Over-the-Counter (OTC) Drug Catalog

Transcription

1 2019 Over-the-Counter (OTC) Drug Catalog

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3 2019 Over-the-Counter (OTC) Drug Catalog Security Health Plan understands that over-the-counter (OTC) drugs and supplies can be expensive. That s why we are offering you a way to save money on these items and have them conveniently delivered to your home. There are eight categories of over-the-counter products you can choose from: antacids, anti-diarrheals and laxatives cough, cold & allergy diabetes management eye and ear care oral care pain relievers skin care-topical *vitamins, minerals and supplements Plans excluded from this service are Ally Rx D-SNP, Secure Saver MSA, BadgerCare Plus, Senior Security Medicare Select, Medicare Supplement, Security Administrative Services, Family Health Center and State of Wisconsin plans. How the service works Each plan subscriber is eligible for a $30 quarterly OTC credit to purchase select OTC health and wellness products through the OTC Drug Catalog. The $30 allowance expires at the end of each quarter. Any unused credit will not carry over to the next quarter. If your order exceeds $30, please include payment information (check, money order or credit card) on your order form. Keep this catalog to reference the health and wellness products you want to order each quarter. 1

4 When placing an order, you will receive the generic equivalent of the name-brand drug. If you choose a product that is unavailable or not in stock, a similar product may be substituted at no additional charge. Some items may vary depending on manufacturer (for example, caplets, tablets, capsules or soft gels may be substituted for one another). How to order Orders will be shipped to your home by the US postal service at no extra cost to you. Please allow 14 business days upon receipt of order to receive shipment. There are several ways you can use the OTC service: Place an order online through your My Security Health Plan online account. Complete the OTC product order form and fax to Complete the product order form and mail it to the following address: SHP OTC Program PO Box 8000 Marshfield, WI Mail orders must be postmarked by March 15, June 15, Sept. 15 and Dec 15. A copy of the OTC Drug Catalog and product order form can be found at If you have any questions, please contact our Pharmacy Benefits Department at or , Monday-Friday 8 a.m. to 5 p.m. If you are hearing- or speech-impaired, please call TTY:

5 2019 OTC product list This product list is subject to change. Item# Name Compared to Package Antacids, anti-diarrheals and laxatives Famotidne 10mg tablets - acid reducer Ranitidine 75mg tablets - acid reducer Antacid tablets - fruit flavor Pepcid AC 25 ct $4.00 Zantac 60 ct $6.00 Tums 150 ct $ Antacid tablets - extra strength fruit flavor Tums Extra Strength 96 ct $ Gas Relief softgels GasX 48 ct $ Loperamide 2mg tablets - antidiarrheal Imodium A-D 12 ct $ Loperamide liquid - anti-diarrheal Imodium A-D liquid 4 oz $ Hemmorrhoid ointment Preparation H 2 oz $ Medicated pads Tucks 40 ct $ Lactase enzyme tablets - dairy aid Lactaid 50 ct $ Fiber laxative tablets FiberCon 90 ct $6.00 3

6 35585 Hemorrhoid suppositories Preparation H supp 12 ct $ Bisacodyl tablets Dulcolax 12 ct $ Milk of magnesia liquid 8420 Peptic relief tablets - pink bismuth Bismuth liquid Phillips Milk of Magnesia Pepto Bismol Chewable Pepto Bismol liquid 16 oz $ ct $ oz $ Polyethylene glycol powder Miralax 8.3 oz $ Senna - natural vegetable laxative tablets Senokot 100 ct $ Docusate sodium 100mg softgels - stool softener Colace 100 ct $ Senna + docusate tablets Senokot-S 9240 Magnesium citrate liquid-laxative Citroma 10 oz $ Enema Fleet Enema 4.5 oz $3.00 4

7 Cough, cold and allergy Daytime cold and flu softgels DayQuil 24 ct $ Diphenhydramine 25mg capsules- allergy Children's allergy liquid cherry flavor Nasal decongestant PE tablets Benadryl 100 ct $4.00 Childrens Benadryl Allergy 4 oz $3.00 Liquid Sudafed PE 36 ct $ Night time cold and flu softgels NyQuil 16 ct $ Throat spray - sugar free Chloraseptic 6 oz $ Throat lozenge - cherry Cepacol 18 ct $ Cough suppressant/ expectorant syrup Robitussin DM syrup 4 oz $ Cough drop - black cherry sugar free Halls sugar free 25 ct $3.00 5

8 16886 Cough drop - honey lemon Halls Regular 30 ct $ Cough syrup - DM sugar free Robitussin DM syrup - sugar free 4 oz $ Cetirizine 10mg - allergy tablets Zyrtec 30 ct $ Loratadine 10mg - allergy tablets Claritin 30 ct $ Allergy relief liquid Claritin liquid 4 oz $ Nasal decongestant spray Afrin nasal spray 1 oz $ Fluticasone nasal spray Flonase OTC 0.34 oz $ Saline nasal spray Ocean Saline Nasal Spray 1.5 oz $ Sinus- acetaminophen/ phenylephriine tablets Tylenol Sinus 24 ct $ Triamcinolone allergy nasal spray Nasacort Allergy 24 hour 0.57 oz $

