ORWeb coupon: Visit www.lotemaxsmpartdcoupon.com to download coupon
- REDEEM Visit a participating pharmacy with your coupon, prescription, and insurance card
- MAILSign and mail the prewritten letter to notify the health plan of your choice to use coupon program benefits. The address can be found on your Medicare card
Terms, limitations and conditions apply. Most eligible commercially insured patients may pay no more than $25 copay
for their first prescription and eligible refills, exclusively at Walgreens and other participating independent pharmacies. Please see www.bauschaccessprogram.com
for eligibility criteria and terms and conditions.