Welcome to Over-the-Counter Essentials 2016 Over-the-Counter Essentials

Transcription

1 Welcome to Over-the-Counter Essentials 2016 Over-the-Counter Essentials Over-the-Counter (OTC) Essentials allows you to purchase health and wellness products from the enclosed product listing. How to order: You can place an order by mailing the order form in the supplied postage paid envelope or by going to If your total order exceeds your credit amount limit, please be sure to include a check or money order to pay the remaining amount due. Failure to submit payment in full will lead to a delay in shipment. Ordering is easy: Part of your UnitedHealthcare health plan. Online: Go to Mail: Fill out the Order Form and mail only the order form page in the postage paid envelope. Mail orders must be postmarked by March 31, June 30, September 30 and December 31 of each year. Keep this catalog. You ll need it to look up the health and wellness products you want to order. <FLM Code> <Print Code> Y0066_150812_ Accepted

2 2016 Over-the-Counter Essentials Your UnitedHealthcare health plan offers Over-the-Counter (OTC) Essentials that allows you to purchase health and wellness products from the enclosed catalog. Each quarter, $50 in Benefit Credits are loaded into your account to purchase health and wellness products. All orders are shipped right to you at no additional cost for shipping, handling and taxes. Benefit Credits expire at the end of each quarter and cannot be redeemed for cash. You cannot apply future credits to your order and each order must total at least $30 in Benefit Credits. Only products in the catalog are covered under this benefit and items offered under this plan benefit may only be used by the plan member. How to order: You can place an order by mailing the order form in the supplied postage paid envelope or by going to If your total order exceeds your credit amount limit, please be sure to include a check or money order to pay the remaining amount due. Failure to submit payment in full will lead to a delay in shipment. Ordering is easy: 2016 Over-the-Counter Essentials 3 Stomach Remedies 1878* Acid Reducer Tablets Pepcid AC 30 $ Antacid Tablets Fruit TUMS 150 $ Antacid Tablets Fruit Extra Strength TUMS Extra Strength 96 $ Antacid Mint Maalox Regular Strength 12 fl oz $ Gas Relief Softgels Ultra Strength Phazyme 60 $ Antacid Plus Gas Relief Mylanta Regular Strength 12 fl oz $ Bismuth Liquid Pepto-Bismol 8 fl oz $ Stomach Relief Chewable Tablets Pepto-Bismol 30 $ Loperamide Hydrochloride Anti-Diarrheal Imodium A-D 4 fl oz $ Anti-Diarrheal Caplets Imodium A-D 12 $ Natural Vegetable Laxative Tablets Senokot 100 $ LaxaClear Powder Miralax 4.1 oz $9.00 Online: Go to Mail: Fill out the Order Form and mail only the order form page in the postage paid envelope. Mail orders must be postmarked by March 31, June 30, September 30 and December 31 of each year Milk of Magnesia Phillips 12 fl oz $ Enema Fleet 3 pack $ Stool Softener Softgels Colace 100 $9.00 Keep this catalog. You ll need it to look up the health and wellness products you want to order. If you have questions around products or delivery, please call FirstLine Medical customer service at (TTY: 711), 7 a.m. 7 p.m. Monday Friday, CT and 7 a.m. 4 p.m. Saturday, CT. This order form is for the 2016 benefit year. Please do not submit your first order until after January 1, If you need additional order forms, you can go to our website to download or you can call FirstLine Medical customer service. FirstLine Medical is the supplier of all products within this mailing. UnitedHealthcare Insurance Company manages FirstLine Medical through its affiliate OptumRx. Plans are insured through UnitedHealthcare Insurance Company or one of its affiliated companies, a Medicare Advantage organization with a Medicare contract. Enrollment in the plan depends on the plan s contract renewal with Medicare. This information is not a complete description of benefits. Contact the plan for more information. Limitations, co-payments, and restrictions may apply. Benefits, premium and/or co-payments/ co-insurance may change on January 1 of each year. * In certain circumstances some items on this page may be covered by the plan, or Original Medicare if you are not enrolled in the plan, and if item is determined to be medically necessary. Please check with your healthcare provider before ordering. If your item is not in stock, an item of similar or greater value may be substituted in your order. Exchange Policy: If you receive a damaged item, please call FirstLine Medical immediately. The item will be exchanged for an identical item at no cost to you. Please note: only damaged products can be exchanged within 30 days of purchase, no other returns are allowed. This catalog contains a listing of all products offered through FirstLine Medical. Benefit Credit amounts vary by health plan and some products in this catalog may not be available to all members. The health information provided in the catalog is general in nature and is not medical advice or a substitute for professional health care. It is provided for your information and convenience only. UnitedHealthcare Insurance Company (UHIC) does not guarantee the accuracy or completeness of the information, and does not recommend or endorse the products which are referenced in the catalog. Note: Your OTC benefit only covers items listed in this catalog and does not cover alternative medicines, baby items, contraceptives, convenience items, cosmetics, food supplements, replacement items, attachments and peripherals.

