2016 Over-the-Counter (OTC) Benefit Catalog
|
|
- Claire Sutton
- 7 years ago
- Views:
Transcription
1 2016 Over-the-Counter (OTC) Benefit Catalog As a member of Care1st Health Plan, you have an Over-the-Counter (OTC) benefit every quarter. This benefit allows you to get OTC products you may need such as bandages, cold and allergy medicines, pain relievers, and vitamins at no cost to you. Benefit amounts do not roll over, so be sure to use them before the end of every quarter. Simply call the toll-free number OR fill out and mail the order form provided. Your order will be shipped directly to your door. Special Benefit for Care1st Health Plan Members Get Over-the-Counter Products Every Quarter at No Cost to You! Information on how to place your OTC order can be found on the last page. *B - May be covered by Medicare Part B. *D - May be covered by Medicare Part D. H5928_16_013_PD_OTC Accepted
2 2. You can get the following items without having to talk with your doctor, but we always recommend that you talk with your doctor before starting a new product regimen. Acne Treatment Acne Gel 10% Benzoyl Peroxide 1.5 oz 1076 $7.20 Allergy, Cold, Flu, Decongestant and Sinus All Day Allergy Tablets 14 tabs 1090 $7.90 All-Nite Cold/Flu mg 1361 $8.30 Children's Dimaphen 4 oz 1426 $6.10 Children's Diphenhydramine HCL 1428 $6.60 Chlorpheniramine Maleate 100 tabs, 4 mg 1008 $6.00 Cromolyn Sodium (Allergy Nasal Spray) 1356 $21.40 Cough & Cold for High Blood Pressure 16 tabs 1166 $9.30 Diphenhist (Antihistamine) 100 tabs 1308 $7.90 Diphenhydramine HCL 24 capsules, 25 mg 1009 $8.30 Multi Symptom Cold Formula 24 tabs 1357 $8.40 Nasal Decongestant Spray 12 Hr, 1oz 1091 $9.50 Nasal Spray (Saline) 1.5 oz 1052 $9.50 Sudogest PE 36 tabs, 10 mg (Nasal and Sinus Decongestant) 1352 $6.00 Vapor Rub 1 oz 1164 $8.40 Pain Relievers and Fever Reducers Acetaminophen 100 tabs, 325 mg 1001 $8.60 Acetaminophen 50 tabs, 500 mg 1105 $6.00 Aleve 100 tabs, 220 mg 1104 $14.20 Aspirin 100 tabs, 325 mg 1095 $4.90 Aspirin Enteric Coated 100 tabs, 325 mg 1096 $7.10 Aspirin Low Dose tabs, 81 mg $7.10 Children's Acetaminophen 30 chewables, 80 mg 1423 $6.20 Children's Ibuprofen 100 mg/ 5 ml 1421 $8.20 Ibuprofen 100 tabs, 200 mg 1004 $8.70 Menstrual Relief 24 tabs 1257 $6.90 Naproxen *D 100 tabs, 220 mg 1097 $14.40 Pain Reliever PM Extra Strength 100 tabs 1332 $11.60 Antacids and Acid Reducers Alka-Seltzer 36 tabs 1313 $15.20 Chewable Antacid 150 tabs, 500mg 1346 $7.00 Effervescent Pain Reliever 36 tabs 1314 $8.90 Famotidine *D 30 tabs 1108 $7.30 Gas-X 36 chewables, 80 mg 1312 $8.60 Antacid/Anti-Gas Liquid 1006 $9.50 Omeprazole *D 28 caps 1110 $39.80 Anti-Arthritic Arthritis Pain Reliver 100 tabs 1311 $19.40 Capsaicin 1367 $11.40 Glucosamine Joint/Muscle capsules $13.30 Glucosamine/Chondroitin 60 capsules 1003 $16.50
3 Anticandial (Yeast) Clotrimazole Vaginal Cream w/applicator *D 1115 $12.80 Micanozole 3 Day Treatment 1117 $16.90 Tioconazole 1 Day Treatment with applicator 1119 $29.10 Antidiarrheal Bismatrol (Bismuth Subsalicylate) 30 tabs 1045 $7.90 Loperamide HCL *D 12 tabs 1133 $5.90 Pepto-Bismol 1317 $15.40 Pink Bismuth 1318 $8.40 Antifungal Clotrim Antifungal Cream 1047 $13.00 Miconazole 2% Cream 1135 $13.60 Terbinafine HCL Tube 1046 $16.70 Tolnaftate Cream 1064 $5.90 Anti-Itch Lotions and Creams Bactine Solution 1142 $12.60 Pramoxine Topical Analgesic 1144 $10.80 Diphenhydramine HCL/ Zinc Acetate 1140 $5.80 Hydrocortisone 1% Cream 1074 $5.80 Contact Lens Supplies Multi Purpose Contact Lens Solution 1468 $8.40 Cough Suppressants and Expectorants Cherry Cough Drop 30 lozenges 1056 $10.10 Diabetic Tussin DM 1323 $9.60 Guaifenesin Cough Expectorant 60 tabs 1180 $11.00 Cough Syrup, Expectorant 1054 $5.00 Mucus Relief DM (Guaifenesin Expectorant and Dextromethorphan Cough Suppressant) 30 tabs, mg 1178 $8.00 Sore Throat Lozenges Cherry 18 lozenges 1176 $7.10 Sugar Free Cough Drop Cherry 25 lozenges 1182 $6.40 Dental/Denture Care Dental Floss 55 yards 1455 $5.90 Denture Cleaning Tablets 40 tabs 1032 $7.90 Fixodent 1187 $9.10 Oral Pain Relief 1286 $8.70 Orajel Pain Relief 1454 $9.30 Cold Sore, Fever Blister and Other Medicated Lip Products Abreva 1152 $20.60 Blistex Lip Ointment 1256 $5.90 Carmex 1255 $5.40 Herpecin-L Lip Balm 1153 $9.10 Releev Cold Sore Treatment 1359 $40.10 Rechargeable Toothbrush 1450 $38.20 Tooth Brush Colgate Clean Adult Soft 1413 $5.20 Tooth Brush Tek Pro Straight Soft 1412 $4.80 Tooth Paste Pepsodent 1414 $5.90 Polident Denture Cream 1324 $11.20 *B - May be covered by Medicare Part B. *D - May be covered by Medicare Part D. 3.
