First, let’s make sure you’re eligible.
Please fill in the information below. Items marked with (*) are required.
Eligible patients will receive their first 30-day prescription free and up to $250 savings for each 30-day refill. The actual savings on your out-of-pocket costs for Xiidra will vary according to personal healthcare insurance coverage. Program subject to change. Not available under federal or state programs. See Xiidra iinsider® card for full details and restrictions.