Lotemax SM

Indicated For

post-operative ocular inflammation and pain

About This Medication

# Bausch Health Patient Assistance Program Patient Guide: How to Get Lotemax SM (loteprednol etabonate) at Low or No Cost Lotemax SM (loteprednol etabonate) is a prescription eye drop used to treat inflammation and pain after eye surgery or for certain eye conditions. The **Bausch Health Patient Assistance Program (PAP)** provides this medication **at no cost** to eligible patients who meet specific criteria, including income limits and lack of insurance coverage.[1][2] ## About Lotemax SM **Lotemax SM** is a corticosteroid eye suspension (0.38%) that reduces swelling, redness, itching, and discomfort in the eyes. It's commonly prescribed post-cataract surgery or for conditions like allergic conjunctivitis, uveitis, or post-operative inflammation. Always use as directed by your doctor—typically 1-2 drops in the affected eye several times daily. Do not stop abruptly without medical advice, as it may worsen symptoms. Common side effects include eye irritation, blurred vision, or increased eye pressure; contact your doctor if you experience pain, vision changes, or signs of infection.[1] This guide explains how the Bausch Health PAP can help uninsured or underinsured patients access Lotemax SM free for up to 12 months, with options to reapply annually.[2][3] ## Who Qualifies for the Program? Eligibility is determined **case-by-case** with **no application fee**. You must:[2] - Be a **legal U.S. resident** (including Puerto Rico). - Have a **valid prescription** from a licensed U.S. healthcare provider for Lotemax SM. - Be treated as an **outpatient** (not in a hospital, nursing home, correctional facility, etc.). - Meet **household income limits**: Annual income ≤ **300% of the Federal Poverty Level (FPL)** based on household size. - Have **no insurance coverage** for Lotemax SM: - Uninsured, or - Denied by commercial insurance (after exhausting appeals), or - No coverage via government programs (Medicare Part D, Medicaid, VA, TRICARE, etc.). **Medicare Part D patients** may appeal for review case-by-case; Medicaid patients use a separate form.[1][2] Your prescriber must not be excluded from federal healthcare programs.[2] ## Income Eligibility Breakdown Income must not exceed **300% FPL**. Use the table below for 2026 guidelines (adjust annually via aspe.hhs.gov). Proof like tax returns or pay stubs is required.[2] | Household Size | Max Annual Income (300% FPL) | |----------------|------------------------------| | 1 | $45,180 | | 2 | $61,320 | | 3 | $77,460 | | 4 | $93,600 | | 5 | $109,740 | | Add per person | +$16,140 | *Notes: FPL varies by year/location; program confirms via documentation. Changes in income/insurance may affect eligibility.*[2] ## Insurance Requirements The program targets those without coverage for Bausch Health products like Lotemax SM.[2][3] - **Uninsured**: Fully eligible if other criteria met. - **Commercial insurance**: Must be denied coverage and exhaust appeals. - **Government insurance** (Medicare Part D, Medicaid, etc.): Generally ineligible, but Medicare appeals possible case-by-case. Medicaid uses special form.[1][2] - **Discount cards**: Not considered coverage. Attach insurance cards (front/back); pharmacy statements help if no coverage.[1] ## Step-by-Step Application Process 1. **Check eligibility**: Review criteria above and visit BauschHealthPAP.com.[1][2] 2. **Download form**: Get the Patient Assistance Program Application PDF (or Medicaid-only version).[1][3] 3. **Patient completes**: - Page 2: Personal, insurance info. - Page 3: Sign authorization/certification. - Optional: Authorize representative.[1] 4. **Doctor completes**: Pages 4-6, including diagnosis, prescription, certification.[1] 5. **Gather documents**: - Insurance cards (front/back). - Income proof (e.g., 1040, W-2, pay stubs). - Prescription copy.[1][3] 6. **Submit**: - **Fax**: 844-705-0160. - **Mail**: Bausch Health PAP, P.O. Box 991624, Louisville, KY 40269.[3] - Online option available after eligibility questions.[3] 7. **Questions?** Call 833-862-8727 (8 AM-5 PM ET, Mon-Fri).[3] Applications reviewed case-by-case; all free to apply.[1] ## Timeline and Delivery - **Processing**: Varies; expect weeks for review (call for status).[3] - **Approval**: Up to 12 months supply, shipped directly to your home or doctor's office.[2][3] - **Annual reconfirmation**: Income/insurance verified yearly; Medicare ends Dec 31, reapply.[2] ## Alternatives if Denied or Ineligible - **Appeal**: If denied coverage by insurance, exhaust then reapply.[2] - **Reapply**: After changes (e.g., lost insurance).[2] - **Other programs**: Check RxAssist.org, NeedyMeds, or PAN Foundation for eye meds. - **Generic loteprednol**: Ask doctor about alternatives. - **Manufacturer savings cards**: For commercially insured (not PAP).[3] - **State assistance**: Pharmacy programs or 340B clinics. ## Disclaimer This guide is for informational purposes based on publicly available program details as of 2026. Eligibility, terms subject to change; Bausch Health decides final approval.[2] Consult your doctor/pharmacist. Not medical/financial advice. Verify current FPL/instructions at BauschHealthPAP.com or by phone. Program availability not guaranteed; apply promptly.[1][2][3] (Word count: 942)

Program information last verified: March 30, 2026