9 17802 Dextromethorphan (cough) liquid - orange flavor Diabetes management Delsym Adult - orange 3 oz $ Glucose tablets DEX4 Glucose 60 ct $ Glucose gel Glutose gm $ Diabetic skin relief foot cream Gold Bond Diabetic Skin Relief Foot Cream 3.4 oz $6.00 Eye and ear care Earwax treatment drops Debrox 0.5 oz. $ Artificial tear dropperette Thera Tears 28 ct $ Lubricating eye drop Systane drops 0.5 oz. $ Lubricating eye ointment Genteal gel 0.3 oz $ Artificial tear Visine Tears 0.5 oz $ Eye drops - redness reliever Visine Allergy 0.5 oz $5.00 7

10 Oral care 864 Denture adhesive Fixodent 1.4 oz $ Effervescent denture tabs Efferdent 90 ct $ Toothpaste Colgate 8oz $ Toothbrush Toothbrush 1 ct $ Dental floss Dental floss 1 ct $ Sensitive toothpaste Sensodyne 4 oz $ Anesthetic gel Anbesol 15 gm $4.00 Pain relievers Acetaminophen 325mg tablets Acetaminophen 500mg caplets Tylenol Regular Strength Tylenol Extra Strength Aspirin 325mg coated tablets Ecotrin 161 Aspirin 81mg coated tablets Bayer Adult Low Strength EC 120 ct $ Aspirin 81mg - chewable tablets 90 ct $ Headache formulaaspirin/acetaminophen/ caffeine Excedrin 100 ct $4.00 8

11 35743 Ibuprofen 200mg coated tablets Advil Naproxen sodium 220mg tablets Aleve 50 ct $ Topical pain creamcapsaicin 0.025% Zostrix Cream 2 oz $ Cold and hot patches Icy Hot Patches 5 ct $ Muscle rub cream Ben Gay Greaseless 2 oz $ Muscle rub gel Vanishing Scent Ben 2 oz $4.00 Gay Skin care - Topical Clotrimazole 1% cream Lotrimin AF 0.5 oz $ Hydrocortisone 1% cream Cortaid 1 oz $ Hydrocortisone 1% ointment Cortaid 1 oz $ White petrolatum Vaseline 10 oz $ Sunscreen lotion SPF 30 Sunscreen 16 oz $9.00 9

12 224 Sunscreen lotion SPF 60 Coppertone 16 oz $ Tolnaftate 1% antifungal cream Tinactin 1 oz $ Triple antibiotic ointment Neosporin 1 oz $ Bacitracin ointment Bacitracin 1 oz $ Calamine lotion Calamine 6 oz $ Benzoyl peroxide 5% gel - acne 1.5 oz $ Miconazole 2% cream - antifungal Micatin 1 oz $ Band aids - 3/4 " 60 ct $ Band aids - assorted 60 ct $3.00 Vitamins and minerals* Daily multivitamin and minerals Centrum 130 ct $ Calcium citrate 600 mg + vitamin D 800 iu Caltrate 600+D 60 ct $

13 57641 Calcium citrate 200mg w/ vitamin D 250 iu Citracal w/ D 100ct $ Vitamin D 1000 IU Vitamin E 400 IU 4091 Magnesium oxide 400mg Mag-Ox 120 ct $ Vitamin B mcg Iron- ferrous gluconate 27mg Vitamin B6 100mg tablets Vitamin B complex 60 ct $ Iron - ferrous sulfate 324mg Feosol 100 ct $ Vitamin C 250mg Eye care vitamins Ocuvite 60 ct $

14 95176 Complete senior vitamins and minerals Centrum Silver 60 ct $ Folic acid 400mcg tablets Flax seed oil 1000mg softgels 100 ct $ CoQ10 100mg softgels 60 ct $11.00 * Vitamins, minerals and supplements should only be taken under the recommendation of your doctor. Debate exists on the merits of supplements, so it is important to speak with your doctor before taking them, especially if you have a serious medical condition. 12

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16 Security Health Plan of Wisconsin, Inc. complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, disability, age, sex, gender identity, sexual orientation or health status. ATTENTION: If you speak a language other than English, language assistance services, free of charge, are available to you. Call (TTY: 711). ATENCIÓN: Si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al (TTY: 711). LUS CEEV: Yog tias koj hais lus Hmoob, cov kev pab txog lus, muaj kev pab dawb rau koj. Hu rau (TTY: 711). Security Health Plan is an HMO-POS, MSA and D-SNP plan with a Medicare contract. Enrollment in Security Health Plan depends on contract renewal North Saint Joseph Avenue PO Box 8000 Marshfield, WI Pharmacy Benefits Department or Monday-Friday, 8 a.m. to 5 p.m Security Health Plan of Wisconsin, Inc. Y0117_MC C _C