3 Over-the-Counter Essentials 2016 Over-the-Counter Essentials 5 Pain Management 2716 Aspirin 81 mg Enteric Coated Bayer Low Strength Aspirin 120 $ Aspirin 81 mg Chewable Tablets 36 $ Pain Relief 325 mg Tablets Regular Strength Tylenol 100 $ Pain Relief PM Extra Strength Tylenol PM 50 $ Ibuprofen 200 mg Coated Tablets Advil 100 $ All Day Relief Aleve 100 $ Pain Reliever Plus Excedrin 100 $ Motion Sickness Tablets Dramamine Original 12 $ Fast Freeze Roll On BioFreeze 3 oz $ Mineral Freez Gel Mineral Ice 8 oz $ Capsaicin Pain Relief Cream Capzasin 2 fl oz $ Muscle and Joint Gel Vanishing Scent Bengay 3 oz $ Muscle Rub Ultra Strength Bengay 3 oz $ Medicated Pads Tucks 100 $ Hemorrhoidal Ointment Preparation H 2 oz $ Miconazole Vaginal Cream Monistat oz $11.00 Cold, Cough & Allergy 3204* All Day Allergy Tablets Zyrtec 30 $ * All Day Allergy Tablets Zyrtec 90 $ * Allergy Relief Tablets Claritin 30 $ Allergy Tablets 4 Hour Chlor-Trimeton 24 $ Children's Allergy Children s Benadryl Allergy Liquid 4 fl oz $ Allergy Relief Tablets Benadryl Allergy Ultratab 24 $ Allergy Relief Tablets Benadryl Allergy Ultratab 100 $ Mucus Relief Tablets 100 $ Nasal PE Tablets Sudafed PE Nasal Decongestant 36 $ Nasal Spray Afrin 1 fl oz $ Saline Nasal Spray Ocean 3 fl oz $5.00 * In certain circumstances some items on this page may be covered by the plan, or Original Medicare if you are not enrolled in the plan, and if item is determined to be medically necessary. Please check with your healthcare provider before ordering. Cold, Cough & Allergy 2972 Medicated Chest Rub Vicks Vaporub 3.53 oz $ Day/Night Combo Pack Tylenol Cold Multi-Symptom Day & Night 3082 Cough Drops Honey Lemon Halls Regular 3081 Cough Drops Black Cherry Sugar-Free Halls Sugar-Free 20 $ packs 30 ct 2 packs 25 ct $3.00 $ DM Cough Syrup Sugar-Free Robitussin DM Sugar-Free 16 fl oz $ DM Cough Syrup Sugar-Free Robitussin DM Sugar-Free 4 fl oz $ CF Cough & Cold Robitussin Cough & Cold CF 4 fl oz $ Sore Throat Lozenges Cepacol 18 $ Sore Throat Spray Menthol Chloraseptic 6 fl oz $ Sore Throat Spray Cherry Chloraseptic 6 fl oz $5.00 Eye & Ear Care 3232 Earwax Treatment Drops Debrox.5 fl oz $ Eye Drops AC Visine AC.5 fl oz $ Artificial Tears Visine Tears.5 fl oz $ Itchy Eye Drops Zyrtec.17 fl oz $13.00 Oral Care 5280 Battery Power Toothbrush 1 $ Replacement Heads for ct $ Toothbrush 1 $ Tongue Cleaner 1 $ Denture Adhesive Fixodent Original 2 oz $ Grande Denture Brush 1 $ Moisture Lip Balm SPF oz $ Biotene Dry Mouth Spray 1.5 fl oz $ Mouth Moisturizer.5 oz $ Medicated Cold Sore Treatment Blistex.21 oz $ Oral Pain Relief Orajel Maximum Strength.33 oz $4.00

