2017 OVER-THE-COUNTER (OTC) CATALOG - WellCare

1 2017 . OVER-THE-COUNTER (OTC) CATALOG . MEDICARE ADVANTAGE PLANS. he Get t ms ite OTC eed. you n H5087_CA034506_WCM_OTC_ENG_FINAL_01 CMS Accepted 07272016. WellCare 2016 CA_11_16 EC7 OTCCAT80036E_1116. The Benefits of Easy Choice Health Plan Add Up. What is Easy Choice's OTC benefit? Simply put, we give you a monthly dollar amount; you spend it on some of the OVER-THE-COUNTER (OTC) items you use every day. It's that easy. The OTC benefit is part of your health plan. Every month you can get brand-name or generic OTC medications and products like bandages, pain relievers, cold medicine, toothpaste, vitamins and much more. You can use this CATALOG , then order online or by phone, and we'll ship your items right to your door. Each plan offers different OTC benefit amounts. Check your Evidence of Coverage or Summary of Benefits for your specific benefit amount for your plan. Remember that your benefit and items are only for your use. Use your benefit each month. It does not roll over to the next month.

2 How Do I Use My OTC Benefit? There are two ways to get your items. No matter how you order them, we'll ship them right to your door. It's that easy. Allow 7-10 business days to receive your order. Find the items you want in this CATALOG , then: 1. Give us a call at 1-888-979-4319, TTY 711, Monday-Friday, 6:30 8:00 Pacific. 2. Visit us at Log in using your member ID. number and date of birth. You can find your member ID number on your Easy Choice member ID card. To Get the Most Out of Your OTC Benefit: 1. Make sure to order your items every month. If you skip a month, the benefits don't carry over to the next month. 2. Use your monthly dollar amount to stock up on a variety of items by ordering different items every month. Call Customer Service to order your OTC items | 1 EC7 OTCCAT80036E_1116.. What Can I Order With My OTC Selection? Eligible items On the next few pages, you'll find a list of products. These are the items that you can order from us and have mailed to your home. Eligible items include but are not limited to: fiber supplements, first aid supplies, medicines, ointments, sprays with active medical ingredients that alleviate symptoms, topical sunscreen, supportive items for comfort such as knee braces and adult incontinence products, and mouth care such as dental floss and toothbrushes.

3 Dual-purpose items What are dual-purpose items? They're medicines and products that can be used for either a medical condition or for general health and well-being. You can get dual-purpose items as part of your OTC benefit if you use them to treat a specific medical condition and your doctor recommends the product or medicine. Talk with your doctor before buying dual-purpose items. For your convenience, we've marked dual-purpose items with a ( ). Dual-purpose items include but are not limited to: Minerals and vitamins Hormone replacement In-home testing and monitoring Weight-loss items Some items, under certain circumstances, may be covered under either Part B or Part D. For example, gauze may be covered under Part B when it is being used, as prescribed, to perform surgical wound dressing changes. For your convenience, we've marked these items with a (**). What's not eligible? The following categories and items listed are not eligible for the OTC benefit. Non-eligible items include but are not limited to: Alternative medicines such as botanicals, herbals, probiotics and nutraceuticals Baby items such as diapers and formula Contraceptives such as birth control pills and spermicides Convenience and comfort items such as scales, fans and magnifying glasses Cosmetic items such as mouthwash, bad breath remedies, deodorants and teeth whitening Food products or supplements Replacement items such as hearing aid batteries and contact lens containers 2 | Call Customer Service to order your OTC items.

4 Items You Can Order From Us Do you prefer lower-cost generics or familiar brand-name products? Your OTC benefit lets you make the choice! Look over the list of eligible items on the next few pages. You can order online or by calling us and telling us the ID numbers of the items you want. We'll send them to your home and deduct the amount from your monthly benefit. OUR CATALOG ITEMS. ID# GENERIC NAME QTY* AMT ID# BRAND NAME QTY* AMT. ALLERGY PREVENTION AND TREATMENT. 1 Allergy Relief (Cetirizine) 30 $10 501 Zyrtec 14 $17. 10mg Tablets 2 Allergy Relief (Loratadine) 30 $7 502 Claritin 10 $12. 10mg Tablets 280 Nasoflow Allergy Relief 60 $24 680 Flonase Allergy Relief ml $37. Sprays ANALGESICS/ANTIPYRETICS. 3 Acetaminophen 325mg 100 $3 503 Tylenol 325mg Regular 100 $10. Tablets Strength Tablets 4 Acetaminophen 500mg 100 $5 504 Tylenol 500mg Extra 100 $16. Tablets Strength Tablets 5 Aspirin 325mg Tablets 100 $3 505 Bayer Aspirin 325mg 100 $8. 6 Aspirin 81mg Chewable 36 $3 NA Bayer Aspirin 81mg NA NA.