4 4. Digestive Health Beano 30 tabs 1316 $9.40 Enema 4.5 oz 1733 $8.00 Lactase Capsules 60 capsules 1067 $12.30 Ear Care Ear Drops 1190 $6.30 Ear Wax Removal System with Rubber Bulb 1363 $9.90 Eye Care Artificial Tears Drops 1192 $6.10 Clear Eyes Eye Drops 1199 $8.20 Eye Drops (Redness Relief) 1061 $6.10 Eye Wash Solution 1196 $7.00 Artificial Tears Ointment 1194 $11.40 First Aid and Medical Supplies Adhesive Bandages 60 bandages 1344 $8.00 Alcohol Pads *D 100 pads 1200 $7.10 Ankle Support 1225 $11.50 Antiseptic Towelettes 100 pack 1201 $7.60 Automatic Blood Pressure Monitor Desktop 1253 $44.40 Bath Bench WITH Back 1728 $71.00 WITHOUT Back 1727 $55.00 Bath Mat (non-skid) 1459 $18.50 Bath Tub Safety Rail 1730 $38.00 Conforming Gauze Sterile *B 12 pads, 3 X 4 yd 1223 $15.00 Cushion FOAM RING 1732 $22.00 LUMBAR 1731 $27.00 Elastic Bandage *B 2 X 5 yd 1207 $ X 5 yd 1209 $ X 5 yd 1211 $ X 5 yd 1213 $6.10 First Aid Kit 48-piece 1215 $10.60 Folding Cane with Ergonomic Handle 1726 $22.00 Hot/Cold Pack for Injury 1062 $8.50 Hydrogen Peroxide 1228 $5.10 Lantiseptic Skin Protectant Ointment 1202 $10.60 Knee Stabilizer 1465 $27.10 Neosporin Plus 1326 $14.70 Night Wrist Support Smart Glove 1463 $35.40 Povidone Iodine 1203 $5.30 Raised Toilet Seat 1729 $36.00 Rib Belt One size fits most MALE 1456 $25.20 FEMALE 1457 $25.20 Shower Mat (non-skid) 1460 $28.50 Tape, Paper Surgical *B 1 X 10 yd 1217 $ X 10 yd 1218 $5.90 Tape, Silk Surgical *B 1 X 10 yd 1219 $ X 10 yd 1220 $7.20 Tape, Transparent Surgical *B 1 X 10 yd 1221 $ X 10 yd 1222 $7.00 Thermometer DIGITAL 1063 $9.60 DIGITAL - EAR 1285 $16.70
5 Wintergreen Isopropyl Alcohol 1229 $7.40 Wrist Splint 1230 $23.90 Wrist Support 1227 $13.50 Foot Care Callus Remover Pads 6 pads 1238 $9.80 Corn Remover Pads 9 pads 1236 $9.80 Medicated Foot Powder 1240 $7.40 Hemorrhoidal Preparations Hemorrhoidal Ointment 1066 $9.00 Hemorrhoidal Suppository box of $6.60 Preparation H Cream 1248 $18.50 Pre-Moist Hemorrhoid Pads 100 pads Home Diagnostics 1364 $12.10 Colon Cancer Test 1416 $18.60 Home Access Cholesterol Test 1251 $38.10 Incontinence Supplies A&D Ointment 1300 $6.60 Adult Briefs Med 32" - 44 waist, 12 pk LG waist, 18 pk XL waist, 15 pk $12.60 $15.60 $15.60 Barrier Cream 1302 $10.50 Underpad 23" x 36" 1299 $16.00 Washcloth w/lanolin 1348 $9.60 Laxatives Bisacodyl 100 tabs 1128 $6.50 Docusate Sodium 100 capsules 1126 $18.10 Ex-Lax 8 tabs 1124 $8.20 Glycerin Suppository tabs, 2 gm $6.80 Methylcellulose 1354 $19.90 Milk of Magnesia 12 oz 1011 $8.40 Natural Vegetable Laxative 1340 $16.00 Polycarbophil Fiber Tablets tabs $13.70 Senna Plus 60 tabs, mg 1130 $8.70 Migraine Relief Migraine Relief 100 tabs 1365 $9.90 Wellpatch Migraine box of $11.10 Minerals Calcium Carbonate Tabs tabs $8.30 Calcium-Vitamin D 60 tabs 1373 $6.50 Ferrous Sulfate 100 tabs, 325 mg 1376 $7.60 Niacin 100 tabs, 100 mg 1378 $7.00 Niacin 100 tabs, 500 mg 1394 $9.60 Magnesium 110 tabs, 250 mg 1418 $8.40 Magnesium Oxide 100 tabs, 250 mg 1377 $9.30 Rena-Vite 100 tabs 1395 $21.40 Zinc Chelated 100 tabs, 50 mg 1419 $7.40 *B - May be covered by Medicare Part B. *D - May be covered by Medicare Part D. 5.