4 Over-the-Counter Essentials 2016 Over-the-Counter Essentials 7 Oral Care 4985 Dental Floss Waxed Mint 100 yds $ Interdental Flossups 90 ct $ BrushPicks 275 ct $ Sensitive Toothpaste Sensodyne 4.3 oz $ Pepsodent Toothpaste Original 5.5 oz $ Aim Mint Gel 5.5 oz $2.00 Vitamins & Supplements 2982 Vitamin A 8,000 IU Tablets 90 $ Vitamin B mg Tablets 100 $ Vitamin B mcg Tablets 100 $ Biotin 500 mcg Tablets 60 $ Vitamin C 500 mg Tablets 100 $ Vitamin C 500 mg Chewable Tablets 100 $ Vitamin D IU Tablets 250 $ Vitamin E 200 IU Softgels 100 $ Calcium 600 mg Tablets 150 $ Chocolate Calcium Chews Regular 60 $ Chocolate Calcium Chews Sugar Free 60 $ Calcium Citrate + Vitamin D Caplets Citracal 100 $ Calcium 600 mg with Vitamin D Tablets Caltrate D 300 $13.00 First Aid 5150 First Aid Kit 1 kit $ Antiseptic Spray 3 oz $ flexseal Spray Bandage Cannot ship to P.O. boxes oz $ Adhesive 3/4" Bandages 80 ct $ Adhesive 2"x4" Bandages 50 ct $ Elastic Bandage 2"x5 yds 1 $ Elastic Bandage 3"x5 yds 1 $ Elastic Bandage 4"x5 yds 1 $ Elastic Bandage 6"x5 yds 1 $ Cotton Swabs 200 ct $ Cotton Balls 200 ct $ Cloth Tape 1"x10 yds 1 $ Gauze Sponges 10 ct $ Gauze Rolls 3 rolls $ Latex Water Bottle with Screw Top 2 qt $ Calamine Lotion 6 fl oz $ Hydrocortisone Cream 1% 1 oz $ Anti-Itch Cream Extra Strength Benadryl cream 1 oz $ Triple Antibiotic Ointment 1 oz $ Bacitracin with Zinc Ointment 1 oz $ CoQ mg Softgels 30 $ Chromium Picolinate 1000 mcg Tablets 100 $ Flax Seed Oil 1000 mg Softgels 60 $ Folic Acid 400 mcg Tablets 100 $ Ferrous Sulfate 325 mg Tablets Equivalent to 65 mg Iron 100 $ Omega-3 Fish Oil 1000 mg Softgels 90 $ Antioxidant Vitamins Tablets 60 $ Diabetes Glucose Tablets 50 $6.00 Members may order these item(s) after discussing the item(s) with their physician who recommends the item(s) for a specific condition. Debate exists on the merits of these supplements, so it is important that you speak with your doctor before taking supplements, especially if you have a serious medical condition. These statements have not been evaluated by the Food and Drug Administration. If your item is not in stock, an item of similar or greater value may be substituted in your order. Exchange Policy: If you receive a damaged item, please call FirstLine Medical immediately. The item will be exchanged for an identical item at no cost to you. Please note: only damaged products can be exchanged within 30 days of purchase, no other returns are allowed. This catalog contains a listing of all products offered through FirstLine Medical. Benefit Credit amounts vary by health plan and some products in this catalog may not be available to all members. The health information provided in the catalog is general in nature and is not medical advice or a substitute for professional health care. It is provided for your information and convenience only. UnitedHealthcare Insurance Company (UHIC) does not guarantee the accuracy or completeness of the information, and does not recommend or endorse the products which are referenced in the catalog. Note: Your OTC benefit only covers items listed in this catalog and does not cover alternative medicines, baby items, contraceptives, convenience items, cosmetics, food supplements, replacement items, attachments and peripherals.

