Transcription
Over-the-Counter(OTC) CatalogMedicare Advantage Plan2022Y0020 WCM 75467E M CMS Accepted 08182021 Wellcare 2021NA2WCMOTC75467E 0000
Please keep this valuable booklet nearby. You’ll need it to look upthe OTC items you want to purchase. It also contains step-by-stepinstructions on how to order online, by phone or use your OTCbenefits in store.
Three convenient ways to place an order.Choose the way that works best for you:#1 In store:You can pick up your OTC items at select OTC Health Solutions enabled stores nationwide. Tofind your nearest location, go to https://www.cvs.com/otchs/wellcare.How to use your OTC Health Solutions benefits in store:1. Refer to your health plan catalog.2. Identify approved items in the catalog. Only the items listed in your catalog are availablethrough your plan. If an item with a blue label is not listed, you will not be able to select it.3. Go to a select OTCHS enabled CVS Pharmacy , CVS Pharmacy y mas or Navarro store.IMPORTANT: Only select CVS stores participate in this benefit. To find your nearest location,go to https://www.cvs.com/otchs/wellcare/storelocator or contact OTCHS at1-866-819-2516 (TTY: 711).4. Look for the blue signs identifying eligible products.* Note: In-store prices may vary fromthose listed in this catalog. However, the prices listed in the catalog are what will bededucted from your benefit. Products with blue labels may be located in the dedicatedOTCHS section or throughout the aisles in the store.5. You can redeem your benefit at any ct Description24 tbPRICE 8.851Consult yourhealth plancatalog.Identify whichitems areavailable foryou in your plancatalog.Go to anyOTCHS enabledCVS Pharmacy.Look for blue labelsGo to anyidentifying eligibleregister toproducts. Products check out andwith blue labelsprovide themay be locatedstore associatein the dedicatedwith yourOTCHS sectionmember IDor throughout thecard.aisles in the store.Not all items may beavailable throughyour plan.Not all items are available in all stores. If your item is not available, please contact OTCHSor visit your plan’s web page to process your order.Please note that the regular retail price in the store may vary. For prices that applywhen you use your OTC benefits, please consult this catalog. Catalog prices cannotbe combined with promotional o ers or ExtraBucks Rewards. Not all products will becarried in all CVS OTCHS enabled stores.* Not all eligible items may be off ered through your health plan, please refer to your health plan catalog for approved list of items.1
Steps to redeem.Choose the way that works best for you:1. Inform the cashier you have OTC Health Solutions.2. Present your health plan ID card first, before the cashier begins to scan products.Your health plan ID card is used to verify eligibility, not as a payment.You can also present the QR code to the store colleague at the register to assistwith the transaction.Colleague Instructions1. Scan QR code.2. You will be automatically redirected to the OTCHS App on the point-of-sale (POS)terminal.3. Ask the member for their health plan ID card.4. Select the member’s plan.5. Enter the member ID or the member’s first and last name.6. Scan eligible products and follow instructions on the POS system to complete thetransaction.7. If you are having trouble locating the member or processing the transaction, pleasecall the dedicated OTCHS Store Support line for assistance.2
