OVER-THE-COUNTER PRODUCTS CATALOG. Cigna-HealthSpring SpecialCare of Illinois CarePack 2016

Transcription

1 OVER-THE-COUNTER PRODUCTS CATALOG Cigna-HealthSpring SpecialCare of Illinois CarePack 2016 ICP_16_34894 Approved

2 2 All Cigna products and services are provided exclusively by or through operating subsidiaries of Cigna Corporation, including HealthSpring of Tennessee, Inc. The Cigna name, logos, and other Cigna marks are owned by Cigna Intellectual Property, Inc. You can get this document in Spanish, or speak with someone about this information in other languages for free. Call (TTY 711). The call is free. Puede recibir este documento en español, o hablar con alguien sobre esta información en otro idioma, sin costo alguno. Llame al (TTY 711), Monday to Friday, 8 a.m. - 5 p.m. La llamada es gratis. Limitations and restrictions may apply. For more information, call Cigna-HealthSpring SpecialCare of Illinois Customer Service or read the Cigna-HealthSpring SpecialCare of Illinois Member Handbook. Call the Illinois Client Enrollment Services at Monday to Friday 8 a.m. to 7 p.m. and Saturdays 9 a.m to 3 p.m. (TTY: ), or visit Cigna

3 YOUR CAREPACK Order your Cigna-HealthSpring CarePack today! Use your $10 a month allowance toward over-the-counter medicines and products. Enjoy FREE delivery to your door. It s easy. Follow the steps below. 1 Choose from the covered list of Cigna-HealthSpring CarePack medicines and products in this catalog. 2 Call Cigna-HealthSpring Over-the-counter Center at (TTY 711), Monday to Friday, 7 a.m. to 8 p.m. Central Time. 3 Double-check your mailing address while you are on the phone. We want to make sure you get your over-the-counter items delivered correctly. For additional questions, contact Customer Service at (TTY 711) Monday to Friday 8 a.m. to 5 p.m. Central Time. DID YOU KNOW? CarePack is an easy way to get your over-the-counter items and keep money in your pocket. 3

4 YOUR CAREPACK Cigna-HealthSpring CarePack covers over-the-counter medicines and products. We ll deliver your items to your door FREE of charge. Available only through Cigna- HealthSpring, CarePack gives each member $10 per month to order common over-the-counter medicines and items that do not need a prescription. We will track your order through your Cigna-HealthSpring member ID number (you can find this number on your member ID card). If there is more than one Cigna-HealthSpring member in your home, please note that each Cigna-HealthSpring CarePack order will be processed separately. This monthly benefit includes over-the-counter medicines and items such as aspirin, vitamins, dental care items, and more. Unused balances are not carried over from month to month and you are allowed only one order per month. The total cost of items you pick must be less than or equal to your $10 allowance in order for the items to be shipped. Please allow up to two weeks for delivery. Once you receive the medicines and products, they cannot be returned. Residents of nursing facilities should check to find out which Cigna- HealthSpring CarePack products may be shipped to their facility before ordering. Product ordering policies may vary by facility. Look up your preferred over the-counter items in the catalog index on the next page. Over-the-counter items may only be ordered for the plan enrollee to address a personal health or medical need. Cigna-HealthSpring does not allow the purchase of overthe-counter items for family members and friends. 4

