Over-the-Counter (OTC) Benefits | Healthfirst

Over-the-Counter (OTC) Benefits

Learn how OTC benefits can help you save money on a variety of over-the-counter products and health-related items.

Benefits Overview

At Healthfirst, we understand some of the medications and health-related items you may need may not require a prescription. If you’re a member of a plan with an OTC benefit, you’ll receive a Healthfirst OTC card with a pre-funded monthly allowance upon enrollment, which you’ll need to activate.

Healthfirst Plans with OTC Benefits:

  1. Life Improvement Plan (HMO SNP)
  2. CompleteCare (HMO SNP)

Your 2020 Benefit Amount

Life Improvement Plan (HMO SNP) members will receive $140 per month ($1,680 per calendar year) for purchase of OTC items (approved non-prescription drugs and health-related items). Any unused balance will automatically expire at the end of each month or upon disenrollment from the plan.

CompleteCare (HMO SNP) members will receive $150 per month ($1,800 per calendar year) for purchase of OTC (approved non-prescription drugs and health-related items) and selected grocery items. Any unused balance will automatically expire at the end of each month or upon disenrollment from the plan.

You must activate your Healthfirst OTC card before you can use it.

Learn More

You may purchase approved OTC nonprescription drugs and health-related items (such as aspirin, cold/flu medicine, and bandages) at any participating pharmacy. If you are a CompleteCare member, you can purchase selected grocery items in addition to the nonprescription, health-related items.

2020 Resources

Life Improvement Plan (HMO SNP) Approved OTC Purchases

CompleteCare (HMO SNP) Approved OTC Purchases

OTC Reimbursement Form

For a complete list of participating pharmacies and retailers, you can:

  1. Visit www.otcnetwork.com/
    member
  2. Call Member Services at:
    1-888-260-1010
    8am–8pm, 7 days a week
    TTY English: 1-888-542-3821
    TTY Español: 1-888-867-4132

At Healthfirst, we understand some of the medications and health-related items you may need don’t always require a prescription. These items are called over-the-counter (OTC) or nonprescription medicine. If you’re a member of a plan with an OTC benefit, you’ll receive a Healthfirst OTC card with a monthly allowance upon enrollment.

Healthfirst Plans with OTC Benefits:

  1. Life Improvement Plan (HMO SNP)
  2. CompleteCare (HMO SNP)

Your 2019 Benefit Amount

Life Improvement Plan (HMO SNP) members will receive $100 per month ($1,200 per year) for purchase of OTC items (approved non-prescription drugs and health-related items). Any unused balance will automatically expire at the end of each month or upon disenrollment from the plan.

CompleteCare (HMO SNP) members will receive $120 per month ($1,440 per year) for purchase of OTC items (approved non-prescription drugs and health-related items). Any unused balance will automatically expire at the end of each month or upon disenrollment from the plan.

You must activate your Healthfirst OTC card before you can use it.

Learn More

You may purchase approved OTC nonprescription drugs and health-related items (such as aspirin, cold/flu medicine, and bandages) at any participating pharmacy.

2019 Resources

Life Improvement Plan (HMO SNP) Approved OTC Purchases

CompleteCare (HMO SNP) Approved OTC Purchases

OTC Reimbursement Form

For a complete list of participating pharmacies and retailers, you can:

  1. Visit www.otcnetwork.com/
    member
  2. Call Member Services at:
    1-888-260-1010
    8am–8pm, 7 days a week
    TTY English: 1-888-542-3821
    TTY Español: 1-888-867-4132

Limitations

Depending on your plan, you’ll receive an OTC card with a maximum limit for purchasing approved OTC nonprescription drugs, health-related items at participating pharmacy locations, and in the case of CompleteCare, selected grocery items. For more information, view your plan details or contact Member Services.

Some items can be purchased only after a discussion with your provider.

While no prescription is needed before purchasing approved OTC nonprescription drugs and health-related items, some dual-purpose items* can be purchased only after a discussion with your provider. They’ll recommend the right OTC items for a specific diagnosis/condition.

*Dual-purpose items may include:

vitamins, minerals, supplements, hormone replacements, weight loss items, and diagnostic tools like blood pressure monitors.

  • OTC items may be purchased only for the enrollee, not for family members or friends.
  • The OTC card is not a debit or credit card and cannot be converted to cash.
  • It cannot be used to purchase Part B or Part D covered prescription drugs.
  • Any unused balances will automatically expire at the end of each month or upon disenrollment from the plan.

Depending on your plan, you’ll receive an OTC card with a maximum limit for purchasing approved OTC nonprescription drugs, health-related items at participating pharmacy locations, and in the case of CompleteCare, selected grocery items. For more information, view your plan details or contact Member Services.

Some items can be purchased only after a discussion with your provider.

While no prescription is needed before purchasing approved OTC nonprescription drugs and health-related items, some dual-purpose items* can be purchased only after a discussion with your provider. They’ll recommend the right OTC items for a specific diagnosis/condition.

*Dual-purpose items may include:

vitamins, minerals, supplements, hormone replacements, weight loss items, and diagnostic tools like blood pressure monitors.

  • OTC items may be purchased only for the enrollee, not for family members or friends.
  • The OTC card is not a debit or credit card and cannot be converted to cash.
  • It cannot be used to purchase Part B or Part D covered prescription drugs.
  • Any unused balances will automatically expire at the end of each month or upon disenrollment from the plan.

How to Activate & Use Your OTC Card

Step 1

Activate your card

<h2>Step 1</h2>
<h3>Activate your card</h3>

Activate your Healthfirst OTC card before its first use. To activate, please call Card Services at 1-888-682-2400 (24 hours a day, 7 days a week) or visit www.otcnetwork.com/member

Please note: Activate your card ONLY at the start of your plan’s effective date! Otherwise, it may activate under your previous plan.

You’ll need to provide:

  • The OTC card number printed on the front of the card
  • Your Healthfirst Medicare Plan Member ID card number
  • Your birthdate (two-digit month, two-digit day, and four-digit year; for example, 05/20/1930)

Step 2

Visit a participating store

<h2>Step 2</h2>
<h3>Visit a participating store</h3>

Take your activated Healthfirst OTC card to a participating store and select the approved items you want to purchase. Because you do not need a prescription, you won’t have to visit the pharmacy window.

You can use your Healthfirst OTC card at any Duane Reade, Walgreens, CVS, or Family Dollar location.

Please note: If you have a 2019 plan, you can still use your OTC card at Rite Aid and many neighborhood pharmacies through the end of the year.

For a complete list of participating pharmacies and retailers, visit
www.otcnetwork.com/member or call our Member Services Representatives at 1-888-260-1010 (TTY 1-888-542-3821), 7 days a week, 8am-8pm.

Step 3

Pay for your items

<h2>Step 3</h2>
<h3>Pay for your items</h3>

Take your items to the front checkout lanes. When you check out, swipe the card for payment. Purchases of approved items are automatically deducted from your card balance.

Coverage is provided by Healthfirst Health Plan, Inc., Healthfirst PHSP, Inc., and/or Healthfirst Insurance Company, Inc. (together, “Healthfirst”). Plans contain exclusions and limitations.

Healthfirst Health Plan, Inc. offers HMO plans that contract with the Federal Government. Enrollment in Healthfirst Medicare Plan depends on contract renewal.

Healthfirst Medicare Plan, Inc. complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.

ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-866-305-0408 (TTY 1-888-867-4132).

注意:如果您使用繁 體中文,您可以免費獲得語言援助服 務。請致電 1-866-305-0408 (TTY 1-888-542-3821).

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