Xiidra (lifitegrast)
Patient Assistance Program Guide — Bausch + Lomb PAP
Current program eligibility
As stated by the Bausch + Lomb PAP guideline we work from. Programs change their rules without notice, so we confirm your eligibility before filing.
- Income limit
- 300% of the federal poverty level
- Employer or private insurance
- Yes
- Medicaid
- Yes
- Medicare A&B
- Yes
- Medicare A&B with Part D
- Yes
Do You Qualify?
Income
Up to $47,880 for a single person
Insurance
The guideline lists patients with employer or private insurance, Medicaid, Medicare Part A and B, Medicare A and B with Part D as eligible to be submitted.
Residency
U.S. resident with a valid U.S. address
Income Limits (300% FPL)
The program guideline sets the limit at 300% of the federal poverty level. Figures use the 2026 HHS guidelines for the 48 contiguous states.
Based on 2026 HHS Federal Poverty Level guidelines.
Ready to Apply for Xiidra Assistance?
RX Advantages handles the entire Bausch + Lomb PAP application on your behalf — paperwork, physician coordination, and refill tracking. It takes about 15 minutes to get started.
No SSN required on the web form · From $49.95/month