5 BRAND NAME INDEX Brand Catalog Item Page 21st Century Glucosamine Joint/Muscle 8 Ace Ankle Support 9 Elastic Bandage 2 in x 5 yd 10 Elastic Bandage 3 in x 5 yd 10 Elastic Bandage 4 in x 5 yd 10 Elastic Bandage 6 in x 5 yd 10 Advil Ibuprofen 12 Afrin Nasal Decongestant Spray 7 Aleve Naproxen 12 AmLactin Ammonium Lactate 12 Anbesol Oral Pain Relief 9 Bacitracin Bacitracin Ointment 12 Band-Aid Generic Sheer Assorted Bandages 10 Bayer Aspirin 11 BD Digital Thermometer Digital Oral Thermometer 9 Benadryl Children s Diphenhydramine 7 Diphenhydramine HCL (antihistamine) 7 Diphenhist (antihistamine) 7 Benadryl (Itch Stop) Diphenhydramine HCL/Zinc Acetate Bengay Pain Relieving Muscle Rub 12 Bonine Meclizine 11 Breathe Right Nasal Strips Medium 12 Nasal Strips Large 12 Caltrate Calcium Carbonate 11 Caltrate-D Calcium-Vitamin D 11 Capzasin Capsaicin 8 Centrum Daily Multiple Vitamin 12 Cepacol Sore Throat Lozenges 8 Children s Tylenol Children s Acetaminophen 11 8 Brand Catalog Item Page Chlor-Trimeton Chlorpheniramine Maleate 7 Clean and Clear Acne Gel 10% Benzoyl Peroxide 7 Colace Docusate Sodium 10 Colgate Colgate Toothbrush 9 Compound W Wart Remover 13 Coppertone Sunscreen Lotion SPF Cortaid Hydrocortisone 1% Cream 8 Curad Alcohol Pads 9 First Aid Kit 10 Dimetapp Children s Dimaphen 7 Dramamine Driminate 11 Dramamine Orange 11 Ecotrin Aspirin 81 mg 11 Aspirin (Enteric Coated) 11 Efferdent Denture Cleaning tablets 9 Excedrin Migraine Migraine Relief 10 Feosol Ferrous Sulfate 11 Fergon Ferrous Gluconate 12 Fibercon Fiber tablets 10 Fixodent Fixodent 9 Fleet Glycerin Suppository 10 Flintstones Children s Multi Vitamin 12 Fruit of the Earth Aloe Vera Cream 12 Gyne-Lotrimin Clotrimazole Vaginal Cream w/ Applicator 1% 8 Hall s Cough Drops 8 Herpecin-L Herpecin-L Lip Balm 8 Hydrogen Peroxide Hydrogen Peroxide 10 Imodium A-D Loperamide HCL 8 Lotrimin AF Clotrim Antifungal 1 oz 8 Maalox Antacid/Anti-Gas Liquid 7 Metamucil Natural Vegetable Laxative 10 5

6 BRAND NAME INDEX Brand Catalog Item Page Motrin Children s Children s Ibuprofen 11 Murine Ear Drops 9 Ear Wax Removal System 9 Nature Made Magnesium Oxide 11 Neosporin Triple Antibiotic Ointment 12 Nexcare Hot/Cold Packs for Injuries 10 Niacin Niacin 11 Ocean Nasal Saline Spray 7 Pepcid Famotidine 7 Pepsodent Pepsodent Toothpaste 9 Pepto-Bismol Bismatrol (Bismuth Subsalicylate) 8 Pink Bismuth 8 Phillips Milk of Magnesia 10 Preparation H Hemorrhoid Ointment 10 Purell Hand Sanitizer 12 Refresh Artificial Tears 9 Refresh PM Artificial Tears Ointment 9 Renu Multi-Purpose Contact Lens Solution 8 Rid Pediculicide 12 Robitussin Guaifenesin Cough Expectorant (tablets) 8 Cough Syrup, Expectorant 8 Senokot-S Senna Plus 10 Brand Catalog Item Page Sudafed PE Sudogest PE (nasal and sinus decongestant) 7 Tek-Pro Tek-Pro Toothbrush 9 Tinactin Tolnaftate 8 Tucks Pre-Moist Hemorrhoidal Pads 10 Tums Chewable Antacid 11 Tylenol Acetaminophen 7 Tylenol Cold Multisymptom Tylenol Extra Strength Multi-Symptom Cold Formula Acetaminophen 7 Unisom Sleep tablets 12 Vicks NyQuil All-Nite Cold/Flu 7 Visine Eye Drops (redness relief) 9 Vitamin A Vitamin A 12 Vitamin B Complex Vitamin B Complex 12 Vitamin B-1 Vitamin B-1 12 Vitamin B-12 Vitamin B Vitamin B-6 Vitamin B-6 13 Vitamin C Vitamin C 13 Vitamin D Vitamin D 13 Vitamin E Vitamin E 13 Zyrtec All Day Allergy tablets (TTY 711) You can place your CarePack order Monday - Friday, 7 a.m. to 8 p.m. Central Time 6