6 Motion Sickness Dramamine Orange 8 chews 1264 $10.70 Driminate 12 tabs 1263 $6.00 Meclizine 100 tabs 1366 $12.00 Pediculicide Lice Treatment Shampoo 1271 $14.00 Permethrin Cream Rinse 1269 $17.70 Personal Care Ammonium Lactate 1368 $14.30 Aloe Vera Cream 1070 $10.70 Hand Sanitizer 1065 $7.20 Sunscreen Lotion SPF $12.80 Sleep Aids Nasal Strips box of 30 SMALL/MEDIUM 1724 $14.00 MEDIUM/LARGE 1725 $14.00 Sleep Tabs 24 tabs 1276 $7.10 Smoking Cessation Nicorelief Gum 1372 $27.00 Nicotine Patches box of 14 STEP 1 21 mg/24 hr 1369 $40.30 STEP 2 14 mg/24 hr 1370 $40.30 STEP 3 7 mg/24 hr 1371 $40.30 Support Items Men's Compression Knee Hi Socks BLACK - LG Shoe size 10 1/2-12 (15-20 mmhg) 1399 $27.40 WHITE - MED Shoe Size 8-10 (15-20 mmhg) 1400 $27.40 WHITE - LG Shoe Size 10 1/2-12 (15-20 mmhg) 1401 $27.40 Women's Compression Knee Hi Socks NUDE - SM Shoe Size 4-5 (8-15 mmhg) 1406 $16.60 NUDE - MED Shoe Size 5 1/2-7 1/2 (8-15 mmhg) 1407 $16.60 NUDE - LG Shoe Size /2 (8-15 mmhg) 1408 $16.60 BLACK - SM Shoe Size 4-5 (8-15 mmhg) 1409 $16.60 BLACK - MED Shoe Size 5 1/2-7 1/2 2 (8-15 mmhg) 1410 $16.60 BLACK -LG Shoe Size /2 (8-15 mmhg) 1411 $16.60 Topical Antibiotics Bacitracin Ointment 1020 $5.80 Triple Antibiotic Ointment 1014 $9.90 Wart Remover Dr. Scholl s Wart Removal System 1288 $19.70 Wart Remover 1075 $9.00 Wartners Wart Removal System Kit 1289 $ *B - May be covered by Medicare Part B. *D - May be covered by Medicare Part D.
7 Before ordering any of the items below, you should talk with your doctor. Vitamins Centrum Silver 60 tabs 1420 $33.50 Daily Multiple Vitamin Tabs 100 tabs 1385 $7.10 Ferrous Gluconate (Iron Supplement) 100 tabs 1375 $7.60 Iron 110 tabs, 27 mg 1417 $10.00 Multi Vitamin Children's 100 chewables 1422 $10.00 Prenatal Vitamins 100 tabs 1274 $10.00 Vitamin A 100 tabs, 10 mu 1379 $6.30 Vitamin B-Complex 100 tabs 1382 $8.20 Vitamin B tabs, 100 mg 1016 $7.50 Vitamin B tabs, 50 mg 1380 $6.60 Vitamin B tabs, 100 mg 1388 $7.10 Vitamin B tabs, 500 mg 1389 $8.20 Vitamin B tabs, 1000 mcg 1381 $11.20 Vitamin C 500 mg, 100 tabs 1017 $6.50 Vitamin Century Senior 90 tabs 1392 $13.10 Vitamin D 100 tabs, 1000 iu 1390 $8.10 Vitamin D 100 tabs, 400 iu 1383 $8.00 Vitamin E 100 tabs, 100 iu 1391 $7.40 Vitamin E 100 tabs, 400 iu Vitamin One A Day 100 tabs 1393 $8.10 Care1st Health Plan is an HMO and an HMO SNP plan with a Medicare contract and a contract with the California State Medicaid Program. Enrollment in Care1st Health Plan depends on contract renewal. This information is not a complete description of benefits. Contact the plan for more information. Benefits, formulary, pharmacy network, premium and/or co-payments/co-insurance may change on January 1 of each year. Limitations, copayments, and restrictions may apply. This information is available for free in other languages. Please contact Member Services: (TTY: 711), 8am - 8pm PST, 7 days a week. Esta información está disponible gratuitamente en otros idiomas. Comuníquese con Servicios para los Miembros: (TTY: 711), de 8:00 a.m. a 8:00 p.m., los 7 días de la semana. 這 項 免 費 資 訊 T 以 其 它 語 言 提 供 懇 請 聯 絡 會 員 服 務 Ł 處 : 免 費 熱 線 ( 聽 障 及 語 障 人 士 h 專 線 711) 每 週 七 天 辦 公, 早 上 8:00 點 I 至 晚 上 8:00 點 7.
8 Helpful Information If you have questions or would like to place an order over the phone, OTC Advocates are available Monday Friday from 8:00am to 5:00pm PST at (TTY 711). If you place your order using an order form, your order total will be applied to the quarter in which we receive your form. For example, if you mail your order form on June 29th, but we receive it on July 1st, your order total will be applied to your July (or third quarter) benefit, not your June (or second quarter) benefit. If you re getting close to the end of the quarter and you do not think your order form will be received in time, you can call in your order. We encourage you to use your full quarterly benefit amount in one order. This benefit amount does not roll over from quarter to quarter. Your order total may not exceed the quarterly benefit amount shown in the letter you received with this catalog. Cash, checks or money orders are not accepted under this OTC benefit. Orders may only be placed by the member, an authorized representative verbally approved by the member at time of the order, and/or the member s power of attorney representative on file. To use your benefit, you must select products from this catalog that will help you with a health or medical need. Your order total may not exceed your benefit amount. OTC products are intended for members use only. Care1st Health Plan prohibits the use of this benefit to order OTC items for family members and friends. OTC items are available through mail-order only. Once your order is received, please allow 7-10 business days for delivery. Products may not be purchased at a local retail pharmacy or through any other source other than the Care1st Health Plan OTC Benefit Catalog. If you disenroll from Care1st Health Plan, your OTC benefit will automatically terminate. Returns are not accepted. Some items listed in this catalog may also be covered under your Medicare Part B (medical) benefit or Part D (pharmacy) benefit. These items have a *B or a *D after their name. For example, alcohol pads are covered under Part D if they are used for administering insulin. For all other purposes, this item is covered under your OTC benefit. Items in the 2016 OTC Benefit Catalog may change throughout the year. A copy of this catalog is also available on the Care1st Health Plan website at For up-to-date information, please call our OTC Advocates from Monday - Friday from 8:00am to 5:00pm PST at (TTY 711).
