Apply to Bausch Health Patient Assistance Program
Free Bausch Health medicines (such as Xifaxan) for US residents with limited income and limited or no coverage for the drug, including Medicaid patients whose plan stopped covering it. Apply directly with the program; here is what it asks and what happens next.
Who can apply?
| Household | 1 person | 2 people | 3 people | 4 people |
|---|---|---|---|---|
| Yearly income up to | $47,880 | $64,920 | $81,960 | $99,000 |
Total annual household income at or below 300% FPL for household size; child support, food stamps and alimony excluded.
Limited or no insurance coverage plus financial need. Government plans (Part D, Medicaid, Medigap, VA, DoD, TRICARE, state programs): must have no coverage for the product or have exhausted all appeals. Bausch Health left the Medicaid Drug Rebate Program on October 1, 2025, so Medicaid patients whose plan no longer covers the drug may qualify. Commercial insurance not addressed. Some forms or strengths may not be covered.
Then what?
Sign
- application
Attach
- income: first 2 pages of latest tax return, or statements for all household income (Social Security, disability, unemployment, pension)
- front and back of insurance cards
- appeal or denial documentation if insured
- Extra Help denial letter if apparently eligible
Your prescriber
- completes prescriber part and provides a valid prescription
Send
Questions: call Bausch Health Patient Assistance Program at 1-833-862-8727. Up to 12 months..
Free. "No cost to apply." EveryCard Rx isn't paid by the program and never sends anything for you. Form , rules checked 2026-11-06 from the program's own pages. Something out of date? Tell us.