By using the Bausch + Lomb Access coupon, you confirm that you
understand and agree to comply with the following terms and
conditions of this offer:
This offer is only valid for eligible patients with commercial insurance
and eligible uninsured patients.
This offer is not valid for any person eligible for reimbursement
of prescriptions, in whole or in part, by any federal, state, or other
governmental programs, including, but not limited to, Medicare
(including Medicare Advantage and Part A, B, and D plans),
Medicaid, TRICARE, Veterans Administration or Department of
Defense health coverage, CHAMPUS, the Puerto Rico Government
Health Insurance Plan, or any other federal or state health
You agree not to seek reimbursement for all or any part of the
benefit received through this offer and are responsible for making
any required reports of your use of this offer to any insurer or other
third party who pays any part of the prescription filled.
This offer is good only in the United States of America (including
the District of Columbia, Puerto Rico and the U.S. Virgin Islands)
at retail pharmacies owned and operated by Walgreen Co. (or its
affiliates) and other participating independent retail pharmacies.
This offer is not valid in Massachusetts or Minnesota or where
otherwise prohibited, taxed, or otherwise restricted.
This offer is not valid for any person that is 65 years of age or older
without commercial insurance. You must be 18 years of age or
older to redeem this offer for yourself or a minor.
You must present this coupon along with your prescription
to participate in this program. You must activate this coupon
before using by calling 1-855-280-0580 or visiting www.activatethecard.com/valeant/opht.
This coupon is good for use only with the products identified herein.
No other purchase is necessary.
This offer cannot be redeemed at government-subsidized clinics.
This coupon is good for a limited number of fills only. Please see
above for the complete listing of the maximum number of fills for
each product for which this offer applies.
Reimbursement limitations apply. Patient is responsible for
all additional costs and expenses after reimbursement limits
This coupon and offer are not health insurance.
The selling, purchasing, trading, or counterfeiting of this coupon
is prohibited by law. Void if reproduced.
This offer is not valid with other offers. This coupon has no cash value.
No cash back.
Bausch + Lomb reserves the right to rescind, revoke,
terminate, or amend this offer at any time, without notice.
This offer expires December 31, 2017.
You understand and agree to comply with the terms and conditions
of this offer as set forth above.