2016 OVER-THE-COUNTER (OTC) BENEFIT CATALOG
2016 OVER-THE-COUNTER (OTC) BENEFIT CATALOG Special Health Plan Benefit Get Over-the-Counter Products Every Quarter As a member of Ultimate Health Plans, you have an Over-the-Counter (OTC) benefit every
More informationHow to Order: Keep this catalog. You will need this to look up the Health and Wellness products you want to order each month.
Did you know that depending on your current Humana plan, you may be able to purchase Health and Wellness products from the RightSource mail-order pharmacy? Call RightSource at 1-855-211-8370 (TTY: 711)
More informationAETNA BETTER HEALTH Over the counter (OTC) product list
TOPICAL ANTIBACTERIAL/ANTIFUNAL OTC DRUGS OTC bacitracin topical ointment OTC clotrimazole (vaginal use) OTC clotrimazole (topical use) OTC miconazole 2% ointment OTC miconazole vaginal suppositories,
More informationKnow What s in the Medicine You Take:
1 Know What s in the Medicine You Take: Active Ingredients in OTC Pain Relievers, Antihistamines, Decongestants and Cough Medicines Single Ingredient Brand Names Pain relievers Acetaminophen Tylenol:,
More informationOver-the-Counter Health & Wellness Products
Over-the-Counter Health & Wellness s 2015 Catalog and Order Form Y0040_GNHHXUEEN 2015 Over-the-Counter (OTC) Health and Wellness Order Form Your current plan may have an over-the-counter benefit that would
More informationproduct list Put our quality and service behind your brand. 200 Hicks Street, Westbury, NY 11590 +1.516.986.1700
product list We are committed to high quality and expedited service, bringing leading and exclusive products to our customers. Our private label products include a broad range of pharmaceutical categories.
More informationSample eligible expenses Personal Care Account (PCA), Health Savings Account (HSA) and Flexible Spending Account (FSA)
Prescription drugs: Prescription drugs or insulin Medicines and drugs from other countries Illegal drugs Cosmetic prescriptions Medical equipment: Artificial limbs Blood pressure monitoring devices Breast
More informationFSA Plan. City of Seattle. Administered by Flex-Plan Services, Inc. Plan Year starting 1/1/2013 and ending 12/31/2013
FSA Plan Administered by Flex-Plan Services, Inc. City of Seattle Plan Year starting 1/1/2013 and ending 12/31/2013 www.flex-plan.com Flex-Plan Services, Inc General FSA Overview An FSA plan is a pre-tax
More informationELIGIBLE FLEXIBLE EXPENSES
ELIGIBLE FLEXIBLE EXPENSES The following is not a comprehensive list of items, but it should cover the majority of eligible expenses that can typically be processed through flexible spending accounts.
More informationFlexible Spending Account Overview
Flexible Spending Account Overview Medical Reimbursement Accounts Dependent Care Reimbursement Accounts Transforming Employee Benefits What is a Flexible? A Flexible is offered through your employer and
More informationDepartment of Human Services
Department of Human Services Proposed PDL for IOWA Medicaid Program Listing Covered OTC Drugs: Effective Date: 10/13/2015 Note: Not all s may be represented and the status of those listed are subject to
More informationOver-the-Counter Health & Wellness Products
Over-the-Counter Health & Wellness Products 2016 Catalog and Order Form Y0040_GNHJBPBEN 0815 2016 Over-the-Counter (OTC) Health and Wellness Product Order Form Your current plan may have an over-the-er
More informationOver-the-Counter (OTC) Catalog Get the OTC items you need.
2015 Over-the-Counter (OTC) Catalog Get the OTC items you need. Medicare Advantage Plans H5087_CA027266_WCM_OTC_ENG CMS Accepted 08302014 WellCare 2014 CA_07_14_EC EC5OTCCAT60343E The Benefits of Easy
More informationEligible Expenses. Your plan may have additional restrictions and entire categories of eligible items may not qualify for reimbursement.
Eligible Expenses The following are examples of IRS allowable and disallowed healthcare expenses for a Healthcare Flexible Spending Account (FSA) or Personal Care Account (PCA). Note: This is only a list
More informationMedical Reimbursement Account. How to Use Your Medical Reimbursement Account. San Francisco City Option Updated April 2016 www.sfcityoption.
Medical Reimbursement Account How to Use Your Medical Reimbursement Account San Francisco City Option Updated April 2016 www.sfcityoption.org Contents About this Handbook...1 What is a Medical Reimbursement
More informationLEVEL II FAK YOUTUBE : USNERDOC
LEVEL II FAK A Level II FAK in a medical roll configuration that provides a deep level of medical capability for groups in a remote austere environment YOUTUBE : USNERDOC MARCH 2010 LEVEL II FAK CONTENTS
More informationQUESTION: ARE THE SALES OF TAXPAYER S HOMEOPATHIC REMEDIES (LISTED AND DESCRIBED IN EXHIBIT A) SUBJECT TO FLORIDA S SALES TAX?
Executive Director Marshall Stranburg QUESTION: ARE THE SALES OF TAXPAYER S HOMEOPATHIC REMEDIES (LISTED AND DESCRIBED IN EXHIBIT A) SUBJECT TO FLORIDA S SALES TAX? ANSWER: THE SALE OF TAXPAYER S HOMEOPATHIC
More informationHow To Pay For Medical Expenses
The Medical Flexible Spending Account is used for tax-deductible health care expenses not paid by insurance for yourself, your spouse and anyone you claim as a dependent on your federal income tax return.