#2 Online:The fastest and easiest way to order 24/7 is to visit: https://www.cvs.com/otchs/wellcare.Online orders must be submitted by 11:59 PM ET to be processed the same day.How to place an order through our website:1. Create an account If it is your first time placing an order online, you will need to create an account by visitinghttps://www.cvs.com/otchs/wellcare.- Choose the “Create Account” button and follow the instructions.- You will need your member ID, date of birth, ZIP code and current email address.Each member registering needs to have a separate email address. If a member shares anemail address with a spouse or caregiver who also has an OTC account, they will only beable to register one account.- You will also need to create a password. If you need help locating your member ID, select “Get help locating your member ID.” Remember to save your password for future orders. You will need your member ID or emailaddress along with your password to sign in again. If you forget your password, choose the “Forgot Password?” button to create a new one.2. Place an order Once you sign in, your benefit amount and balance will be displayed at the top of the page. Browse through the available products and add to your basket. Your order total willautomatically deduct from your balance at the top of the page. Once you are ready to place your order, choose “Checkout.” On the Checkout page, you must confirm the shipping address displayed is correct byselecting the disclaimer. Then, review and place your order. It will arrive within 14 days. You will receive an email with tracking information once your order has shipped and anotheremail once your order has been delivered. Please review the order frequency limits located on the FAQs to avoid missing benefit funds.Reminder: Orders for each benefit period must be placed by 11:59 PM ET of the last day of theperiod.Return Policy: Due to the personal nature of the products, no returns or exchanges areallowed. If you haven’t received your order or if you received a defective or damaged item,please call OTC Health Solutions within 30 days of placing your order.- If your item is not in stock, an item of similar or greater value may besubstituted in your order.3
#3 By phone:Orders can be placed by calling 1-866-819-2516 (TTY: 711). You can speak to a live agentMonday to Friday, from 9 AM to 8 PM local time. You can also order 24/7 via our automatedinteractive voice response (IVR) system. Please have your member ID and order ready whenplacing your order by phone.How to place an order by phone (IVR system):1. Call OTCHS using the phone number on file.Note: The phone number on file is the number provided to OTCHS by your health provider.If you wish to use a different number to order through the IVR system, you can provide thealternative number to an OTCHS agent so it can be added to your account.2. Once the system locates your account you will be asked to input your date of birth in MMDDformat.3. The account authentication process will start and the system will verify the name andaddress on the account.4. Please enter the numerical portion of the item code. Example: If you would like to order item “B33 unscented wipes,” you will select “33” andwait for the prompt to confirm the item. Once the system locates the item, it will read backthe product name and quantity and ask if the selection is correct. Please allow the systemto complete the statement before making your selection. If yes, the system will add the item to your cart. If no, the system will provide an option to edit the product or the quantity.5. Once the order is completed, you will have the choice to review the items in the cart orsubmit the order. If you submit the order without review, the system will provide a confirmation number andthe call will be disconnected. If you want to review your order, the system will allow you to edit the items, start over, submitthe order or speak with a representative.Note: Should you choose to speak to a representative, your items will not be saved and you willhave to restart your order. Through the IVR system, you will also be able to track your order and/or request a catalog.Return Policy: Due to the personal nature of the products, no returns or exchanges areallowed. If you haven’t received your order or if you received a defective or damaged item,please call OTC Health Solutions within 30 days of placing your order.- If your item is not in stock, an item of similar or greater value may besubstituted in your order.4
