Patient Assistance - Alcon Cares Patient Assistance Program

Summary

Alcon Labratories Inc.was founded by pharmacists Robert Alexander and William Conner in Forth Worth, Texas in 1945. Alcon Labratories Inc. is a worldwide leader in nearly all ophthalmology related areas. Providing one of the strongest portfolios of ophthalmic pharmaceutical products has allowed them to continue development and innovation in their field.

Alcon Labratories Inc. has a variety of products that provide comfort and treatment for glaucoma, eye infections, allergies, and ear infections.

Eligibility

Alcon Cares Patient Assistance Program is the core patient assistance program provided by Alcon Labratories Inc.. They offer all of the medications listed to the right at no cost for a 30 day supply to those who are eligible for the program. Eligibility is based off of the following requirements:

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You must not be covered by any private, public, or Medicare Part D prescription coverage programs.

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You must be an outpatient currently under the care of a physician.

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Your income must be less than or equal to 200% of the Federal Poverty Guideline for the size of your household (see chart below).

Note: Having Medicare Part D or a high co-pay does not exclude you from eligibility and it is recommended that you still apply.

SOURCE: 2008 HHS Poverty Guidelines

Persons in Family or Household	48 Contigous States and D.C.	Alaska	hawaii
1	$10,400	$13,000	$11,960
2	$14,000	$17,500	$16,100
3	$17,600	$22,000	$20,240
4	$21,200	$26,500	$24,380
5	$24,800	$31,000	$28,520
6	$28,400	$35,500	$32,660
7	$32,000	$40,000	$36,800
8	$35,600	$44,500	$40,940
For each addtional person, add	$3,600	$4,500	$4,140

What’s Next?

Fill out the program enrollment form located to your right. If you don’t see an enrollment form available please call Alcon Labs program directly. After filling out the enrollment form please bring the form to your doctor for proper signatures and procedures. Do not forget a self stamped envelope for them to mail in your application to the program.

Other Tips

If you have any questions please call the Alcon Labs program directly

Fill out as much of the information on the enrollment form as possible. The more information you have pre-filled the easier the progrm is to enroll in

Write down the refill dates for your program and set a reminder here on PatientAssistance.com so that you don’t run out of medication.

Do not write messy on your forms as this will delay any response

Call and write thank you notes to Alcon Labs program. Without their help millions of people will be without medication.