7 CAREPACK MEDICATIONS AND PRODUCTS Before ordering any of the items below, you should talk with your doctor. Category Product Item # Brand/Description Cost Acne Treatment Acne Gel 10% Benzoyl Peroxide 1076 Compare to Clean and Clear, 1.5 oz tube; A registered trademark of Johnson & Johnson Consumer Companies, Inc. Allergy, Cold, Flu Decongestant and Sinus All Day Allergy tablets 1090 All-Nite Cold/Flu 1361 Compare to Zyrtec, 10 mg tablets, 14 per box; A registered trademark of McNeil-PPC, Inc. Compare to Vicks NyQuil Cough, 4 oz per bottle; A registered trademark of Procter & Gamble $7.00 $7.00 Children s Dimaphen 1426 Compare to Dimetapp Children s, 4 oz bottle; A registered trademark of Pfizer Consumer Healthcare Children s Diphenhydramine HCL 1428 Compare to Benadryl Children s, 4 oz bottle; A registered trademark of McNeil-PPC, Inc. $7.00 Chlorpheniramine Maleate 1008 Compare to Chlor-Trimeton Allergy, 4 mg tablets, 100 per box; A registered trademark of Schering-Plough HealthCare Products, Inc. Diphenhist (antihistamine) 1308 Compare to Benadryl, 25 mg tablets,100 per box; A registered trademark of Pfizer Consumer Healthcare Diphenhydramine HCL 25mg 1009 Compare to Benadryl, 24 per pack; A registered trademark of Pfizer Consumer Healthcare Multi-Symptom Cold Formula 1357 Compare to Tylenol Cold Multisymptom, 24 tablets; A registered trademark of McNeill-PPC, Inc. Nasal Decongestant Spray 12hr 1091 Compare to Afrin, 1 oz spray; A registered trademark of Schering-Plough HealthCare Products, Inc. Nasal Saline Spray 1052 Compare to Ocean Premium Saline Nasal Spray, 1.5 oz spray; A registered trademark of Fleming Pharmaceuticals Sudogest PE (nasal and sinus decongestant) 1352 Compare to Sudafed PE, 36 tablets per box; A registered trademark of Johnson & Johnson Corporation Antacids and Acid Reducers Antacid/ Anti-Gas Liquid 1006 Compare to Maalox Regular Strength,12 oz per bottle; A registered trademarkof William H. Rorer, Inc. Chewable Antacid 1346 Compare to Tums, 150 tablets per bottle; A registered trademark of SmithKline Beecham Famotidine 1108 Compare to Pepcid, 10 mg tablets, 30 per box; A registered trademark of Merck & Co., Inc. Anti-Arthritic Acetaminophen 1105 Compare to Tylenol Extra Strength; 50 tablets; A registered trademark of McNeill-PPC, Inc. $8.00 7

