Moxeza

Indicated For

bacterial conjunctivitis

About This Medication

# Alcon Patient Assistance Program Patient Guide: How to Get **Moxeza** at Low or No Cost Moxeza (moxifloxacin ophthalmic solution 0.5%) is an antibiotic eye drop used to treat bacterial conjunctivitis, a common eye infection causing redness, itching, and discharge. This guide explains the **Alcon Patient Assistance Program** (also called Alcon Cares™), which provides **Moxeza** and other Alcon prescription eye medications **at no cost** to eligible U.S. patients facing financial hardship with limited or no prescription coverage. ## Who Qualifies for the Program? The program helps **U.S. residents** who: - Have **limited or no private or public prescription coverage** (e.g., no commercial insurance or government programs like Medicaid that cover prescriptions adequately). - Experience **financial hardship** and meet **income eligibility** at or below **200% of the Federal Poverty Level (FPL)** based on household size. - Are treated by a **U.S.-licensed healthcare provider** (like an ophthalmologist or optometrist) who confirms medical need. **Important:** Medicare Part D patients may have separate options like Alcon Direct Access Support coupons, but the full patient assistance program requires no or limited coverage. Patients qualifying for state/federal programs must show they cause financial hardship. ## About Moxeza **Moxeza** is a prescription eye drop containing **moxifloxacin**, a fluoroquinolone antibiotic. It's FDA-approved for treating bacterial conjunctivitis in patients 1 year and older. Apply 1 drop in the affected eye(s) **3 times daily** for **7 days**, as prescribed. Common side effects include eye irritation, pain, or blurred vision—contact your doctor if severe. Always complete the full course to prevent resistance. Store at room temperature; discard after 28 days. This program covers Moxeza along with other Alcon products like Vigamox (similar moxifloxacin formulation), ensuring access for eye infection treatment without cost barriers. ## Income Eligibility Breakdown Eligibility requires household income at or below **200% of the current Federal Poverty Level (FPL)**. Specific dollar thresholds vary yearly and by household size—check the latest at [ASPE.gov](https://aspe.hhs.gov/topics/poverty-economic-mobility/poverty-guidelines). Here's a sample table based on 2026 guidelines (approximate; confirm current values): | Household Size | 100% FPL | 200% FPL (Eligibility Max) | |---------------|----------|----------------------------| | 1 | $15,060 | **$30,120** | | 2 | $20,440 | **$40,880** | | 3 | $25,820 | **$51,640** | | 4 | $31,200 | **$62,400** | | +1 person | +$5,380 | **+$10,760** | **Notes:** Include all household income (wages, benefits, etc.). Provide proof like tax returns or pay stubs. Assets and other factors may be reviewed. ## Insurance Requirements You must have **limited or no prescription coverage**: - **No private insurance** covering the medication, or coverage that leaves unaffordable costs. - **No public programs** (Medicaid, Medicare Part D) unless they create hardship (documented). - If you have insurance, exhaust copay programs first (e.g., Alcon Patient Access Program for commercial plans). Medicare patients: Use Direct Access coupons separately ($60-$79 fixed copay for some products, but not patient assistance free meds). ## Step-by-Step Application Process 1. **Contact for Application:** Call **1-800-222-8103** (option 2) to request the form, or ask your doctor—they can obtain it. Download from Alcon sites or RxHope if available. 2. **Patient Section (Section 1):** Fill out personal details, household size, income, insurance status. Sign as patient/legal guardian. 3. **Healthcare Provider Section (Section 2):** Your doctor completes, signs, and confirms diagnosis/need for Moxeza. No purchase required. 4. **Gather Documents:** Attach **proof of residency** (utility bill/ID), **proof of income** (recent tax return, W-2s, pay stubs for all household), **proof of insurance status** (insurance card showing no/low coverage or denial letter). 5. **Submit:** **Fax to 800-554-2660** or **mail to Alcon Cares, Inc., TB3-4, 6201 South Freeway, Fort Worth, TX 76134**. Spanish version available. 6. **Track Status:** Call 1-800-222-8103. Incomplete apps are rejected. Applications are good for **one year**. ## Timeline and Delivery Processing time isn't specified but typically weeks—call to check. Approved patients get up to a **six-month supply** shipped directly (coordinate with doctor for refill). For year-long approval, reapply or request second six-month supply if no changes. Delivery to your address; no pharmacy pickup mentioned. ## Alternatives if Denied - **Receive denial letter** explaining reasons (e.g., income too high, insurance issue) and resubmission steps. - **Copay Programs:** Commercial insurance? Use Alcon Patient Access Program (savings card, as low as $30 copay). - **Medicare Coupons:** Direct Access Support for fixed low cost. - **Other PAPs:** RxHope, NeedyMeds, or generic moxifloxacin assistance. - **BlinkRx:** First fill free trials for some Alcon meds. - **State Programs:** Check local Medicaid or charity clinics. - **Don't resubmit** if criteria unmet permanently. ## Disclaimer This guide is for informational purposes based on available program details as of 2026. Eligibility, terms, and covered drugs (including Moxeza) can change—verify with Alcon at 1-800-222-8103 or your doctor. Not medical/financial advice. Consult professionals for personalized guidance. Alcon reserves rights; no guarantees of approval.

Program information last verified: March 30, 2026