Every Xiidra assistance program you may qualify for - manufacturer and foundation programs, not a discount card. About a minute, no login.
Xiidra help that still works on Medicare - the programs copay cards leave out.
Tell us five things. We’ll do the rest.
Xiidra (lifitegrast ophthalmic solution 5%) is a lfa-1 antagonist (topical ophthalmic) made by Bausch + Lomb. It is commonly prescribed for: Signs and symptoms of dry eye disease. Without financial assistance, Xiidra typically costs around $700 per month.
Income limits
1 of the 2 active Xiidra assistance programs we track caps household income. The lowest cutoff is $47,880 a year for a single person. Most programs publish their cutoff as a percent of the federal poverty level - here is what that means in dollars.
Household income at or below 300% of the federal poverty level:
| Household size | Annual income limit |
|---|---|
| 1 person | $47,880 |
| 2 people | $64,920 |
| 3 people | $81,960 |
| 4 people | $99,000 |
| Each additional person | + $17,040 |
Dollar amounts for percent-of-poverty caps are computed from the 2026 federal poverty guidelines for the 48 contiguous states and Washington, DC ($15,960 for one person, plus $5,680 for each additional household member). Alaska and Hawaii use higher figures. Each program makes the final eligibility decision - confirm on the official application linked above.
Xiidra offers more than one kind of program, and they have opposite rules:
We show both programs, and the real income limits, below. Or read the full copay card vs patient assistance guide
This is the full list before we filter by your situation. Use the calculator above to see only the ones you may qualify for.
Bausch + Lomb · Xiidra
Patient pays: as little as $0 per prescription
commercial insurance
How to apply: online, phone, or text
Bausch + Lomb Patient Assistance Program · Xiidra
uninsured · underinsured · Medicare Part D
How to apply: online or phone
Your prescriber signs part of the form.
Keep tabs on Xiidra assistance
We recheck every program’s rules on a regular schedule - income limits, eligibility, and whether a program is still open all change without much notice. Leave your email and we’ll send a short note if something changes for Xiidra.
Yes. Bausch + Lomb Patient Assistance Program runs the Bausch + Lomb Patient Assistance Program - Xiidra, which provides Xiidra free of charge to eligible patients. Household income generally needs to be at or below 300% of the federal poverty level. The full rules and the official application link are in the program list above.
Medicare coverage for Xiidra depends on your own plan: depending on how it is given, a drug can fall under Part B (administered in a clinic) or Part D (filled at a pharmacy), and each plan decides what it covers. Your plan's documents or Medicare's plan finder are the only reliable check. Separate from coverage, Bausch + Lomb Patient Assistance Program - Xiidra is open to some Medicare patients when out-of-pocket costs stay high - details above.
Yes - the XIIDRA My Savings Program (Bausch + Lomb Access) from Bausch + Lomb. Eligible patients pay as little as $0 per prescription. It works for patients with commercial (private) insurance. Patients on Medicare or Medicaid cannot use the card itself, but other Xiidra programs above do work with government insurance. If you searched for a Xiidra coupon, this manufacturer card is the official version of it.
Without insurance or assistance, Xiidra typically costs around $700 per month in the US. The Bausch + Lomb Patient Assistance Program - Xiidra above can bring that down substantially for eligible patients - use the calculator to check your situation.
The official application form for the Bausch + Lomb Patient Assistance Program - Xiidra is on patientassistance.bausch.com - the application links on this page go straight to the program's own form. Some programs call it an enrollment form; it is the same document. Applying is always free; never pay a third-party service to file a patient assistance form for you.
Yes. Bausch + Lomb Patient Assistance Program - Xiidra is open to some patients on Medicare - each program's exact rules are listed above, and the calculator checks the income limits against your household.
Manufacturers like Bausch + Lomb use "patient support program" as an umbrella term for nurse lines, insurance navigation, and financial help. The financial help is what we track here - for Xiidra that is the Bausch + Lomb Patient Assistance Program - Xiidra. The support phone line is listed on the official program site linked above.