Frequently asked questionsWhere can I find my member ID number?It can be found on the front of your health plan ID card.What is the benefit?The OTC benefit offers you an easy way to get generic over-the-counter health and wellnessproducts by going to select OTC Health Solutions-enabled CVS Pharmacy, CVS Pharmacy ymas or Navarro stores nationwide. You can also order by phone at 1-866-819-2516 (TTY: 711) oronline at https://www.cvs.com/otchs/wellcare. You order from a list of approved OTC items,and OTC Health Solutions will mail them directly to your home address.How much is my OTC benefit?The amount depends on your benefit plan. Check your plan documents or call OTC HealthSolutions at 1-866-819-2516 (TTY: 711).How often can I use my OTC benefit?Your OTC benefit can be used three times during the quarter if you use the home deliveryservice, that is, if you order by phone or online. However, you can use your benefit unlimitedtimes at a select OTCHS-enabled CVS Pharmacy during the quarter. Quarterly benefit periodsare distributed as follows: Quarter 1 (January, February and March) Quarter 2 (April, May and June) Quarter 3 (July, August and September) Quarter 4 (October, November and December)Can I carry over unused benefit amount to the next benefit period?Unused benefit amounts do not roll over to the next quarter.Can I order more than my benefit amount?You cannot exceed your benefit amount online or by phone. However, you may exceed yourbenefit amount at an OTC Health Solutions-enabled CVS Pharmacy, CVS Pharmacy y mas orNavarro store, however, you will be responsible to pay the difference out of pocket.Are all items available at the stores?Not all items are available in stores. Items marked with a “8” in the catalog can only be orderedover the phone or online.How long will it take to receive my order?You will receive your order within 14 days after it was placed.Can I cancel my order once it has been placed?Orders can only be cancelled within 30 minutes after being processed.How do I confirm my order was placed?Once the order has been completed, you will receive a confirmation number. Always make sureto receive and keep your confirmation number.Can I track my order?You can opt in to receive tracking information via email or text; simply advise an agent whenplacing your order.* In the event an item is out of stock, an item of similar or greater value will be substituted in your order. If an item is recalled by the manufacturer for any reason, it will be removed from the product offering immediately.5
How can I receive another copy of this catalog?You will receive a digital version of the catalog with every tracking email/text. You can also printa copy from the OTC web page.Where can I get additional information about the products?In this catalog you will find SKU numbers that can be used at https://www.cvs.com to searchfor product images and obtain additional product information such as ingredients.How will the items be shipped?Items are shipped via USPS to your home at no charge to you. Please allow up to 14 days fordelivery.Additional notes: There is no limit on the number of items you may order. There is, however, a quantity limitof nine per any single item, per quarter. There are some select products that have speciallimits and these are marked by a “«” or “n” in this catalog In order to purchase certain