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This program provides brand name medications at no or low cost.
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| Pharmaceutical Company |
ALCON |
| Program Name |
Alcon Cares |
| Program Address |
Alcon Cares, Inc.
TB3-4
6201 South Freeway
Fort Worth, TX
76134-0450 |
| Phone Number |
800-222-8103
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| Fax Number |
800-554-2660 |
| Medications on Program |
Maxitrol Opthalmic Ointment (neomycin/polymyxin/dexamethasone)
Maxitrol Suspension 5ml bottle (dexamethasone/neomycin/polymyxin b)
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| Application Forms |
Alcon Cares
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On-line Application
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No on-line application available at this time |
| Web Site |
Click to go to program's web site |
| Eligibility Guidelines and Notes |
Applicants with insurance are eligible. and have an income at or below 200% of the Federal Poverty Level, adjusted for family size. Medical diagnosis necessary for this program is not specified. The patient must also be under treatment from a US doctor. Applicants with Medicare Part D are considered. Those over the 200% FPL guidelines may have their medical expenses taken into consideration. This program also provides generic products to those eligible. OTC products may be sent to either the patient's home or the doctor's office.
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| Application Process |
Anyone can call to get an application faxed out. The application can be either faxed or mailed out upon request. The completed application can be faxed or mailed back.
Doctor or patient needs to call to find out about acceptance/denial. No letter is sent out.
The medication will be shipped within 10-14 days.
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| Application Requirements |
The doctor must fill out a section and sign the application. The patient must also complete, sign the application and attach proof of income.
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| Program Details |
The medication is sent to the doctor's office. A copy of the same application with new dates is needed for refills.
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| Last Updated |
July 08, 2010 |
