ARAZLO

Indicated For

acne vulgaris

About This Medication

# Bausch Health Patient Assistance Program Guide: How to Get ARAZLO at Low or No Cost ## About ARAZLO ARAZLO (tazarotene) is a prescription medication made by Bausch Health. If you've been prescribed ARAZLO but are struggling with the cost, the Bausch Health Patient Assistance Program (BHC PAP) may help you obtain your medication at no cost. ## Who Qualifies for This Program? To be eligible for the Bausch Health Patient Assistance Program, you must meet several requirements: **Basic Requirements:** - Be a legal United States resident - Have a valid prescription from a licensed U.S. healthcare professional for ARAZLO - Be treated as an outpatient (not hospitalized or in a nursing home) - Not reside in a correctional facility or court-appointed program **Income Eligibility:** Your annual household income must not exceed 300% of the Federal Poverty Level (FPL) based on your household size.[2] While specific income thresholds vary by year and household composition, the program typically serves individuals earning $40,000 or less, couples under $60,000, and families up to $100,000.[1] | Household Size | Approximate Income Limit (300% FPL) | |---|---| | Individual | $40,000 | | Couple | $60,000 | | Family of 3 | $100,000 | | Family of 4 | $100,000 | *Note: These are approximate figures. Exact limits are updated annually by the Federal Poverty Level Guidelines.* **Insurance Requirements:** You must meet one of these insurance conditions:[2] - Be completely uninsured, OR - Have been denied coverage for ARAZLO by your commercial insurance and exhausted all appeal options, OR - Not have coverage for ARAZLO through government health insurance (Medicare Part D, Medicaid, Medigap, VA, DoD, TRICARE, or other federal/state pharmacy programs) If you have Medicare Part D coverage, you may appeal for eligibility evaluation on a case-by-case basis.[2] Discount cards are not considered prescription drug coverage for program eligibility purposes. ## How to Apply The application process involves several steps and requires coordination between you and your healthcare provider. **Step 1: Gather Required Documents** Before starting your application, collect:[1] - Copy of your medical insurance card (front and back) - Copy of your prescription insurance card (front and back) - Your valid prescription for ARAZLO from your healthcare provider - Proof of household income (pay stubs, tax returns, or benefit statements) **Step 2: Complete the Patient Application** Download the application form from BauschHealthPAP.com. Complete the following sections:[1] - Patient Information (name, address, contact details) - Insurance Information (current coverage details) - Patient Authorization and Certification (sign and date) **Step 3: Have Your Prescriber Complete Their Section** Provide your healthcare provider with the application form. They must:[1] - Complete pages 4, 5, and 6 - Sign the Prescriber Certification - Verify that you are being treated as an outpatient **Step 4: Submit Your Application** Mail your completed application with all supporting documents to:[3] BAUSCH HEALTH PATIENT ASSISTANCE PROGRAM P.O. Box 991624 Louisville, KY 40269 Alternatively, you can fax your application to: 844-705-0160[3] You can also apply online or download the application after answering eligibility questions on the program website.[3] **Step 5: Await Approval** All applications are reviewed on a case-by-case basis.[1][3] There is no cost to apply. Once approved, you will be notified of your eligibility status. ## Timeline and Medication Delivery The program does not specify exact processing times in publicly available materials. However, once approved, eligible patients may receive ARAZLO at no cost for up to 12 months from the date of approval.[2] If you have questions about your application status, contact the program: - **Phone:** 833-862-8727 (8 AM to 5 PM ET)[3] - **Fax:** 844-705-0160[3] ## What If You're Denied? If your application is denied, you have options: 1. **Review the denial reason** — Contact the program to understand why you were not approved. Common reasons include income exceeding limits or insurance coverage that should be exhausted first. 2. **Reapply if circumstances change** — If your income decreases or your insurance coverage changes, you may reapply. 3. **Explore other assistance options** — Ask your healthcare provider about other patient assistance programs, generic alternatives, or discount programs. 4. **Appeal if applicable** — If you believe the decision was made in error, contact the program to discuss appeal options. ## Reauthorization and Ongoing Eligibility If you are approved, your assistance is valid for up to 12 months from your approval date.[2] Before your 12-month period ends, you may reapply if you continue to meet eligibility requirements and have a valid prescription.[3] If you are enrolled in Medicare Part D, you will be automatically terminated on December 31 and must reapply for the following year.[2] The program will annually reconfirm your income and insurance eligibility.[2] If your circumstances change—such as obtaining insurance coverage or an increase in household income—you may be deemed no longer eligible. ## Important Disclaimers - Bausch Health Companies Inc. determines participation in the BHC PAP at its sole discretion. - Your prescriber must not be on the List of Excluded Individuals and Entities maintained by the Office of Inspector General, U.S. Department of Health and Human Services. - This program is designed for outpatient use only. - All information is subject to program terms and conditions, which may change. - For the most current eligibility requirements and application forms, visit BauschHealthPAP.com. ## Contact Information **Bausch Health Patient Assistance Program** - Phone: 833-862-8727 (8 AM to 5 PM ET)[3] - Fax: 844-705-0160[3] - Mailing Address: P.O. Box 991624, Louisville, KY 40269[3] - Website: BauschHealthPAP.com

Program information last verified: March 30, 2026