vitamin and mineral supplements, your physician mustrecommend it to you for a specific diagnosed condition. These are called “dual-purposeitems” which are marked with a “u.” Please speak with your physician before ordering thesetype of items. Some items may be covered under Part B or Part D and are marked with a “ ”. When anitem is covered by Part B or Part D due to your certain circumstances, you would not useyour OTC benefit to obtain the item. For example, gauze may be covered under Part B whenit is being used as prescribed to perform surgical wound dressing changes. Products in this catalog are intended for personal use and may be ordered only for theenrollee.If you have not received your items within 14 days after ordering, please call:1-866-819-2516 (TTY: 711), Monday to Friday, 9 AM to 8 PM local time.6
Adult careCODESKUPRODUCTCOMPARE TOI70830476Women’s Small/Medium UnderwearMaxDepend36 CT 19I71830475Women’s Large Underwear MaxDepend32 CT 19I72830474Women’s XL Underwear MaxDepend28 CT 19I73830473Men’s Small/Medium Underwear MaxDepend36 CT 19I75842939Men’s L/XL Underwear MaxDepend32 CT 19I76163094Unisex Extra Large Briefs MaxDepend14 CT 12I77641431Unisex Large Briefs MaxDepend16 CT 12I78240487Women’s Protective Pads ModeratePoise20 CT 5I79964701Overnight Women’s Bladder ControlPadsTena Serenity30 CT 12I80520577Adult Care WipesNo Comparable48 CT 8I83383703Unisex Overnight Underwear XLDepend12 CT 13I84383182Unisex Overnight Underwear LDepend14 CT 13I86512509Underpads XL 23’’x36’’No Comparable18 CT 9I87795728Women’s Bladder Control Pads, LongPoise27 CT 12I88163093Men’s Bladder Control PadsPoise52 CT 12Item list is subject to change.You will receive the generic equivalent of all items.AMOUNT PRICE7
AllergyCODESKUPRODUCTCOMPARE TOA2477066Allergy relief tabletsBenadryl24 CT 4A3444238Cetirizine 10mg TabletsZyrtec30 CT 14A5232642Loratadine 10mg, 24 Hr RegularClaritin30 CT 15A6847260Fexofenadine Tablets 180mgAllegra30 CT 14A10232641Loratadine 10mgClaritin10 CT 8A11389345Levocetirizine Allergy ReliefXyzal35 CT 16A12922201Children’s Cetirizine SF GrapeZyrtec8 OZ 13A16583518Loratadine 10mg TabletsClaritin365 CT 40A17302860Flonase Allergy Relief SprayNo Comparable0.38 OZ 19A18442579 Zyrtec Allergy 24hr Relief 10mg Tablets No Comparable90 CT 47A19625325Claritin 24hr 10mg TabletsNo Comparable100 CT 50A20477072Child Allergy ElixirChildren’sBenadryl4 OZ 5A53444236Allergy Cetirizine 10mg TabletsZyrtec14 CT 11A59238246Fluticasone Nasal SprayFlonase0.34 OZ 13Item list is subject to change.You will receive the generic equivalent of all items.8AMOUNT PRICE
Baby careCODESKUPRODUCTCOMPARE TOAMOUNT PRICEB10803987Diaper Rash OintmentDesitin2 OZ 4B13478939Infant’s Ibuprofen Oral SuspensionMotrin1 OZ 8B15858818Infant’s Acetaminophen OralSuspensionInfants’ Tylenol2 OZ 4Cold remediesCODESKUPRODUCTCOMPARE TOC3895139Cold Flu & Sore Throat MaxMucinexFast-Max6 OZ 11uC5970454AirShield Adult GummiesNo Comparable42 CT 10C7587618Medicated Chest RubVicks Vaporub3.5 OZ 6n C8155912Digital ThermometerNo Comparable1 CT 8uC9381791AirShield Twin Pack OrangeAirborne20 CT 10C11707032Sore Throat LozengesCepacol18 CT 4C12971824Tussin CFRobitussin CF4 OZ 6C13707516Tussin DMRobitussin DM4 OZ 6uC15889580AirShield Berry ChewAirborne32 CT 6C16297625Nasal Decongestant TabsSudafed PE18 CT 4C19297885Chest Congestion Relief 400mgHumibid e60 CT 9C21164183No Drip Nasal MistAfrin1 OZ 6u Dual-purpose item.Item list is subject to change.You will receive the generic equivalent of all items.AMOUNT PRICEn Limited to one (1) per benefit period.9
