Prolensa

Indicated For

post-cataract surgery inflammation and pain

About This Medication

# Bausch + Lomb Access Program Patient Guide: How to Get Prolensa (bromfenac) at Low or No Cost Prolensa (bromfenac ophthalmic solution) is a prescription eye drop used to reduce pain and inflammation after cataract surgery, and the **Bausch + Lomb Access Program** (also known as Bausch Health Patient Assistance Program) helps **uninsured or underinsured US residents** get it for free if they meet eligibility rules like income limits and residency.[1] This guide explains everything you need to know in simple terms, from who qualifies to how to apply. It's based on official program details to help you access affordable care.[1][2] ## About Prolensa (bromfenac) **Prolensa** is a nonsteroidal anti-inflammatory drug (NSAID) eye drop. Doctors prescribe it once daily for 14 days after cataract surgery to ease swelling, burning, and light sensitivity in the eye. It's sterile, preservative-free, and comes in single-use vials. Common side effects include temporary stinging or redness; always follow your doctor's instructions and report issues promptly. This program targets financial barriers, not medical advice—consult your eye doctor for usage.[1] ## Who Qualifies for the Program? The program assists **legal US residents** treated as outpatients with a valid prescription for Bausch + Lomb products like Prolensa. Key requirements: - **Residency**: Legal US resident.[1] - **Prescription**: From a licensed US healthcare provider.[1] - **Insurance**: Uninsured for the product or underinsured (no coverage specifically for Prolensa). Medicaid patients use a separate form.[1] - **Income**: Household income below program thresholds (exact % of Federal Poverty Level not specified publicly; reviewed case-by-case). Provide proof like tax returns or pay stubs.[1][2] - **Outpatient status**: Not hospitalized.[1] All applications are free and evaluated individually. No guaranteed approval—depends on full documentation.[1] ## Income Eligibility Breakdown Income limits aren't publicly listed as fixed FPL percentages but are assessed per household. Submit recent proof (e.g., 2025 tax return, W-2s, pay stubs) showing total annual household income. Here's a general table based on typical PAP structures (confirm with program as they verify case-by-case):[1] | Household Size | Estimated Max Income (300% FPL example)* | |----------------|-----------------------------------------| | 1 person | ~$45,000 | | 2 people | ~$61,000 | | 3 people | ~$77,000 | | 4 people | ~$93,000 | | +1 per person | +$16,000 | *This is illustrative; actual thresholds vary. Program notes: 'Income below certain threshold for uninsured/underinsured.' Contact via application for your situation.[1][2] ## Insurance Requirements You must be **uninsured or underinsured** for Prolensa—no coverage from private insurance, Medicare Part D, or similar for this drug. Attach front/back copies of insurance cards (if any) and a pharmacy statement showing denial or high cost. **Medicare patients**: Use the Medicaid-only form if applicable; standard form excludes those with coverage.[1] Fully insured patients don't qualify—program is for financial need.[2] ## Step-by-Step Application Process Applications are **multiple methods** (fax/mail); download the form from BauschHealthPAP.com or RxAssist.org.[1][2] Here's how: 1. **Download and complete patient sections**: Fill Patient Information, Insurance Info (page 2), and sign Authorization/Certification (page 3).[1] 2. **Gather documents**: Income proof (taxes, stubs), insurance cards (front/back), prescription proof.[1][2] 3. **Prescriber completes**: Doctor fills clinical info (pages 4-6) and signs certification. No stamped signatures.[1] 4. **Submit**: Fax to 844-705-0160 or mail to Bausch Health Patient Assistance Program, P.O. Box 991624, Louisville, KY 40269.[1] 5. **Wait for review**: Case-by-case; missing info holds application.[1] **Required documents**: - Income documentation - Prescriber signature - Insurance cards/pharmacy statement[1][2] ## Timeline and Delivery **Processing time** not specified—typically 2-4 weeks based on similar programs, but submit complete forms to avoid delays. Once approved, medication is **shipped to patient or physician's office** free of charge. Track via program contact if needed (details on form).[1][2] ## Alternatives if Denied or Ineligible - **Ask about reauthorization**: May need for refills.[1] - **Other programs**: Check RxAssist.org for Prolensa alternatives or generic bromfenac options (none listed as biosimilars).[2] - **Manufacturer copay cards**: Bausch + Lomb may offer savings for insured (not this PAP).[2] - **State assistance**: Local pharmacies, 340B clinics, or NeedyMeds.org. - **Generic NSAIDs**: Discuss with doctor (e.g., other post-op drops like Ketorolac). - **Appeal**: Resubmit with more income proof if denied for eligibility.[1] ## Important Disclaimer This guide is for informational purposes only, based on available program data as of 2026. Eligibility, rules, and forms can change—always verify at BauschHealthPAP.com or by contacting the program. Not medical or legal advice. Consult your doctor for treatment; program doesn't guarantee approval or supply. Bausch + Lomb reserves rights to modify.[1][2] (Word count: 942)

Program information last verified: March 30, 2026