8 CAREPACK MEDICATIONS AND PRODUCTS Category Product Item # Brand/Description Cost Anti-Arthritic Capsaicin 1367 Compare to Capzasin, 2 oz per tube; A registered trademark of Chattam Laboratories $10.00 Glucosamine Joint/Muscle 1114 Compare to 21st Century; 60 capsules; A registered trademark of 21st Century Healthcare, Inc. $10.00 Anticandidal (yeast) Clotrimazole Vaginal Cream w/ applicator 1% 1115 Compare to Gyne-Lotrimin, 45 gm per tube; A registered trademark of Schering-Plough HealthCare Products, Inc. $7.00 Antidiarrheal Bismatrol (Bismuth Subsalicylate) 1045 Compare to Pepto-Bismol, 30 chewable tablets per box; A registered trademark of Proctor & Gamble Pink Bismuth 1318 Compare to Pepto-Bismol, 8 oz per bottle; A registered trademark of Procter & Gamble Loperamide HCL 1133 Compare to Imodium A-D, 2 mg tablets, 12 per box; A registered trademark of McNeil-PPC, Inc. Antifungal Clotrim Antifungal Cream 1 oz Compare to Lotrimin AF, 1 oz per tube; A registered trademark of Schering-Plough HealthCare Products, Inc. Tolnaftate 1% Cream 1064 Compare to Tinactin,.5oz per tube; A registered trademark of Schering-Plough HealthCare Products, Inc. Anti-Itch Lotions and Creams Diphenhydramine HCL/Zinc Acetate Hydrocortisone 1% Cream Compare to Benadryl Anti-Itch, 1 oz per tube; A registered trademark of Pfizer Consumer Healthcare Compare to Cortaid Cream, 1 oz per tube; A registered trademark of Johnson & Johnson Corporation Cold Sore, Fever Blister, and other Medicated Lip Products Herpecin-L Lip Balm 1153 Compare to Herpecin-L Lip Balm, 0.1 oz per stick; A registered trademark of Chattem, Inc. $8.00 Contacts Lens Supplies Multi-Purpose Contact Lens Solution 1468 Compare to Renu Multi-Purpose Solution, 120 ml per bottle; A registered trademark of Bausch & Lomb Cough Suppressants and Expectorants Cough Drops 1056 Guaifenesin Cough Expectorant (tablets) 1180 Compare to Hall s Cough Drops, 30 Lozenges; A registered trademark of Mondelēz International, Inc. Compare to Robitussin, 200 mg tablets, 60 per bottle; A registered trademark of Pfizer-Wyeth Consumer Healthcare $7.00 Cough Syrup, Expectorant 1054 Compare to Robitussin, 4 oz per bottle; A registered trademark of Pfizer-Wyeth Consumer Healthcare Sore Throat Lozenges 1360 Compare to Cepacol, 16 lozenges per box; A registered trademark of Rickett Benckiser $7.00 8

9 Category Product Item # Brand/Description Cost Dental/Denture Colgate Toothbrush Compare to Colgate Toothbrush; A registered 1413 Care - Adult Soft trademark of Procter & Gamble Ear Care Eye Care First Aid and Medical Supplies Denture Cleaning tablets Compare to Efferdent Anti-Bacterial Denture 1032 Cleanser, 40 tablets per box; A registered $7.00 trademark of Medtech Products Compare to Fixodent, 0.75 oz per tube; A Fixodent 1187 $7.00 registered trademark of Procter & Gamble Compare to Anbesol,.5 oz; A registered trademark Oral Pain Relief 1286 of American Home Products Corporation Pepsodent Toothpaste Tek-Pro Toothbrush (Soft) Compare to Pepsodent Toothpaste, 6 oz per tube; A 1414 registered trademark of Church & Dwight Co., Inc. Compare to Tek-Pro Toothbrush; A 1412 $4.00 registered trademark of Dr. Fresh Compare to Murine Ear Drops, 15 ml per bottle; A Ear Drops 1190 registered trademark of Prestige Brands International, Inc. Ear Wax Removal System (w/ Rubber) Compare to Murine Ear Wax Removal System, ml per bottle with syringe; A registered trademark of Prestige Brands International, Inc. Compare to Refresh,.5 oz per bottle; A Artificial Tears 1192 registered trademark of Allergan Inc. Artificial Tears Ointment Eye Drops (redness relief) Compare to Refresh PM, 3.5 gm per tube; A 1194 registered trademark of Allergan Inc. Compare to Visine Original, 15 ml per bottle; A 1061 registered trademark of McNeill-PPC, Inc. Compare to Curad Alcohol Swabs, 100 per Alcohol Pads 1200 box; A registered trademark of Medline Inc. Compare to Ace Elastic Ankle Support, 1 per pack; A Ankle Support 1225 $8.00 registered trademark of 3M Consumer Healthcare Digital Oral Thermometer Compare to BD Digital Thermometer, 1 per pack; A 1063 registered trademark of Becton Dickinson and Company (TTY 711) You can place your CarePack order Monday - Friday, 7 a.m. to 8 p.m. Central Time 9

