Welcome to the Bausch + Lomb VYZULTA™ Activation Site
This program is only available to residents of the United States and US territories (including the District of Columbia, Puerto Rico, Guam and the U.S. Virgin Islands), except where prohibited. This program is valid for most eligible commercially insured and most eligible uninsured patients. Individuals who are enrolled in a government health care program and/or eligible for Medicare are not eligible to participate in this program. If your insurance changes, you may no longer be eligible to use this coupon. These coupons can only be processed exclusively at Walgreens and other participating independent pharmacies.
To activate your coupon, please answer the following questions:
  • Does the patient have a coupon?

Eligibility Criteria/Terms and Conditions:

By using the Bausch + Lomb Access coupon, you confirm that you understand and agree to comply with the following terms and conditions of this offer:

  • This offer is only valid for eligible patients with commercial insurance and eligible uninsured patients.
  • This offer is not valid for any person eligible for reimbursement of prescriptions, in whole or in part, by any federal, state, or other governmental programs, including, but not limited to, Medicare (including Medicare Advantage and Part A, B, and D plans), Medicaid, TRICARE, Veterans Administration or Department of Defense health coverage, CHAMPUS, the Puerto Rico Government Health Insurance Plan, or any other federal or state health care programs.
  • You agree not to seek reimbursement for all or any part of the benefit received through this offer and are responsible for making any required reports of your use of this offer to any insurer or other third party who pays any part of the prescription filled.
  • This offer is good only in the United States of America (including the District of Columbia, Puerto Rico, Guam and the U.S. Virgin Islands) at retail pharmacies owned and operated by Walgreen Co. (or its affiliates) and other participating independent retail pharmacies. This offer is not valid in Massachusetts or Minnesota or where otherwise prohibited, taxed, or otherwise restricted.
  • This offer is not valid for any person that is 65 years of age or older without commercial insurance. You must be 18 years of age or older to redeem this offer for yourself or a minor.
  • You must present the coupon along with your prescription to participate in this program. You must activate the coupon before using by calling 1-844-864-3015 or by visiting www.VyzultaCoupon.com.
  • The coupon is good for use only with the products identified herein. No other purchase is necessary.
  • This offer cannot be redeemed at government-subsidized clinics.
  • This coupon is good for a maximum number of three (3) fills.
  • Reimbursement limitations apply. Patient is responsible for all additional costs and expenses after reimbursement limits are reached. For questions, please call 1-844-864-3015.
  • The coupon and offer are not health insurance.
  • The selling, purchasing, trading, or counterfeiting of the coupon is prohibited by law. Void if reproduced.
  • This offer is not valid with other offers. The coupon has no cash value. No cash back.
  • Bausch + Lomb reserves the right to rescind, revoke, terminate, or amend this offer at any time, without notice.
  • This offer expires June 30, 2018.
  • You understand and agree to comply with the terms and conditions of this offer as set forth above and at www.VyzultaCoupon.com
  • For questions call: 1-844-864-3015.