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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:
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 Poverty Chart
| Family Size | 100% | 133% | 150% | 200% | 250% | 300% |
| 1 | $10,830 | $14,404 | $16,245 | $21,660 | $27,075 | $32,490 |
| 2 | $14,570 | $19,378 | $21,855 | $29,140 | $36,425 | $43,710 |
| 3 | $18,310 | $24,352 | $27,465 | $36,620 | $45,775 | $54,930 |
| 4 | $22,050 | $29,327 | $33,075 | $44,100 | $55,125 | $66,150 |
| 5 | $25,790 | $34,301 | $38,685 | $51,580 | $64,475 | $77,370 |
| 6 | $29,530 | $39,275 | $44,295 | $59,060 | $73,825 | $88,590 |
| 7 | $33,270 | $44,249 | $49,905 | $66,540 | $83,175 | $99,810 |
| 8 | $37,010 | $49,223 | $55,515 | $74,020 | $92,525 | $111,030 |
| For each additional family member | $3,740 | $4,974 | $5,610 | $7,480 | $9,350 | $11,220 |
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.
- PAP Links:
- Website:
- Address:
- Phone:
- Fax:
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List of Medications
Azopt Suspension 1%(15 Ml Bottle) (brinzolamide), Betoptic S Othphalmic 0.25% (betaxolol), Bion Tears Eye Drops (dextran/hydroxypropyl Methylcellulose), Carteolol Ophthalmic Solution 1% (10 Ml Bottle) (carteolol Ophthalmic Solution), Ciloxan Ophthalmic Ointment 3.5gm Tube (ciprofloxacin Ophthalmic Solution), Ciloxan Solution 5ml/bottle (ciprofloxacin Ophthalmic Solution), Cipro HC Ophthalmic Solution 10ml Bottle (ciprofloxacin/hydrocortisone Ophthalmic Solution), Ciprodex Suspension 5ml, 7.5ml (ciprofloxacin/dexamethasone Ophthalmic Suspension), DuoTrav Eye Drops 2.5ml (travoprost/timolol), Econopred Plus Suspension 10ml Bottle (corticosteriod Ophthalmic), Flarex Suspension 5ml Bottle, 10ml Bottle (fluorometholone), I-Caps Eye Vitamin AREDS Formula Softgels (eye Vitamin & Mineral Supplement), I-Caps Lutein & Zeaxanthin Formula Tablets (eye Vitamin & Mineral Supplement), I-Caps Multivitamin Formula Tablets (eye Vitamin & Mineral Supplement), Iopidine Suspension 0.5% (10ml/bottle, 15ml/bottle) (apraclonidine), Isopto Carbachol Solution 0.75%, 1.5%, 2.25%, 3% (carbachol), Isopto Carpine Ophthalmic Drops 1%(15 Ml Bottle), 2%(15 Ml Bottle), 4%(15 Ml Bottle) (pilocarpine), Levobunolol HCL Ophthalmic Solution 0.5% (10ml Bottle) (levobunolol Ophthalmic), Maxitrol Suspension 5ml Bottle (dexamethasone/neomycin/polymyxin B), Metipranolol Eye Drop 0.3(10ml (metipranolol), Nevanac Ophthalmic Solution 0.1% (nepafenac Ophthalmic Suspension), Pataday Ophthalmic Solution 0.2% (olopatadine Hydrochloride), Patanol Ophthalmic Solution 0.1% (olopatadine Hydrochloride), Pilopine HS Gel 4%(4 Gram Tube) (pilocarpine), Systane Ophthalmic Drops (lubricant Eye Drops), Tears Naturale Forte Eye Drops (saline Ophthalmic), Tears Naturale Free Lubricant Ophthalmic Drops (saline Ophthalmic), Tears Naturale PM Ophthalmic Ointment (saline Ophthalmic), TobraDex Ophthalmic Ointment 3.5 (tobramycin Ophthalmic), TobraDex Ophthalmic Suspension 10ml (tobramycin Ophthalmic), Travatan Ophthalmic Suspension 0.4% (travoprost Ophthalmic), Unisol 4 Saline Oral Solution (saline Ophthalmic), Vexol 5ml, 10ml (rimexolone Ophthalmic), Vigamox Solution 3ml Bottle (moxifloxacin)
Forms and other information are Copyright © Alcon Cares Patient Assistance Program
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