Bayer HealthCare Pharmaceutical Patient Assistance Program

The Bayer HealthCare Patient Assistance Program provides medication for those in need, who have no prescription drug coverage and limited financial resources.

Contact Information:

Bayer Patient Assistance Program

Phone: (866) 575-5002

Fax: (866) 575-6568

How to Apply:

Select one of the links below to download the application or go to the program site for more information on how to apply. Once you fill out your application, send it to the address on the application. Remember not to send program applications to the PPA.


To be accepted into the Bayer Patient Assistance Program, a patient must be resident of the United States.

Any patient who is enrolled in any Government Prescription Programs (other than a Medicare Part D Prescription Drug Benefit plan) or Private Prescription Plans including, but not limited to Medicaid, State-sponsored Prescription Assistance programs, or has employee, military, retirement, or pension program drug coverage is not eligible for the Bayer Patient Assistance Program.

If the patient receives benefits from any of these types of programs or plans, the Bayer Patient Assistance Program cannot provide medication, even if the benefit program or plan does not cover the full cost of, or places limits on, medications. In the event that the patient does enroll in a Medicare Part D Prescription Drug Benefit plan, the patient will still be eligible to receive free medication under the Bayer Patient Assistance Program for this calendar year. **Pharmacy discount cards or pharmaceutical assistance programs are not insurance coverage. You may still apply if you participate in these programs.

Other information:

To apply the Patient should call the Bayer toll-free number 1-866-575-5002 between 8 am and 8 pm ET. Healthcare providers and patients need to complete application forms. Both patient and healthcare provider's information must be returned to the Bayer Patient Assistance Program. Completed applications will be reviewed and approved by the Bayer Patient Assistance Program. The Patient will receive notification in writing of the eligibility determination. If eligible, a three-month supply of medication will be received at the patient's home, usually within a week to 10 days. For further information, please call the Bayer Patient Assistance Program.

Product(s) covered by program:

Cipro HC Otic
Cipro I.V.
Cipro® Oral Suspension
Cipro® XR
Climara Pro®