Cold remediesCODESKUPRODUCTCOMPARE TOn C22202227Micro Temple ThermometerNo Comparable1 CT 23n C23834800Temple ThermometerNo Comparable1 CT 38C24890425Daytime Cold/Flu Soft GelsVicks Dayquil16 CT 6C25465804Cold Remedy Melts CitrusZicam25 CT 9C26954407Severe Nighttime Cold &Flu Relief BerryNyQuil8 OZ 7C29159734Nasal Decongestant InhalerNo Comparable0.07 OZ 5C31972801Sore Throat & Cough Lozenges MixedBerryCepacol18 CT 4C33173270Mucus ER DM Max StrengthMucinex14 CT 13C34277898Medicated Chest RubVicks Vaporub1.76 OZ 4C36277790Nasal Spray Saline 2 Pack Twin PackOcean1.5 OZ 5C37430367Mucinex Max Strength DMNo Comparable14 CT 22C38855591Vicks DayQuil LiquiCapsNo Comparable16 CT 10C39216829Vicks NyQuil LiquiCapsNo Comparable16 CT 10C40477060Tussin DM Sugar FreeRobitussin DM8 OZ 7C41688783Cold Remedy Sugar FreeZicam25 CT 10C42853587Cold Sore TreatmentNo Comparable0.07 OZ 18C52891465Saline Nasal SprayOcean1.5 OZ 4C54890411Nighttime Cold/Flu Soft GelsVicks Nyquil16 CT 6n Limited to one (1) per benefit period.Item list is subject to change.You will receive the generic equivalent of all items.10AMOUNT PRICE
Cold remediesCODESKUPRODUCTCOMPARE TOAMOUNT PRICEC56408566Sinus AcetaminophenTylenol SinusHeadache (Day)24 CT 6C57316620Sore Throat SprayChloraseptic6 OZ 4C58181059Child’s Cold Multi-SymptomChildren’sMucinex4 OZ 10C60244956Cough and Cold HBPCoricidin16 CT 7C64320711AirShield Orange TabletsEmergen-C10 CT 6C66858828Nasal MistAfrin0.5 OZ 7Digestive healthCODESKUPRODUCTCOMPARE TOD2310425Stool SoftenerColace100 CT 12D4206805Gas Relief E/S SoftgelsGas X E/S30 CT 5D5878020BeanAid CapsulesBeano30 CT 5D6108530Adult Glycerin SuppositoriesFleet Glycerin25 CT 3D8860849Heartburn Relief TabletsGaviscon100 CT 8D9451300Omeprazole TabsNo Comparable14 CT 10D10958326Daily Fiber SFMetamucil10 OZ 9D11348639Bisacodyl Laxatives TabsDulcolax25 CT 6D12672550Anti-Diarrheal TabletsImodium A-D12 CT 6Item list is subject to change.You will receive the generic equivalent of all items.AMOUNT PRICE11
Digestive healthCODESKUPRODUCTCOMPARE TOD13703368Pink Bismuth Chewable TabsPepto-Bismol30 CT 5D14690256Acid Controller TabsPepcid AC30 CT 7D15139139Motion Sickness TabsNo Comparable12 CT 6D16690260Easy FiberBenefiber8.6 OZ 13D17252794Fiber CapsulesMetamucil160 CT 12D18272722Esomeprazole Magnesium CapsulesNexium42 CT 24D19919055Probiotic Adult 4 StrainsCulturelle30 CT 16D20689598Stomach Relief CapletsPepto-Bismol24 CT 3D21401472Medicated Hemorrhoidal WipesPreparation H48 CT 6D22961468Hemorrhoidal SuppositoriesPreparation H12 CT 6D23144212Hemorrhoidal OintmentPreparation H2 OZ 9D24494222Milk of MagnesiaPhillips’12 OZ 6D25480996Laxative Bisacodyl SuppositoriesDulcolax4 CT 6D26452277Hemorrhoidal CreamPreparation H1.8 OZ 11D27689614Stool SoftenerPhillips’30 CT 4D28250975Prilosec OTC Acid Reducer 24hr Relief20mg TabsNo Comparable42 CT 29D30451305Omeprazole TabletsPrilosec42 CT 20D31267635Dairy ReliefLactaid60 CT 13Item list is subject to change.You will receive the generic equivalent of all items.12AMOUNT PRICE
Digestive healthCODESKUPRODUCTCOMPARE TOAMOUNT PRICED33967601Nexium 24 HoursNo Comparable42 CT 29D34198529Metamucil Fiber Therapy CapsulesNo Comparable160 CT 22D40836320Antacid Calcium ES TabletsTums E-X96 CT 5D45883948Probiotic Adult 9 StrainsNo Comparable15 CT 14D46272739Esomeprazole Magnesium TabNexium14 CT 10D47883055Lansoprazole 15mg CapsNo Comparable14 CT 10D49713639Purelax PowderMiraLAX8.3 OZ 11Ear and eye careCODESKUPRODUCTCOMPARE TOE7110973Earwax Removal DropsDebrox0.5 OZ 4E8941579Earwax Care KitNo Comparable1 CT 10E14171322Artificial TearsNo Comparable1 OZ 9E17337097Eye WashNo Comparable4 OZ 6E18695753Contact SolutionNo Comparable4 OZ 5E19976354Eye Health 50 VitaminsOcuvite90 CT 20E20457496Swimmers Ear SolutionSwim-Ear1 OZ 4E21973866Earwax Removal KitDebroxKIT 8Item list is subject to change.You will receive the generic equivalent of all items.AMOUNT PRICE13