5 Over-the-Counter Essentials First Aid 5655 Hydrogen Peroxide 4 fl oz $ Hydrogen Peroxide 16 fl oz $ ** Alcohol Prep Pads 200 ct $ % Isopropyl Alcohol Cannot ship to P.O. boxes. 16 fl oz $ Petroleum Jelly Vaseline 13 oz $ Hand Sanitizer Alcohol Free 7.5 oz $ Digital Thermometer 1 $8.00 Therapeutic Skin Care 5695 Sunscreen Lotion SPF 30 Coppertone 8 oz $ Sunscreen Lotion SPF 50 Coppertone 8 oz $ Aloe Vera Gel 16 oz $ Remedy Nourishing Skin Cream 8 oz $ Remedy Skin Repair Cream 4 oz $ Remedy Skin Protectant Cream 4 oz $ Soothe & Cool Antifungal Cream 5 oz $12.00 Leg & Foot Care 5801 Bunion Guard 1 $ S Toe Protector size Small 1 $ L Toe Protector size Large 1 $ XL Toe Protector size X-Large 1 $ Lamb s Wool Padding Dr. Scholl's 1 $ Corn Cushions Dr. Scholl's 9 ct $ Medicated Corn Removers Dr. Scholl's 9 ct $ Medicated Foot Powder Gold Bond 4 oz $ Antifungal Cream 1% Lotrimin AF.5 oz $ Over-the-Counter Essentials 9 Leg & Foot Care 5878 WS 5878 WM 5878 WL 5878 BLS 5878 BLM 5878 BLL Incontinence Jobst Sensifoot Diabetic Sock color White size Small Jobst Sensifoot Diabetic Sock color White size Medium Jobst Sensifoot Diabetic Sock color White size Large Jobst Sensifoot Diabetic Sock color Black size Small Jobst Sensifoot Diabetic Sock color Black size Medium Jobst Sensifoot Diabetic Sock color Black size Large Women s Shoe Size: 7 9 Men s Shoe Size: 6 8 Women s Shoe Size: Men s Shoe Size: Women s Shoe Size: Men s Shoe Size: Women s Shoe Size: 7 9 Men s Shoe Size: 6 8 Women s Shoe Size: Men s Shoe Size: Women s Shoe Size: Men s Shoe Size: Remedy Olivamine Calazime 4 oz $ Soothe & Cool Cornstarch Body Powder 4 oz $ Soothe & Cool Cornstarch Body Powder 14 oz $ Remedy Phytoplex Nourishing Cream 8 oz $ Aloe Touch Disposable Washcloths 100 ct $ Sanitizing Wipes Cannot ship to P.O. boxes. 160 ct $ Washable Bed Pad 34" x 36" 1 $ Disposable Bladder Control Pad 5.5" x 10.5" 28 Pack $ Disposable Bladder Control Pad 6.5" x 13.5" 28 Pack $ M 2074 R 2074 L 2074 XL size Medium size Regular size Large size X-Large Waist size: 32 42" Waist size: 40 50" Waist size: 48 58" Waist size: 57 66" **Some items on this page may be covered by the plan, or Original Medicare if you are not enrolled in the plan, and if item is determined to be medically necessary. Please check with your physician before ordering. **Some items on this page may be covered by the plan, or Original Medicare if you are not enrolled in the plan, and if item is determined to be medically necessary. Please check with your physician before ordering.

6 Over-the-Counter Essentials Incontinence Order Form 2236 M** FitRight Ultra Disposable Underwear size Medium Waist size: 28 40" $ L** FitRight Ultra Disposable Underwear size Large Waist size: 40 56" $ XL** FitRight Ultra Disposable Underwear size X-Large Waist size: 56 68" $ S Light & Dry Washable Men s Brief size Small Waist size: 30 33" 1 brief $ M Light & Dry Washable Men s Brief size Medium Waist size: 34 36" 1 brief $ L Light & Dry Washable Men s Brief size Large Waist size: 37 40" 1 brief $ XL Light & Dry Washable Men s Brief size X-Large Waist size: 41 45" 1 brief $ XXL Light & Dry Washable Men s Brief size XX-Large Waist size: 46 52" 1 brief $ S Light & Dry Washable Women s Brief size Small Waist size: 22 26" 1 brief $ M Light & Dry Washable Women s Brief size Medium Waist size: 26 29" 1 brief $ L Light & Dry Washable Women s Brief size Large Waist size: 30 33" 1 brief $ XL Light & Dry Washable Women s Brief size X-Large Waist size: 34 36" 1 brief $ XXL Light & Dry Washable Women s Brief size XX-Large Waist size: 37 40" 1 brief $17.00 # Fill out each section of the order form completely and mail in the envelope provided. Member ID # (See front of health insurance card.) Member Name Shipping Address 1 Shipping Address 2 (Apt./Room#/Facility Name) City State ZIP Code Responsible Party (if applicable) Daytime Phone of Member or Responsible Party ( ) Item # Size Color Product Description Quantity Price TOTAL Bath Safety Item # Product name Size/Capacity Count Price 2334 Tub Safety Bar 250 lbs Capacity 1 $ Bath Mat 29" x 13.4" 1 $ Tub and Stair Safety Treads $ Raised Toilet Seat 250 lbs Capacity 1 $ Toilet Safety Rails 300 lbs Capacity 1 $40.00 If your item is not in stock, an item of similar or greater value may be substituted in your order. Exchange Policy: If you receive a damaged item, please call FirstLine Medical immediately. The item will be exchanged for an identical item at no cost to you. Please note: only damaged products can be exchanged within 30 days of purchase, no other returns are allowed. This catalog contains a listing of all products offered through FirstLine Medical. Benefit Credit amounts vary by health plan and some products in this catalog may not be available to all members. The health information provided in the catalog is general in nature and is not medical advice or a substitute for professional health care. It is provided for your information and convenience only. UnitedHealthcare Insurance Company (UHIC) does not guarantee the accuracy or completeness of the information, and does not recommend or endorse the products which are referenced in the catalog. Note: Your OTC benefit only covers items listed in this catalog and does not cover alternative medicines, baby items, contraceptives, convenience items, cosmetics, food supplements, replacement items, attachments and peripherals. Order total must be at least $30 in Benefit Credits. Items may only be purchased for plan members. 30OTC2016 $0 Shipping, handling and taxes TOTALX $ Thank you for your order!