10 CAREPACK MEDICATIONS AND PRODUCTS Category Product Item # Brand/Description Cost First Aid and Medical Supplies Hemorrhoidal Preparations Laxatives Elastic Bandage 2 in x 5 yd Elastic Bandage 3 in x 5 yd Elastic Bandage 4 in x 5 yd Elastic Bandage 6 in x 5 yd Sheer Adhesive Bandages First Aid Kit 1215 Hot/Cold Packs for Injuries 1062 Compare to Ace Elastic Bandage, 1 per pack; A registered trademark of 3M Consumer Healthcare Compare to Ace Elastic Bandage, 1 per pack; A registered trademark of 3M Consumer Healthcare Compare to Ace Elastic Bandage, 1 per pack; A registered trademark of 3M Consumer Healthcare Compare to Ace Elastic Bandage, 1 per pack; A registered trademark of 3M Consumer Healthcare Compare to Band-Aid Sheer, Box of 60 per box; A registered trademark of Johnson & Johnson Consumer Products Compare to Curad, 48 pieces; A registered trademark of Medline Industries. Compare to Nexcare, 2 per pack - 1 small and 1 large; A registered trademark of 3M Consumer Healthcare $4.00 $4.00 $7.00 $10.00 $7.00 Hydrogen Peroxide 1228 Compare to Hydrogen Peroxide, 8 oz / 236 ml Hemorrhoid Ointment Pre-Moist Hemorrhoidal Pads Docusate Sodium 1126 Fiber tablets 1155 Glycerin Suppository 1125 Milk of Magnesia 1011 Natural Vegetable Laxative 1340 Senna Plus 1130 Migraine Relief Migraine Relief 1365 Compare to Preparation H Hemorrhoidal Ointment, 2 oz per tube; A registered trademark of Pfizer Consumer Healthcare Compare to Tucks, 100 per box; A registered trademark of Johnson & Johnson Consumer Compare to Colace, 100 mg capsules, 100 per bottle; A registered trademark of Purdue Products Compare to Fibercon, 500 mg tablets, 60 per bottle; A registered trademark of Pfizer-Wyeth Consumer Healthcare Compare to Fleet Glycerin Suppositories, 25 suppositories per bottle; A registered trademark of C.B. Fleet Co., Inc. Compare to Phillips Milk of Magnesia, 12 oz bottle; A registered trademark of Bayer HealthCare LLC Compare to Metamucil, 13 oz powder per bottle; A registered trademark of Procter & Gamble Compare to Senokot-S, 50 mg ; 60 tablets per bottle; A registered trademark of Purdue Products Compare to Excedrin Migraine, 250 mg; Acetaminophen, 250 mg; Aspirin, 65 mg; Caffeine tablets, 100 per bottle; A registered trademark of Novartis Consumer Health $8.00 $10.00 $

11 Category Product Item # Brand/Description Cost Minerals Motion Sickness Pain Relievers and Fever Reducers Compare to Caltrate 600, 600 mg tablets, 60 per bottle; Calcium Carbonate 1291 A registered trademark of Pfizer Consumer Healthcare Compare to Caltrate, D Calcium Supplement, Calcium-Vitamin D mg tablets, 60 per bottle; A registered $7.00 trademark of Pfizer Consumer Healthcare Compare to Feosol, 325 mg tablets, 100 per bottle; A Ferrous Sulfate 1376 registered trademark of Meda Consumer Healthcare Inc. Compare to Nature Made, 250 mg tablets, 100 per Magnesium Oxide 1377 bottle; A registered trademark of Pharmative, LLC Niacin 1378 Compare to Niacin, 100 mg tablets, 100 per bottle Compare to Dramamine, 50 mg tablets, 12 per Driminate 1263 pack; A registered trademark of Medtech Products Compare to Dramamine, 8 chewable tablets per Dramamine Orange 1264 $7.00 pack; A registered trademark of Medtech Products Compare to Bonine, 12.5 mg; 100 tablets; A Meclizine 1366 $8.00 registered trademark of Emerson Healthcare Compare to Tylenol, 325 mg tablets, 100 per Acetaminophen 1001 bottle; A registered trademark of McNeil-PPC, Inc. Compare to Bayer Genuine Aspirin, 325 mg tablets, 100 Aspirin 1095 per bottle; A registered trademark of Bayer HealthCare LLC Compare to Ecotrin, 81 mg tablets, 120 per bottle; Aspirin 81 mg 1002 A registered trademark of Medtech Products Aspirin (Enteric Coated) Children s Acetaminophen Compare to Ecotrin Regular Strength, mg tablets, 100 per bottle; A registered trademark of Medtech Products Compare to Children s Tylenol, 30 chewable tablets; 1423 A registered trademark of McNeil-PPC, Inc. Compare to Children s Motrin, 4 oz bottle; A Children s Ibuprofen 1421 $8.00 registered trademark of McNeil-PPC, Inc (TTY 711) You can place your CarePack order Monday - Friday, 7 a.m. to 8 p.m. Central Time 11