Feminine careCODESKUPRODUCTCOMPARE TOAMOUNT PRICEG1927025Maxi Super Long PadsAlways Maxi42 CT 5G2692443Maxi Regular PadsAlways Maxi48 CT 5G3872912Ultra Thin Long PadsAlways Ultra Thin40 CT 5G6234554Urinary Pain Relief TabletsAzo30 CT 6G9721062Miconazole Vaginal Insert and CreamMonistat1 CT 13G30333336Miconazole 7 Day Vaginal CreamMonistat7 CT 10uG38326808Pregnancy TestFirst Response1 CT 10G40842800Overnight Maxi PadsMaxi36 CT 8G41289061Feminine Wipes Fragrance FreeNo Comparable32 CT 5First aidCODESKUPRODUCTCOMPARE TOF3875957Fabric Anti-Bacterial BandagesNo Comparable20 CT 4F4109405Calamine LotionCaladryl6 OZ 6F6322430Triple Antibiotic & Pain Relief OintmentNeosporin0.5 OZ 4F8618348Triple Antibiotic Ointment, Pain & ScarNeosporin0.5 OZ 7F9383505Clear BandagesNo Comparable45 CT 4u Dual-purpose item.Item list is subject to change.You will receive the generic equivalent of all items.14AMOUNT PRICE
First aidCODESKUPRODUCTCOMPARE TOAMOUNT PRICEF11550749Anti-Itch CreamBenadryl1 OZ 5F13955322Calamine Plus SprayCaladryl4.1 OZ 8F14875952Flex Fabric AB Fingertip KnuckleBandagesNo Comparable20 CT 4F15241483Antibacterial Bandages AssortmentBand-Aid120 CT 12F16488598Bandages Assortment Value PackNo Comparable200 CT 10F17894077Transparent Dressing Wound CoverNo Comparable8 CT 7F18832864Freeze Wart RemoverNo ComparableKIT 15F19330703Lidocaine Burn Relief GelSolarcaine8 OZ 6F20717967Sensitive Skin Adhesive BandagesNo Comparable20 CT 5F21602441IodineNo Comparable1 OZ 4F22311533MerthiolateNo Comparable2 OZ 5F23405572First Aid KitNo Comparable1 CT 6F28270304Waterproof Large TransparentDressingNexcare4 CT 14F31864765Antiseptic Skin CleanserHibiclens8 OZ 10 F32482649Epsom SaltNo Comparable22 OZ 5F33351170Wart RemovalCompound W0.5 OZ 8F38270351Waterproof Assorted TransparentDressingNexcare10 CT 9F39998839Wound Care Kit S/MNo Comparable30 PC 15 Could be covered under Part B or D.Item list is subject to change.You will receive the generic equivalent of all items.15
First aidCODESKUPRODUCTCOMPARE TO F40489905Surgical Face MasksNo Comparable25 CT 15 F41360094Small Surgical Face MasksNo Comparable20 CT 12F45219642Zinc Oxide OintmentNo Comparable1 OZ 4F47337274Finger Injury KitNo ComparableKIT 7 F48444797Rubbing Alcohol WipesNo Comparable40 CT 6F49946095Witch Hazel SprayT.N Dickinson’s6 OZ 7 F50935683Gauze Pad Non Stick 2x3No Comparable25 CT 6 F51893121Gauze Pad 4x4No Comparable25 CT 7 F52893120Gauze Pad 3x3No Comparable25 CT 6 F53894104Gauze Roll 4’’ 2ydsNo Comparable1 CT 4 F62964606First Aid TapeNo Comparable1 CT 2F68531343Petroleum JellyVaseline2.5 OZ 3 F69259370Butterfly ClosuresNo Comparable12 CT 3F73373092Hydrocortisone Ointment 1%Cortisone1 OZ 5F74219634BacitracinNo Comparable1 OZ 7 Could be covered under Part B or D.Item list is subject to change.You will receive the generic equivalent of all items.16 Home delivery only.AMOUNT PRICE
Foot careCODESKUPRODUCTCOMPARE TOAMOUNT PRICET2521682Tolnaftate Antifungal CreamTinactin Cream1 OZ 8T3211003Clotrimazole Cream, USP 1%Lotrimin0.5 OZ 7T4334566Odor Control Spray PowderOdor-Eaters4 OZ 6T5894580Moleskin PaddingDr. Scholl’s2 CT 4T9314468Medicated Corn CushionNo Comparable9 CT 2 T13658784Light Compression Socks L/XL White No Comparable1 PAIR 10 T14658829Light Compression Socks S/M WhiteNo Comparable1 PAIR 10 T15978348Light Compression Socks L/XL BlackNo Comparable1 PAIR 10 T16978349Light Compression Socks S/M BlackNo Comparable1 PAIR 10 T17184626Non-Binding Copper Crew SocksS/M WhiteNo Comparable3 PAIRS 10 T18184730Non-Binding Copper Crew SocksL/XL BlackNo Comparable3 PAIRS 10 T19184812Non-Binding Copper Crew SocksL/XL WhiteNo Comparable3 PAIRS 10 T20184935Non-Binding Copper Crew SocksS/M BlackNo Comparable3 PAIRS 10T35139231Liquid Corn & Callus RemoverDr. Scholl’s0.5 OZ 6 T36893272Diabetic Socks S/MNo Comparable2 PAIR 9 T37893270Diabetic Socks L/XLNo Comparable2 PAIR 9 T38658593Firm Compression Socks S/M BlackNo Comparable1 PAIR 12 T39658582Firm Compression Socks L/XL BlackNo Comparable1 PAIR 12T40229790Foot PowderGold Bond10 OZ 9 Home delivery only.Item list is subject to change.You will receive the generic equivalent of all items.17
