Diastat

Indicated For

acute repetitive seizures, seizure clusters

About This Medication

# Bausch Health Patient Assistance Program Patient Guide: How to Get **Diastat (diazepam)** at Low or No Cost Diastat (diazepam) is a rectal gel form of the benzodiazepine medication diazepam, used to treat prolonged or clustered seizures, known as acute repetitive seizures, in people who are already taking other seizure medications. This guide explains the **Bausch Health Patient Assistance Program (PAP)**, which provides **Diastat** at no cost to eligible patients who meet specific criteria like residency, income, and insurance status[1][2]. ## About Diastat (diazepam) **Diastat** is an FDA-approved rescue medication administered rectally during seizure emergencies when oral diazepam isn't possible. It works by calming overactive brain signals to stop seizure clusters quickly, typically within 5-15 minutes. It's prescribed for patients with epilepsy, especially children and adults prone to breakthrough seizures. Common doses are 5 mg, 10 mg, or 20 mg pre-filled syringes. Always use under medical guidance, as it can cause drowsiness, respiratory depression, or dependence with misuse. Consult your doctor for full prescribing information[1]. ## Who Qualifies for the Program? The Bausch Health PAP helps uninsured or underinsured U.S. residents access medications like Diastat free of charge for up to 12 months. Key requirements include: - Legal U.S. resident (including Puerto Rico)[1][2][3]. - Valid prescription from a licensed U.S. healthcare professional for a covered product like Diastat[1][2]. - Treated as an outpatient (not in hospital, nursing home, prison, or similar facility)[1][2]. - Household income at or below **300% of the Federal Poverty Level (FPL)** based on family size[2]. - Specific insurance rules (detailed below)[1][2]. - Prescriber not excluded from federal healthcare programs[2]. All applications are reviewed case-by-case at no cost to apply. Bausch Health makes the final decision[1][2]. ## Income Eligibility Breakdown Eligibility hinges on annual household income not exceeding **300% FPL**. Use the table below for 2026 guidelines (adjust for your year via aspe.hhs.gov/poverty-guidelines). Include all household income sources. | Household Size | 100% FPL | 300% FPL Threshold | |----------------|----------|---------------------| | 1 | $15,060 | **$45,180** | | 2 | $20,440 | **$61,320** | | 3 | $25,820 | **$77,460** | | 4 | $31,200 | **$93,600** | | +1 person | +$5,380 | **+$16,140** | *Example: A family of 4 with income under $93,600 may qualify.* Proof like tax returns or pay stubs is required during review[2][3]. ## Insurance Requirements You must lack coverage for Diastat specifically: - **Uninsured** for the product[1][2]. - **Denied** by commercial insurance after exhausting appeals[2]. - No coverage via government programs (Medicare Part D, Medicaid, VA, TRICARE, etc.). Medicaid patients use a special form; certain cases where coverage stopped may qualify[1][2]. - Medicare Part D patients can appeal for review (case-by-case); all terminated Dec 31 annually[2]. - Discount cards don't count as coverage[2]. Attach insurance cards (front/back) and pharmacy statements[1]. If insured but denied, provide denial proof[2]. ## Step-by-Step Application Process 1. **Check Eligibility**: Confirm you meet all criteria above. Visit BauschHealthPAP.com for full details and product list (Diastat is covered)[1][2]. 2. **Download Form**: Get the standard application PDF or Medicaid-only version[1][3][4]. 3. **Patient Section**: Fill pages 2-3: personal info, insurance details, sign authorization/certification. Add authorized rep if needed[1]. 4. **Prescriber Section**: Doctor completes pages 4-6, including prescription and certification[1]. 5. **Gather Documents**: Insurance cards (front/back), income proof (e.g., 1040, W-2s, pay stubs), prescription proof[1][3]. 6. **Submit**: Fax to 844-705-0160 or mail to Bausch Health PAP, P.O. Box 991624, Louisville, KY 40269. Or apply online after eligibility questions[3]. Call (833) 862-8727 (8 AM-5 PM ET) for help[3]. Applications reviewed case-by-case; multiple methods available[1][3]. ## Timeline and Delivery Processing time varies (not specified; expect weeks). Approved patients get up to 12 months supply, shipped directly (details post-approval). Reconfirm eligibility annually; report changes in income/insurance immediately[2][3]. Medicare patients reapply yearly post-Dec 31[2]. ## Alternatives if Denied or Ineligible - **Appeal**: Contact program if denied; provide more docs[2]. - **Other PAPs**: Check RxAssist.org or NeedyMeds.org for diazepam alternatives[4]. - **Generic Diazepam**: Cheaper options via GoodRx discounts. - **State Programs**: Medicaid, 340B clinics, or epilepsy foundations like Epilepsy Foundation assistance. - **Manufacturer Copay Cards**: If commercially insured (not for PAP). - **Patient Access Network (PAN) Foundation**: Grants for seizure meds. Reapply if circumstances change[3]. ## Important Disclaimer This guide is for informational purposes based on publicly available program info as of 2026. Eligibility, terms, and coverage can change; Bausch Health decides solely. Not medical/financial advice. Consult your doctor/pharmacist. Verify current details at BauschHealthPAP.com or call (833) 862-8727. Income tables approximate; use official FPL. Program not for incarcerated/hospitalized patients[1][2].

Program information last verified: March 30, 2026