5 Chewable 7 Aspirin Enteric Coated 120 $5 507 Bayer EC Aspirin 81mg 32 $4. 81mg Tablets (Adult Regimen). 8 Aspirin Enteric Coated 100 $4 508 Ecotrin Tablets 325mg 100 $6. 325mg Tablets Items, quantities, sizes and values may change depending on availability * = Quantities and brands may vary depending upon availability. ** = Covered under either Part B or Part D. = Dual-purpose items Item cost may change from year to year Some items may vary depending on manufacturer. (For example, caplets, tablets, capsules or soft gels may be substituted for one another.). Call Customer Service to order your OTC items | 3.. ID# GENERIC NAME QTY* AMT ID# BRAND NAME QTY* AMT. ANTACIDS AND ACID REDUCERS. 9 Acid Reducer 30 $6 509 Pepcid AC Tab 10mg 30 $11. (Famotidine) 10mg Tablets 10 Acid Reducer 14 $14 510 Prilosec OTC 20mg 14 $12. (Omeprazole) 20mg 11 Acid Reducer (Ranitidine) 30 $7 511 Zantac Tablets 75mg 30 $15. 75mg Tablets 12 Antacid Tablets 150 $5 512 Tums Tablets 150 $8. 13 Effervescent Tablets 36 $4 513 Alka-Seltzer 24 $7.

6 14 Gas Relief Softgel Extra- 30 $4 514 Gas-X Extra Strength 18 $6. Strength NA Acid Reducer (Omeprazole) NA NA 686 Nexium 14 $26. NA Acid Reducer (Omeprazole) NA NA 687 Nexium 28 $48. NA Acid Reducer (Omeprazole) NA NA 688 Nexium 42 $64. ANTICANDIDAL (YEAST). 15 Miconazole Vaginal 1 $14 515 Monistat Vaginal Cream 1 $24. Cream 3 Day 3 Day ANTIDIARRHEAL AND LAXATIVES. 16 Adult Glycerin 25 $3 516 Fleet Adult 50 $5. Suppositories Suppositories 17 Anti-Diarrheal Caplets 12 $4 NA Imodium A-D Caplets NA NA. 18 Anti-Nausea Liquid 4 oz. $6 518 Emetrol 4 oz. $9. 19 Bisacodyl 5mg Tablets 25 $4 519 Dulcolax Tablets 25 $8. 231 Enema, Mineral Oil oz. $4 NA Enema, Mineral Oil NA NA. 279 Enema, Saline oz. $2 679 Fleet Enema A24, oz. $4. Laxative Saline 20 Laxative (Bisacodyl) 10mg 12 $5 520 Dulcolax Suppositories 8 $13. Suppositories 21 Stomach Relief Flavored 30 $3 521 Pepto-Bismol Tablets 30 $6. Tablets 290 Stomach Relief Flavored 8 oz. $6 690 Pepto-Bismol 8 oz. $9. Liquid NA Stomach Relief Flavored NA NA 691 Pepto-Bismol 16 oz.

7 $15. Liquid 22 Stool Softener Softgel 100 $4 522 Colace Caplets 30 $13. 4 | Call Customer Service to order your OTC items . ID# GENERIC NAME QTY* AMT ID# BRAND NAME QTY* AMT. ANTI-INFLAMMATORY. 23 Ibuprofen 200mg Liquid 20 $5 523 Advil Liquid Gel Caps 20 $6. Gel Caps 200mg 24 Ibuprofen 200mg Tablets 50 $6 524 Advil Tablets 200mg 50 $10. 25 Naproxen Sodium 220mg 50 $8 525 Aleve Caplets 220mg 24 $7. Caplets ARTHRITIS MEDICINE. 26 Arthritis Pain Relief 24 $5 NA Tylenol Arthritis NA NA. Caplets 27 Hot/Cold Patches 5 $5 527 Icy Hot Patches 5 $7. BLADDER CONTROL ITEMS. 167 Adult Protective Briefs 20 $18 NA Adult Protective Briefs NA NA. Small/Medium Small/Medium 168 Adult Protective Briefs 20 $18 NA Adult Protective Briefs NA NA. Large Large 169 Adult Protective Briefs XL 20 $20 NA Adult Protective Briefs XL NA NA. 170 Adult Bladder Control 28 $9 NA Adult Bladder Control NA NA. Pads Pads 200 Disposable Bed 5 $6 NA Disposable Bed NA NA. Underpads Underpads COLD/COUGH/FLU REMEDIES. 53 APAP Sinus Congestion 24 $4 553 Tylenol Sinus Congestion 24 $8.