12 CAREPACK MEDICATIONS AND PRODUCTS Category Product Item # Brand/Description Cost Pain Relievers and Fever Reducers Compare to Advil, 200 mg tablets, 100 per bottle; A Ibuprofen 1004 $7.00 registered trademark of Pfizer Consumer Healthcare Compare to Aleve, 50 tablets; A registered Naproxen 1041 $10.00 trademark of Bayer Healthcare LLC Pain Relieving Muscle Rub Compare to Bengay, 2 oz bottle; 1475 A registered trademark of Johnson & Johnson Consumer Companies, Inc. Lice Treatment Compare to Rid, 4 oz per bottle; A registered Pediculicide 1271 $9.00 Shampoo trademark of Pfizer Consumer Healthcare Personal Care Sleep Aids Compare to Fruit of the Earth, 240 ml per tube; A Aloe Vera Cream 1070 registered trademark of Fruit of the Earth, Inc. Compare to AmLactin, 8 oz; A registered Ammonium Lactate 1368 $9.00 trademark of Upsher-Smith Laboratories, Inc. Compare to Purell, 8 oz per bottle; A Hand Sanitizer 1065 registered trademark of GOJO Ind. Sunscreen Lotion SPF 30 Compare to Coppertone, 3.5 oz per bottle; 1284 A registered trademark of Bayer AG Compare to Breathe Right, 30 per box; A Nasal Strips Medium 1724 $10.00 registered trademark of Glaxo Smith Kline Compare to Breathe Right, 30 per box; A Nasal Strips Large 1725 $10.00 registered trademark of Glaxo Smith Kline Compare to Unisom Nighttime Sleep-Aid, 50 tablets per Sleep tablets 1276 box; A registered trademark of Pfizer Consumer Healthcare Topical Triple Antibiotic Compare to Neosporin, 1 oz per tube; A registered 1014 $7.00 Antibiotics Ointment trademark of Pfizer Consumer Healthcarew Bacitracin Ointment 1020 Compare to Bacitracin, 1 oz per tube Vitamins Children s Multi Compare to Flinstones, 100 chewables; 1422 $7.00 Vitamin A registered trademark of Bayer Health Care Daily Multiple Vitamin Ferrous Gluconate (iron supplement) Compare to Centrum, 100 tablets per bottle; A 1385 $7.00 registered trademark of Pfizer Consumer Healthcare Compare to Fergon, 240 mg tablets, 100 per bottle; 1375 A registered trademark of Morberg Pharma Vitamin A 1379 Compare to Vitamin A, 100 tablets per bottle Vitamin B Complex 1382 Compare to Vitamin B Complex, 100 tablets per bottle Vitamin B Compare to Vitamin B-1, 100 mg, 100 tablets per bottle Vitamin B Compare to Vitamin B-12, 100 tablets per bottle $

13 Category Product Item # Brand/Description Cost Vitamins Vitamin B Compare to Vitamin B-6, 50 mg, 100 tablets per bottle Vitamin C 1017 Compare to Vitamin C, 500 mg, 100 tablets per bottle Vitamin D 400 iu Compare to Vitamin D 400 iu 100, 100 tablets per bottle Vitamin E 400 iu 1384 Compare to Vitamin E 400 iu, 100 tablets per bottle $8.00 Compare to Compound W Wart Remover,.5oz per Wart Removal Liquid Wart Remover 1075 $7.00 bottle; A registered trademark of Medtech Products, Inc (TTY 711) You can place your CarePack order Monday - Friday, 7 a.m. to 8 p.m. Central Time 13

14 KEEP TRACK OF YOU ORDERS BELOW Date Item 14

15 Date Item 15

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