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Savings Program Card Web Activation
Welcome to the enrollment page for your LUMIGAN®(bimatoprost ophthalmic solution) 0.01% CONNECTS Program from Allergan. When you activate your LUMIGAN 0.01% co-pay savings card, you are eligible to receive the benefits of pay-no-more-than $30 no matter the bottle size (which works out to only $10/month for a 7.5mL, $15/month for a 5mL, and $30/month for a 2.5mL) (with a maximum savings of $300 per 7.5 mL bottle). When you use this card, you are certifying that you understand the program rules, regulations, and terms and conditions. You are not eligible if prescriptions are paid by any state or other federally funded programs, including, but not limited to, Medicare or Medicaid, Medigap, VA, DOD, or TriCare, or where prohibited by law; and you will otherwise comply with the terms above.

Out of pocket costs may vary depending on your individual plan.

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