More informationELIGIBLE EXPENSES. FSA Eligible & Ineligible Expenses MEDICAL/PRESCRIPTIONS DENTAL VISION
ELIGIBLE EXPENSES MEDICAL/PRESCRIPTIONS Acupuncture - if to treat a medical condition Ambulance Expenses Artificial Limbs/Prosthetics Breast Reconstruction Surgery - following a mastectomy to ameliorate
More informationFSA Health Care Eligible & Ineligible Expense Items. FSA Eligible Health Care Expenses
FSA Eligible Health Care Expenses Acupuncture Alcoholism Treatment Ambulance Artificial Limb Autoette/Wheelchair Bandages Braille Books and Magazines Breast Pumps and Lactation Supplies Chiropractor Christian
More informationHealth Savings Accounts (HSAs)
Health Savings Accounts (HSAs) What does the Beniversal HSA provide? Tax-free savings on eligible medical expenses for today and tomorrow. A savings opportunity! You own the account. Funds carry over from
More informationWelcome. What s Inside. Have questions? A Guide to Your Flexible Spending Account (FSA) As you start the new plan year, remember that:
Welcome A Guide to Your Flexible Spending Account (FSA) As you start the new plan year, remember that: ``You are saving tax dollars. You won t pay taxes when you use your money for eligible health and/or
More informationPATIENT INSTRUCTIONS PRIOR TO MOHS SURGERY
Columbia University Medical Center New York Presbyterian Hospital Director Unit for Dermatologic Surgery and Cutaneous Oncology Mohs Micrographic Surgery Laser Surgery Site: Lesion: Size: For an appointment
More informationOhio Medicaid Fee-For-Service Cough and Cold Drug List Effective October 1, 2013 $ 2 Co-Pay May Apply
NDC ANALGESICS Label Name Generic Drug Name Drug Strength Dosage Form 00713011801 ACEPHEN 120 MG SUPPOSITORY ACETAMINOPHEN 120 MG SUPP.RECT 45802073233 ACETAMINOPHEN 120 MG SUPPOSITORY ACETAMINOPHEN 120
More informationHEALTH SAVINGS ACCOUNT BASICS
HEALTH SAVINGS ACCOUNT BASICS WHAT IS A HEALTH SAVING ACCOUNT? A Health Savings Account (HSA) is a tax-favored account which you and your employer can make contributions to pay for qualified medical expenses
More informationAdvantageOptimum Plan (HMO)
CARE1ST PRE-EnRollmEnT Book 2014 ALAMEDA, SAN FRANCISCO & SANTA CLARA COUNTIES H5928_14_119_MKB Accepted Thank you for Your Interest in TABLE OF CONTENTS 1. Thank you for Your Interest in / Table of Contents
More information2015 Plan Guide ALLEGIAN ADVANTAGE (HMO) H8554_013-2015 Accepted
2015 Plan Guide ALLEGIAN ADVANTAGE (HMO) H8554_013-2015 Accepted Allegian Advantage is an HMO plan. We proudly serve Texas residents in Cameron, Hidalgo and Willacy counties, offering doctor, hospital
More informationFSA Eligible Expenses Crosby Benefit Systems, Inc. www.crosbybenefits.com Version: 04/19/2011
FSA Expenses www.crosbybenefits.com Version: 04/19/2011 Please Note: Effective January 1, 2011, all over-the-counter (OTC) medications and drugs must be prescribed by a physician to be eligible for reimbursement.
More informationFlexible Spending Account Enrollment Guide
Flexible Spending Account Paying for healthcare is now easier and less expensive with a Flexible Spending Account (FSA) from ConnectYourCare. What is a Flexible Spending Account (FSA)? A Flexible Spending
More informationIRS Eligible Expenses (Frequently Asked About)
IRS Eligible Expenses (Frequently Asked About) RX (Prescription) Co-payment (Medical) Office visit (Medical) Dental (for non-cosmetic purposes) Over-the-counter (OTC) As of 1/1/2011 Over-the-counter medicines
More informationFSA Eligible Expenses Crosby Benefit Systems www.crosbybenefits.com v09122014
FSA Expenses All over-the-counter (OTC) medications and drugs must be prescribed by a physician to be eligible for reimbursement. This change was effective January 1, 2011, regardless of your plan year.
More informationFSA Eligible Expenses Crosby Benefit Systems www.crosbybenefits.com v04072014
FSA Expenses All over-the-counter (OTC) medications and drugs must be prescribed by a physician to be eligible for reimbursement. This change was effective January 1, 2011, regardless of your plan year.
More informationDiabetic supplies Diagnostic items/services Diaper rash ointments/creams Diarrhea medication
Flexible Spending Account Eligible Expenses Your Health Care Reimbursement Flexible Spending Account lets you pay for medical care expenses not covered by your insurance plan with pre-tax dollars. The
More informationFlexible Spending Accounts
Flexible Spending Accounts FLEX Your Check Get More Muscle from Your Pay Oakland University Flexible Spending Account Flexible Spending Accounts let you set aside money from your paycheck before federal,
More informationHome medical equipment and supplies In addition to our wide selection of equipment and supplies, we offer expert assistance to help you or your loved
Home medical equipment and supplies In addition to our wide selection of equipment and supplies, we offer expert assistance to help you or your loved ones find the right products for security, independence
More informationFlexible Spending Account (FSA)
Flexible Spending Account (FSA) A Flexible Spending Account (FSA) is a benefit governed by the IRS and sponsored by your employer. An FSA allows you to pay certain Health Care and/or Dependent Care expenses
More informationcall 811 to get advice from a nurse, or have someone drive the patient to a hospital Emergency Department. Patients should NOT drive themselves.
Taking Care at Home After Surgery This checklist is to help you and your support person know what to do after you go home following your surgery. If you are given instructions verbally or in writing by
More informationFSA FAQs. 3. What happens if I don t use all the money in my FSA by the end of the plan year?
