|
This program provides brand name medications at no or low cost.
|
| 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
|
| Fax Number |
800-554-2660 |
| Medications on Program |
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 0.004% (travoprost ophthalmic)
Unisol 4 Saline Oral Solution (saline ophthalmic)
Vexol 5ml, 10ml (rimexolone ophthalmic)
Vigamox Solution 3ml bottle (moxifloxacin)
|
| Application Forms |
Alcon Cares
|
On-line Application
|
|
| Web Site |
Click to go to program's web site |
| Eligibility Guidelines and Notes |
Patients must not have any insurance and are not eligible for state or federally funded healthcare programs 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.
|
| 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.
The patient is notified of eligibility for the program. The medication will be shipped within 10-14 days.
|
| 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.
|
| Program Details |
The medication is sent to the doctor's office. A copy of the same application with new dates is needed for refills.
|
| Last Updated |
November 13, 2009 |