Home diagnosticsCODESKUPRODUCTCOMPARE TOH19130344Alcohol Prep SwabsNo Comparable100 CT 3H20149650Glucose Chewable TabletsNo Comparable10 CT 2H21149647Glucose Tablets OrangeNo Comparable50 CT 6H22149616Glucose Tablets RaspberryNo Comparable50 CT 6uH25235157Ultra Thin Lancets, 30 GaugeNo Comparable100 CT 4uH26149668Thin Lancets, 26 GaugeNo Comparable100 CT 4uH27343477Lancing DeviceNo Comparable1 CT 6uH71«708884BP Monitor Upper Arm Auto8.7” x 16.5”No Comparable1 CT 40uH72«800232BP Monitor Upper Arm Manual8.7” x 12.6”No Comparable1 CT 18uH73«800824Auto Wrist Blood Pressure MonitorNo Comparable1 CT 52uH74«800231Advanced Auto Blood PressureMonitorNo Comparable1 CT 52uH75«800230Premium Blood Pressure MonitorUpper ArmNo Comparable1 CT 70uH76«800229Touchpad Premium Blood PressureMonitor Upper ArmNo Comparable1 CT 90uH77«814854Pulse OximeterNo Comparable1 CT 40u Dual-purpose item.Item list is subject to change.You will receive the generic equivalent of all items.18« Limited to one (1) per year.AMOUNT PRICE
Home healthcareCODESKUPRODUCTCOMPARE TOAMOUNT PRICE J1861900Drive Medical Bath MatNo Comparable1 CT 17 J2792495Suction Grab BarNo Comparable1 CT 10 J4741739ReacherNo Comparable1 CT 22 J5n741741Raised Toilet Seat 4”No Comparable1 CT 45 J6n741727Quad Cane BlackNo Comparable1 CT 26 J8980705Black Cane Tip 3/4No Comparable1 CT 4MiscellaneousCODESKUPRODUCTCOMPARE TOM75135615Mosquito Repellent w/ 30% DEETOFF!6 OZ 7uM77«864739Digital Body ScaleNo Comparable1 CT 13 Home delivery only.u Dual-purpose item.Item list is subject to change.You will receive the generic equivalent of all items.AMOUNT PRICEn Limited to one (1) per benefit period.« Limited to one (1) per year.19
Oral careCODESKUPRODUCTCOMPARE TOO6307117Sensitive Toothpaste Extra WhiteningSensodyne4 OZ 4O7808698Pro Clean Power Toothbrushw/ Replacement HeadsNo Comparable1 CT 9O8978931Sensitive FlosspicksNo Comparable90 CT 3O9469085Extra Comfort Floss Mint 43.7 YDOral-B Glide1 CT 3O10230196Denture Adhesive RegularFixodent2.4 OZ 4O12910693Toothbrush (Soft)Colgate1 CT 1O13933844Extra Comfort Floss Mint 43.7 YDOral-B Glide2 PK 6O14122340Effervescent Denture Cleanser TabletsPolident84 CT 5O15933823Interdental Brushes Tight SpacesGUM16 CT 5O16572131Tongue BrushNo Comparable2 CT 6O17902457Comfort Dental Night GuardNo Comparable2 CT 20O18809800Lower Dental GuardNo Comparable2 CT 30O19956360Clear Pro Toothbrush (Medium)No Comparable3 CT 3O20897755Toothbrush MediumNo Comparable2 CT 5O21377971Tri Clean Soft PicksGUM60 CT 6 O23378381Smilesonic Replacement HeadsNo Comparable2 CT 32O24454376Flosser Picks MintNo Comparable90 CT 3O25695108Temporary Lost Filling And CrownRepairNo Comparable1 CT 4 Home delivery only.Item list is subject to change.You will receive the generic equivalent of all items.20AMOUNT PRICE
Oral careCODESKUPRODUCTCOMPARE TOAMOUNT PRICEO26341166EasyFlex Replacement Brush HeadsNo Comparable3 PK 19O27974657Kids Candy Stripe ToothbrushNo Comparable2 PK 4O29378314Cordless Water Flossing SystemNo Comparable1 CT 55O31227508Ultra Tight Interdental BrushNo Comparable32 CT 6O36485907Sensodyne Pro Namel WhiteningToothpasteNo Comparable4 OZ 8O37705527Crest Whitening ToothpasteNo Comparable5.8 OZ 4O38452206Crest Toothpaste For ChildrenNo Comparable4.6 OZ 4O39357891Toothbrush ProtectorNo Comparable2 CT 7O40725922Oral-B Pro-Health Dual Clean PowerToothbrushNo ComparableEACH 19O42234697Crest Sensitive & Enamel ShieldToothpasteNo Comparable4.6 OZ 5n O44920657Oral-B Pro 1000 RechargeableToothbrushNo ComparableEACH 70O46873493Dry Mouth SprayBiotene1.5 OZ 7O47813436Oral-B Replacement Brush HeadsNo Comparable3 CT 34O48798709Sensodyne Extra Whitening ToothpasteNo Comparable2-Pack4 OZ 12O52933834Oral Pain ReliefAnbesol Gel0.33 OZ 6O71454381Flosser PicksNo Comparable90 CT 3O72368775Sensitive ToothpasteSensodyne3.4 OZ 4n Limited to one (1) per benefit period.Item list is subject to change.You will receive the generic equivalent of all items.21