FSA FAQs Get the answers you re looking for 1. What is a Health Care FSA? 2. How is using an FSA like giving myself a raise? 3. What happens if I don t use all the money in my FSA by the end of the plan
More informationFlexible Spending Accounts
Flexible Spending Accounts A Flexible Spending Account (FSA), also known as a Section 125 Flexible Benefit Plan or Cafeteria Plan is a voluntary, tax-free way for employees to save for qualified medical,
More informationPOTENTIALLY ELIGIBLE* ELIGIBLE YES
MEDICAL FLEXIBLE SPENDING ACCOUNT EXPENSES Abortion Acne Treatment Acupuncture Adaptive Equipment Alcoholism treatment Allergy medicine Alternative healers/chinese herbal Ambulance Appearance Improvements
More informationCITY OF NEW BERN. A Guide To Your Flexible Spending Account
CITY OF NEW BERN A Guide To Your Flexible Spending Account FSA Reminders for City of New Bern Group number: 212 Plan year: 07/01/15-06/30/16 FSA Reimbursement checks: Claims are processed weekly. Healthcare
More informationHealth Care Eligible Items
Health Care Eligible Items Your Health Care Flexible Spending Account (FSA) is a smart way to save money on everyday expenses! Take a moment to review the following items for eligibility as outlined by
More informationDRUG INTERACTIONS: WHAT YOU SHOULD KNOW. Council on Family Health
DRUG INTERACTIONS: WHAT YOU SHOULD KNOW Council on Family Health Drug Interactions There are more opportunities today than ever before to learn about your health and to take better care of yourself. It
More informationQUALIFIED FSA EXPENSES (For Health Care Flexible Spending Accounts)
QUALIFIED FSA EXPENSES (For Health Care Flexible Spending Accounts) * This list is by no means exhaustive. Please consult IRS 213 for additional information, or contact MGIS directly (flexinfo@mgis.com).
More informationUT FLEX Plan Year: 9/1/2009 8/31/2010. Flexible Spending Account
UT FLEX Plan Year: 9/1/2009 8/31/2010 Flexible Spending Account What will be covered? UT FLEX Flexible Spending Account (FSA) Eligible / Ineligible Healthcare Expenses UT FLEX Card (optional) Grace Period
More informationItems generally considered Eligible from IRS Publication 502
This list has been compiled for the convenience of our clients and participants and is designed to provide a general overview of expenses that may be eligible under section 213(d) of the Internal Revenue
More informationGeorgia s health care choice. Member. Handbook
Georgia s health care choice Member Handbook 2011-2013 WELCOME TO WELLCARE We are glad you joined our family! WellCare is the health care plan that really puts you in control. You can choose from a large
More informationGeneral Information for Prospective Seminarians Fall 2015
General Information for Prospective Seminarians Fall 2015 New seminarians are to arrive for the Fall semester on Saturday, August 15, 2015 by 1:00 PM. Should you need to arrive before or after August 15,
More informationAdvantages of a Flexible Spending Account
Advantages of a Flexible Spending Account Increase Your Take-Home Pay by Reducing Your Taxable Income! A Flexible Spending Account (FSA) allows you to save up to 30% on your eligible healthcare and/or
More informationYOU RE GOING TO NEED A BIGGER BANK. BASIC FLEX
YOU RE GOING TO NEED A BIGGER BANK. BASIC FLEX GET MORE OUT OF YOUR PAYCHECK. Do you pay medical expenses? How about insurance premiums? Child care? If you answered yes to any of these questions then keep
More informationNO-COST PREVENTIVE CARE DRUGS
NO-COST PREVENTIVE CARE DRUGS INFORMATION FOR NON-GRANDFATHERED ASO GROUPS The Affordable Care Act (ACA) requires that certain preventive care drugs and drug categories be covered at no cost to health
More informationHealth and Wellness Preference Data Segments Arts & Entertainment > Reading > Health Baby Health & Safety Beauty, Health & Fitness > Cosmetics &
Health and Wellness Preference Data Segments Arts & Entertainment > Reading > Health Baby Health & Safety Beauty, Health & Fitness > Cosmetics & Beauty Products Beauty, Health & Fitness > Fitness & Exercise
More informationFlexible Spending Accounts
A l l i a n c e B e n e f i t G r o u p ( 8 5 5 ) 8 6 6-8 0 6 0 w w w. a b g a c c e s s. c o m Flexible Spending Accounts A Flexible Spending Account (FSA), also known as a Section 125 Flexible Benefit
More informationFlexible Spending Account (FSA) Enrollment Kit. Significant savings 24/7 web access Fast, efficient, convenient The benefit that benefits everyone
Flexible Spending Account (FSA) Enrollment Kit Significant savings 24/7 web access Fast, efficient, convenient The benefit that benefits everyone The FSA Plan A Flexible Spending Account (FSA) is an employee
More informationNote: Unless we have parental authorization, we CANNOT administer ANY medications.
Appendix B: Cleveland State University Youth Program/Camp Parent/Guardian Authorization, Waiver and Consent for Over-the-Counter Medication Form PROGRAM/CAMP INFORMATION Program/Camp Name: (hereafter Program
More informationDependent Care Assistance Account (Dependent Care FSA) For your expenses related to dependent day care such as after school child care.
Flexible Spending Accounts (FSA) Health Care Reimbursement Account (Health FSA) For your out-of-pocket medical, dental, vision and hearing expenses. You and your dependents do not have to be covered under
More informationOver-the-Counter Drug List
Over-the-Counter Drug List This list includes some of the over-the-counter drugs covered by Passport Health Plan. To get these covered, you must have a prescription from your doctor. NOTE: Generic is always
More informationRosemount-Apple Valley-Eagan School District #196 Flexible Spending Account (FSA) Benefit Guide 2014-2015
Rosemount-Apple Valley-Eagan School District #196 Flexible Spending Account (FSA) Benefit Guide 2014-2015 Plan Outline Administrator: Corporate Health Systems, Inc. Local Phone: (952) 939-0911 Toll Free
More informationList of Covered Drugs for 2015. (Medicaid Formulary)
List of Covered s for 2015 (Medicaid Formulary) Name Respiratory Tract/Pulmonary Agents Respiratory Tract Agents, Other hydrocodone bitartrate/homatropine methylbromide tablet 3 DP 1.5mg; 5mg hydrocodone
More informationOF INSURANCE, MEDICAID, OR MEDICARE CARDS IN THE BOXES BELOW.
