Miebo

Indicated For

dry eye disease

About This Medication

# Bausch Health Patient Assistance Program Patient Guide: How to Get **Miebo (perfluorohexyloctane)** at Low or No Cost This guide explains how to apply for free or low-cost **Miebo** through the **Bausch Health Patient Assistance Program (BHC PAP)**. Miebo is a prescription eye drop used to treat **dry eye disease** by reducing tear evaporation, helping relieve symptoms like irritation and discomfort.[1][2] ## Who Qualifies for the Program? The BHC PAP helps **uninsured, underinsured, Medicare, and Medicaid patients** who meet strict criteria. You may qualify if you: - Are a **legal US resident** (including Puerto Rico). - Have a **valid prescription** for Miebo from a licensed US healthcare professional. - Are treated as an **outpatient** (not in a hospital, nursing home, correctional facility, or similar). - Lack insurance coverage for Miebo or have been **denied coverage** by commercial insurance (after exhausting appeals). - Have an **annual household income** not exceeding **300% of the Federal Poverty Level (FPL)** based on household size. - Your prescriber is not excluded from federal healthcare programs. All applications are reviewed **case-by-case** with **income verification**. There is **no cost to apply**.[1][2][3] **Medicaid patients** use a special application form.[1] ## About Miebo (perfluorohexyloctane) **Miebo** is an innovative eye drop containing **perfluorohexyloctane**, a water-free formula that forms a protective layer on the eye's surface. It targets the **evaporative** type of dry eye disease, common in millions of Americans, by slowing tear evaporation. Unlike traditional drops, Miebo doesn't contain preservatives and is dosed **four times daily** (one drop per eye, as prescribed). It's FDA-approved for chronic dry eye and can provide **rapid symptom relief**. Common side effects include blurred vision (temporary) and eye redness. Always follow your doctor's instructions and report issues promptly. This program makes Miebo accessible at **no cost** for eligible patients, up to 12 months.[1][2][3] ## Income Eligibility Breakdown Eligibility is **needs-based** with household income ≤ **300% FPL**. Use the table below for 2026 guidelines (adjust for your household; check https://aspe.hhs.gov/poverty-guidelines for updates). | Household Size | 100% FPL | 300% FPL (Max Income) | |----------------|----------|-----------------------| | 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 | **Notes**: Income includes all household members. Provide proof like tax returns or pay stubs. Bausch Health verifies annually.[2] ## Insurance Requirements - **Uninsured**: No prescription coverage needed. - **Underinsured/Commercial**: Must be **denied Miebo coverage** and exhaust appeals. - **Medicare Part D**: Possible case-by-case; appeals reviewed. Terminated Dec 31—**reapply yearly**. - **Medicaid**: Use Medicaid-only form; eligible if meets other criteria. - **Other government (VA, TRICARE, etc.)**: No coverage for Miebo required. **Discount cards** don't count as coverage. Report insurance changes immediately.[1][2][3] ## Step-by-Step Application Process 1. **Confirm Eligibility**: Review criteria above. Discuss with your doctor. 2. **Download Form**: Visit BauschHealthPAP.com for the standard or Medicaid-only application PDF.[1] 3. **Complete Patient Sections** (pages 2-3): - Patient info, insurance details. - Sign **Patient Authorization and Certification**. 4. **Doctor Completes** (pages 4-6): - Prescription for Miebo, clinical info. - Sign **Prescriber Certification** (docu-sign OK; no stamps for controlled substances, though Miebo isn't). 5. **Gather Documents**: - Copies of **insurance cards** (front/back, if any). - **Proof of income** (e.g., tax return, W-2, pay stubs). - Pharmacy statement if applicable.[1] 6. **Submit**: - **Fax**: 844-705-0160 - **Mail**: Bausch Health Patient Assistance Program, P.O. Box 991624, Louisville, KY 40269 - **Phone help**: (833) 862-8727 (8 AM-5 PM ET).[1][3] 7. **Track Status**: Call the phone number for updates. **Tip**: Ensure **all asterisked fields** are complete, or it's on hold.[1] ## Timeline and Delivery - **Processing**: Case-by-case; typically weeks—call for status. - **Approval**: Up to **12 months** supply, shipped **free to your home**. - **Reauthorization**: **Required annually**; reconfirm income/insurance. Medicare ends Dec 31.[2][3] - **Refills**: Doctor submits new form or reconfirmation. ## Alternatives if Denied or Ineligible - **Appeal**: Contact program if denied (e.g., Medicare cases).[2] - **Other Assistance**: Check HealthWell Foundation, PAN Foundation, or NeedyMeds for dry eye drugs. - **Manufacturer Savings Cards**: For commercially insured (not PAP-eligible). - **Generic Options**: No biosimilars for Miebo; ask doctor about alternatives like Restasis or Xiidra programs. - **State Programs**: Pharmacy assistance in your state. - **Low-Cost Pharmacies**: GoodRx for discounts. Reapply if circumstances change.[3] ## Important Disclaimer This guide is for informational purposes based on program details as of 2026. Eligibility, terms, and FPL change—verify at BauschHealthPAP.com or call (833) 862-8727. Bausch Health decides eligibility at its discretion. Not legal/medical advice; consult your doctor. Program can end or modify without notice. Income tables approximate; use official FPL.[1][2]

Program information last verified: March 30, 2026