Oral careCODESKUPRODUCTCOMPARE TOO73213330Denture Cleanser TabsEfferdent O74 n422345 EasyFlex Pro Rechargeable Toothbrush No Comparable O75415475Replacement BrushheadsNo ComparableAMOUNT PRICE40 CT 31 CT 455 CT 25Pain relieversCODESKUPRODUCTCOMPARE TOP1371948Ibuprofen 200mgAdvil50 CT 4P2200964Muscle RubBengay3 OZ 7P4230268Enteric Aspirin 81mgBayer Low Dose120 CT 5P6371914Acetaminophen 500mgTylenol E/S100 CT 7P8547802Chewable Aspirin 81mgBayer Low DoseChewable36 CT 2P12261925Children’s Ibuprofen SuspensionChildren’s Motrin4 OZ 6P13207688Children’s Acetaminophen SuspensionChildren’s TylenolCherry4 OZ 6P14957604Hot/Cold PatchesIcy HotMedicated Patch5 CT 6P16371271Lidocaine PatchSalonpas6 CT 11P17109017Headache Relief CapletsExcedrin E/S100 CT 9P18695905Cold & Hot Pain Relieving CreamIcy Hot3 OZ 6P19299470Naproxen 220mgAleve24 CT 4 Home delivery only.Item list is subject to change.You will receive the generic equivalent of all items.22n Limited to one (1) per benefit period.AMOUNT PRICE
Pain relieversCODESKUPRODUCTCOMPARE TOP21444770Medicated Heat PatchSalonpas1 CT 2P22152116Knee Support Sleeve LNo Comparable1 CT 12P23902106Wrist Support StrapNo Comparable1 CT 9P24151571Ankle Support Sleeve LNo Comparable1 CT 11P25453866Compression Sleeve Elbow LNo Comparable1 CT 15P26977934Lidocaine CreamAspercreme2.7 OZ 7P30942453Knee High Hosiery ModerateCompression LNo Comparable1 PAIR 20P31342829Knee High Hosiery ModerateCompression MNo Comparable1 PAIR 20P32524660 Anti-Embolism Stocking Knee Length L No Comparable1 PAIR 35P33524694 Anti-Embolism Stocking Knee Length M No Comparable1 PAIR 35P34318180Hot/Cold Multi CompressNo Comparable1 CT 11P35340744Naproxen Muscle & Back TabletsAleve24 CT 4P36324111Reusable Ice PackNo Comparable1 CT 6P37185226Migraine Relief CapletsExcedrin24 CT 4P38864199Sleep Aid 50mg SoftgelsUnisom32 CT 6P39933380Sleep-Aid LiquidZzzQuil6 OZ 5P40866534Melatonin 5mg TabletsNo Comparable90 CT 9P41475817Ibuprofen PM CapletsAdvil PM20 CT 5P42317581Acetaminophen 500mg Rapid ReleaseGelsTylenol100 CT 9Item list is subject to change.You will receive the generic equivalent of all items.AMOUNT PRICE23
Pain relieversCODESKUPRODUCTCOMPARE TOP43879536Acetaminophen 500mg CapletsTylenol225 CT 13P46738694Urinary Relief Max StrengthAzo12 CT 6P47923748Ibuprofen 200mg TabletsAdvil500 CT 18P48306397Ibuprofen 200mg SoftgelsAdvil Liqui-Gels80 CT 8P49263652Naproxen Sodium 220mg CapletsAleve100 CT 8P50456231Menstrual Pain Relief MaxMidol Complete24 CT 6P51140897Aspirin Enteric Coated 325mgEcotrin125 CT 8 P52729759Elastic Bandage 6”No Comparable1 CT 8P53124886Acetaminophen PM 500mg CapletsTylenol PM100 CT 9P54193588Arthritis Pain Relief 650mgTylenol Arthritis100 CT 10P55472994Knee Support Sleeve SNo Comparable1 CT 12P56151894Knee Support Sleeve MNo Comparable1 CT 12P57482556Knee Support Sleeve XLNo Comparable1 CT 12P58245414Acetaminophen PM 500mg CapletsTylenol PM24 CT 5P59343538Melatonin Gummy 5mg StrawberryNo Comparable60 CT 11P60191238Ch
It can be found on the front of your health plan ID card. What is the benefit? The OTC benefit offers you an easy way to get generic over-the-counter health and wellness products by going to select OTC Health Solutions-enabled CVS Pharmacy, CVS Pharmacy y mas or Navarro stores nationwide. You can also order by phone at 1-866-819-2516 (TTY: 711) or