MEDICAL INFORMATION PAGE CAMP LOYALTOWN 2016 INDIVIDUAL S NAME: Dear Parents and Guardians, Please submit this form with the required information attached, signed and dated. If the medical forms will cover
More informationPrescription Drug Plan
Prescription Drug Plan The prescription drug plan helps you pay for prescribed medications using either a retail pharmacy or the mail order program. For More Information Administrative details and procedures
More informationCAMPER HEALTH HISTORY FORM 1
CAMPER HEALTH HISTORY FORM 1 Developed and reviewed by: American Camp Association, American Academy of Pediatrics Council on School Health, & Association of Camp Nurses Dates will attend camp: from to
More informationAnnual Notice of Changes for 2015
Dear Member: Liberty Health Advantage Dual Power (HMO SNP) Offered by Liberty Health Advantage, Inc. Annual Notice of Changes for 2015 You are currently enrolled as a member of Liberty Health Advantage
More informationPost-operative Instructions Following Rhinoplasty
Post-operative Instructions Following Rhinoplasty Early healing of the nose depends upon how well you take care of yourself after surgery. Please review the following instructions before surgery and ask
More informationExamples of Gemini Pharmaceuticals Common Supplement Products
Examples of Gemini Pharmaceuticals Common Supplement Products CALCIUM Calcium 600mg Calcium 600mg with Vitamin D 200 Calcium 600mg with Vitamin D 400 Calcium 600mg with Vitamin D 800 Calcium 600mg with
More information2014 Summary of Benefits
P.O. Box 52424, Phoenix, AZ 85072-2424 SilverScript (Employer PDP) sponsored by REHP 2014 Summary of Benefits SilverScript (Employer PDP) is a Prescription Drug Plan. This plan is offered by SilverScript
More informationYour Guide to Coumadin / Warfarin Therapy
Your Guide to Coumadin / Warfarin Therapy 5 Things You MUST Know About Coumadin (Generic Name Warfarin) 1. You must have your blood checked regularly to prevent clots and bleeding. 2. Many medicines interact
More informationOxford Centre for Head and Neck Oncology. Sore Mouth or Throat (Mucositis) Dry Mouth (Xerostomia) Oral Thrush (Candida) Information for patients
Oxford Centre for Head and Neck Oncology Sore Mouth or Throat (Mucositis) Dry Mouth (Xerostomia) Oral Thrush (Candida) Information for patients This leaflet gives you some suggested remedies which previous
More informationFlexible benefits plan (Section 125)
C Flexible benefits plan (Section 125) Dedicated to the educational community At Horace Mann, we believe educators are taking care of our children s future, and we need to take care of theirs. While other
More informationwww.tripmomlists.com Trip Mom: Lists
General items for family list sunscreen bug spray tissues First Aid kit (as applicable): bandages antibacterial ointment medicine* (pain relievers, allergy, etc.) calamine lotion gauze tape cold compress
More informationFSA. Flexible Spending Account Overview Medical Reimbursement Accounts Dependent Care Reimbursement Accounts. Business Solutions
FSA Flexible Spending Account Overview Medical Reimbursement Accounts Dependent Care Reimbursement Accounts Business Solutions What is a Flexible Spending Account? A Flexible Spending Account is offered
More informationPre-Tax Benefit Plan
Pre-Tax Benefit Plan Berkeley Unified School District Plan Year: January 1, 2014 through December 31, 2014 This packet includes: Flex Plan Summary Parking and Transit Enrollment & Change Form Your Flex
More informationFLEXIBLE SPENDING ACCOUNT. Lower taxes. More take home pay.
FLEXIBLE SPENDING ACCOUNT Lower taxes. More take home pay. FLEXIBLE SPENDING ACCOUNT [FSA] WHAT IS A FLEXIBLE SPENDING ACCOUNT? [FSA] A Flexible Spending Account is a program that the Federal Government
More informationPrescription Drug Rider
Prescription Drug Rider This Rider is part of the Evidence of Coverage and is effective on the date Your group is effective or renews its coverage with Southern Health Services, Inc. Benefits are available
More informationCONEXIS Benefit Card Frequently Asked Questions
CONEXIS Benefit Card Frequently Asked Questions What is the CONEXIS Benefit Card? The CONEXIS Benefit Card is a stored-value card that simplifies the process of paying for qualified health flexible spending
More informationMass Group Marketing, Inc.
Guide to Eligible Health and Dependent Care Flexible Spending Account Expenses Mass Group Marketing, Inc. A Section 125 Cafeteria Plan offered by Mass Group Marketing, Inc. A Section 125 Plan is a part
More information!nnual Notice of Changes for 2015
Central Health Medi-Medi Plan (HMO SNP) offered by Central Health Plan of California!nnual Notice of Changes for 2015 You are currently enrolled as a member of Central Health Medi-Medi Plan (HMO SNP).