8 54 Cough/Throat Drops 30 $3 554 Halls Cough Drops 30 $3. 55 Daytime Cold/Flu Relief 16 $5 555 DayQuil Caplets 16 $8. Softgel 56 Daytime Cold/Flu Relief 4 oz. $5 556 DayQuil Liquid 8 oz. $8. Liquid 174 Daytime/Nite-time Cold/ 20 $5 674 DayQuil /NyQuil 32 $18. Flu Caplets Caplets 230 Diphenhydramine 25mg 24 $3 NA Benadryl NA NA. Capsules 57 Mucus Relief DM Tablets 30 $9 557 Mucinex-DM 20 $17. 58 Mucus Relief Tablets 30 $8 558 Mucinex 20 $15. 59 Nasal Decongestion 1 oz. $4 559 Afrin Nasal Spray oz. $10. Spray 60 Nasal Decongestion PE 36 $4 NA Sudafed PE NA NA. Tablets Call Customer Service to order your OTC items | 5.. ID# GENERIC NAME QTY* AMT ID# BRAND NAME QTY* AMT. COLD/COUGH/FLU REMEDIES Continued 61 Nite-Time Cold/Flu 16 $5 561 NyQuil Caplets 16 $8. Relief Softgel 62 Nite-Time Cold/Flu 4 oz. $7 562 NyQuil Liquid 8 oz. $8. Relief Liquid 63 Saline Nasal Spray oz. $3 563 Ocean Nasal Spray oz. $6. 64 Sore Throat Spray 6 oz. $4 NA Chloraseptic Sore Throat NA NA. Spray 65 Tussin DM Syrup SF 4 oz.

9 $6 565 Robitussin DM Syrup 4 oz. $8. 66 Tussin Syrup 4 oz. $4 NA Robitussin Syrup NA NA. 67 Vapor Rub oz. $5 NA Vicks Vaporub NA NA. 211 Sugar-Free Cough/Throat 25 $3 NA Sugar-Free Halls Cough NA NA. Drops Drops DENTAL AND DENTURE CARE. 69 Denture Adhesive oz. $5 569 Fixodent oz. $7. Cream 70 Denture Cleaner 40 $4 570 Efferdent 20 $5. 71 Fluoride Toothpaste oz. $3 571 Colgate 4 oz. $5. 72 Adult Toothbrush - 1 $2 572 AIM Toothbrush - Soft 1 $4. Medium 73 Dental Floss 1 $2 573 AIM Dental Floss 1 $3. 75 Sensitive Teeth oz. $5 NA Sensodyne NA NA. Toothpaste 76 Toothache Relief Liquid/ oz. $4 576 Anbesol Liquid/Gel oz. $9. Gel EAR CARE. 77 Ear Syringe 1 $3 NA Ear Syringe NA NA. 78 Ear Wax Drops oz. $6 578 Debrox Ear Wax Drops oz. $8. EYE CARE. 79 Artificial Tears oz. $4 579 Visine Tears oz. $7. 238 Collyrium Eye oz. $4 NA Collyrium Eye Wash NA NA. Wash 118ml 93 Red Eye Relief Drops oz. $3 593 Visine Drops oz. $6. 6 | Call Customer Service to order your OTC items . ID# GENERIC NAME QTY* AMT ID# BRAND NAME QTY* AMT.

10 FIBER SUPPLEMENTS. 94 Fiber Gummies 60 $10 594 Vitafusion Fiber Well 90 $18. Gummies 95 Fibertab Tablets 90 $9 NA FiberCon Caplets NA NA. 281 Psyllium Powder, Orange 13 oz. $10 681 Metamucil Orange 114 $40. NA Psyllium Powder, Orange NA NA 682 Metamucil Orange 114 $40. Sugar Free NA Psyllium Powder, Orange NA NA 683 Metamucil Orange 72 $35. Sugar Free FIRST AID AND MEDICAL SUPPLIES. 96 Adhesive First-Aid Tape** 1 $2 NA Adhesive First-Aid Tape** NA NA. 189 Aid Ankle Support 1 $7 NA Aid Ankle Support NA NA. 191 Aid Elbow Support 1 $7 NA Aid Elbow Support NA NA. 192 Aid Hand Support 1 $7 NA Aid Hand Support NA NA. 166 Aid Knee Support 1 $7 NA Aid Knee Support NA NA. 190 Aid Wrist Support 1 $7 NA Aid Wrist Support NA NA. 97 Alcohol Pads** 100 $3 NA Alcohol Pads** NA NA. 162 Anti-Embolism Stockings 1 $13 NA Anti-Embolism Stockings NA NA. Extra Large Extra Large 163 Anti-Embolism Stockings 1 $13 NA Anti-Embolism Stockings NA NA. Large Large 164 Anti-Embolism Stockings 1 $13 NA Anti-Embolism Stockings NA NA.