More informationFall 2015 Health & Family Newsletter
Fall 2015 Health & Family Newsletter In This Issue Improving Services to Molina Healthcare Members... 1-2 Where to Find Answers to Drug Benefits...3 ID Cards...3 Protecting Your Privacy... 4-5 Prevent
More information2015 SUMMARY OF BENEFITS
2015 SUMMARY OF BENEFITS January 1, 2015 December 31, 2015 Community (HMO SNP) H3818, Plan 2 FamilyCare Health Plans, Inc. 825 NE Multnomah, Suite 1400 Portland, OR 97232 866-225-CARE (2273) Toll-Free
More informationa unique approach to HR technology and managing benefits administration The Full Benefits of a Flexible Spending Account with a Debit Card
a unique approach to HR technology and managing benefits administration The Full Benefits of a Flexible Spending Account with a Debit Card What Is A Flexible Spending Account? Flexible Spending Account
More informationCHOTA COMMUNITY HEALTH SERVICES - SCHOOL-BASED HEALTH CLINIC
CHOTA COMMUNITY HEALTH SERVICES - SCHOOL-BASED HEALTH CLINIC STUDENT Health History Annual Update 2015-2016 Student's Name: Date of Birth: Phone Number: Grade: Primary Care Doctor: Dr's Phone Number: Pharmacy:
More informationAnnual Notice of Changes for 2016
Central Health Focus Plan (HMO SNP) offered by Central Health Plan of California Annual Notice of Changes for 2016 You are currently enrolled as a member of Central Health Focus Plan. Next year, there
More informationImportant information about our provider directory
Important information about our provider directory This online directory provides a list of Aetna Medicare Plan (HMO) (PPO) network providers. To get detailed information about your health care coverage,
More informationYour Vitamin and Mineral Needs Before and After Bariatric Surgery
UW MEDICINE PATIENT EDUCATION Your Vitamin and Mineral Needs Before and After Bariatric Surgery Basic guidelines This handout for patients preparing for bariatric surgery gives basic guidelines for choosing
More informationLeading the Consumer Health Products Market in Canada (1)
Executive Summary Updating Tax Policy to Support Responsible Self-Care The vast majority of Canadians treat their minor ailments through self-care with consumer health products, including over-the-counter
More informationExtra! Extra! Read all about our special benefits and services. KS-MEM-0167-13 10.13 (Plus)
Extra! Extra! Read all about our special benefits and services. KS-MEM-0167-13 10.13 (Plus) Welcome to Amerigroup Kansas! We re happy you re with us. We cover all of your KanCare benefits. Plus we offer
More informationGuidelines for Surgical Patients
Guidelines for Surgical Patients Guidelines for Surgical Patients We are pleased that you and your physician have selected us to provide your surgical care. Everyone associated with the hospital is dedicated
More informationFor Pediatric Oncology Patients and Families
Atlantic Provinces Pediatric Hematology Oncology Network Réseau d oncologie et d hématologie pédiatrique des provinces de l Atlantique 5850/5980 University Avenue, PO Box 9700, Halifax, NS, B3K 6R8, 1.902.470.7429,
More informationAC Chemotherapy Regimen (Doxorubicin + Cyclophosphamide)
AC Chemotherapy Regimen (Doxorubicin + Cyclophosphamide) AC is a regimen or treatment plan that includes a combination of chemotherapy drugs that your doctor prescribed for the treatment of your cancer.
More informationFlexible spending account expense guide
Flexible spending account expense guide or the UniAccount SM FSA This guide provides details about: Things that are and are not allowed expenses for the FSA. These lists are based on IRS rules. Keep in
More informationFlexible. Spending Accounts. Instructions for using your. Medical Care Flexible Spending Accounts. Dependent Care Flexible. Spending Accounts.
Medical Care Flexible Spending Accounts Instructions for using your Flexible Spending Accounts Dependent Care Flexible Spending Accounts FAQ s Requesting Reimbursement Account Balance Customer Service
More informationRetail Prescription Program Drug List
Retail Prescription Program Drug List Price Matters New Men s Health Category Convenience Free Home Delivery Our 4 prescriptions have saved our customers over 3 billion The program is available to everyone,
More informationPreventing Bleeding When You Have a Low Platelet Count
PATIENT EDUCATION patienteducation.osumc.edu Preventing Bleeding When You Have a Low Platelet Count What is a low platelet count? A platelet count measures the number of platelets you have in your blood.
More informationAnnual Notice of Changes for 2016
Central Health Medicare Plan (HMO) offered by Central Health Plan of California Annual Notice of Changes for 2016 You are currently enrolled as a member of Central Health Medicare Plan. Next year, there
More informationPRODUCT LIST BY THERAPEUTICS
Jaapharm Canada Inc. 510 Rowntree Dairy Road, Building J, Woodbridge, Ontario, Canada L4L 8H2 Tel.: 905-851-7885 Canada/USA: 1-800-465-9587 Fax: 905-856-5838 Canada/USA: 1-888-606-4777 Email: info@jaapharm.com
More informationAdded 1 Sundown Lycopene
CLASS 1 / 2 STORES NORTHEAST/CENTRAL/SOUTHERN/MIDWEST MARKETING AREA Added 1 Lycopene 7.12 in 7.12 in 6 in 5 in One A Day Womens Centrum Tablets Prenatal Vitamin Adora Dark 30005445171 1650055281 Chocolate
More informationCHECK LIST FOR COLONOSCOPY 2 DAY PREP
CHECK LIST FOR COLONOSCOPY 2 DAY PREP Medication Sheet: Fill out & take to Day Surgery on day of procedure Pre-Register - by phone: 979-299-2888 Blood Thinning Medications: Hold for 5 days prior to procedure
More information2016 PHARMACY. Benefit Summary Book. RXSUMBK2016 www.fepblue.org
2016 Benefit Summary Book RXSUMBK2016 www.fepblue.org REVIEW THIS SUMMARY BOOKLET TO LEARN HOW TO GET THE MOST FROM YOUR PRESCRIPTION BENEFIT. THIS INCLUDES INFORMATION ABOUT: n Your prescription drug
More informationFlexible Spending Accounts (FSAs) & Dependent Care Accounts (DCAs)
What s Inside: What is an FSA? Benefits of Debit Mastercard Rules and Restrictions FSA Worksheet Eligible/Ineligible Expenses Claims Procedures FAQs Inventory Information Approval System (IIAS) Important
More informationDELETED 20525-11741 ADDED 20525-11780
7.12 in 9 in 7.8 6 in Centrum Tablets 30005445171 Shelf: 1 Centrum Flavor Burst Chews Mixed Fruit 30005490092 Shelf: 2 Centrum Silver Ultra Women 30005475650 Shelf: 3 Centrum Silver Ultra Men 30005475850
More information