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

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 www.otc-essentials.com. 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 www.otc-essentials.com 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_105106 Accepted

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 www.otc-essentials.com. 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 $8.00 1881 Antacid Tablets Fruit TUMS 150 $5.00 1890 Antacid Tablets Fruit Extra Strength TUMS Extra Strength 96 $5.00 1884 Antacid Mint Maalox Regular Strength 12 fl oz $5.00 1792 Gas Relief Softgels Ultra Strength Phazyme 60 $8.00 1816 Antacid Plus Gas Relief Mylanta Regular Strength 12 fl oz $5.00 1579 Bismuth Liquid Pepto-Bismol 8 fl oz $4.00 1584 Stomach Relief Chewable Tablets Pepto-Bismol 30 $4.00 1592 Loperamide Hydrochloride Anti-Diarrheal Imodium A-D 4 fl oz $7.00 1603 Anti-Diarrheal Caplets Imodium A-D 12 $4.00 1571 Natural Vegetable Laxative Tablets Senokot 100 $10.00 1619 LaxaClear Powder Miralax 4.1 oz $9.00 Online: Go to www.otc-essentials.com 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. 1624 Milk of Magnesia Phillips 12 fl oz $5.00 1660 Enema Fleet 3 pack $6.00 1558 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 1-877-795-4521 (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, 2016. 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.

4 2016 Over-the-Counter Essentials 2016 Over-the-Counter Essentials 5 Pain Management 2716 Aspirin 81 mg Enteric Coated Bayer Low Strength Aspirin 120 $5.00 2680 Aspirin 81 mg Chewable Tablets 36 $2.00 2664 Pain Relief 325 mg Tablets Regular Strength Tylenol 100 $8.00 2703 Pain Relief PM Extra Strength Tylenol PM 50 $6.00 2588 Ibuprofen 200 mg Coated Tablets Advil 100 $8.00 2760 All Day Relief Aleve 100 $9.00 2352 Pain Reliever Plus Excedrin 100 $11.00 2610 Motion Sickness Tablets Dramamine Original 12 $3.00 2366 Fast Freeze Roll On BioFreeze 3 oz $10.00 2357 Mineral Freez Gel Mineral Ice 8 oz $7.00 2388 Capsaicin Pain Relief Cream Capzasin 2 fl oz $12.00 3097 Muscle and Joint Gel Vanishing Scent Bengay 3 oz $5.00 3113 Muscle Rub Ultra Strength Bengay 3 oz $8.00 2753 Medicated Pads Tucks 100 $7.00 3138 Hemorrhoidal Ointment Preparation H 2 oz $8.00 3099 Miconazole Vaginal Cream Monistat 7 1.59 oz $11.00 Cold, Cough & Allergy 3204* All Day Allergy Tablets Zyrtec 30 $10.00 3202* All Day Allergy Tablets Zyrtec 90 $18.00 3235* Allergy Relief Tablets Claritin 30 $8.00 3167 Allergy Tablets 4 Hour Chlor-Trimeton 24 $6.00 2969 Children's Allergy Children s Benadryl Allergy Liquid 4 fl oz $6.00 3282 Allergy Relief Tablets Benadryl Allergy Ultratab 24 $6.00 3193 Allergy Relief Tablets Benadryl Allergy Ultratab 100 $10.00 3355 Mucus Relief Tablets 100 $12.00 3370 Nasal PE Tablets Sudafed PE Nasal Decongestant 36 $6.00 3216 Nasal Spray Afrin 1 fl oz $6.00 3244 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 $5.00 3001 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 $6.00 2 packs 30 ct 2 packs 25 ct $3.00 $4.00 3360 DM Cough Syrup Sugar-Free Robitussin DM Sugar-Free 16 fl oz $9.00 3364 DM Cough Syrup Sugar-Free Robitussin DM Sugar-Free 4 fl oz $6.00 3375 CF Cough & Cold Robitussin Cough & Cold CF 4 fl oz $8.00 2837 Sore Throat Lozenges Cepacol 18 $5.00 3119 Sore Throat Spray Menthol Chloraseptic 6 fl oz $5.00 2943 Sore Throat Spray Cherry Chloraseptic 6 fl oz $5.00 Eye & Ear Care 3232 Earwax Treatment Drops Debrox.5 fl oz $6.00 5124 Eye Drops AC Visine AC.5 fl oz $4.00 3346 Artificial Tears Visine Tears.5 fl oz $6.00 2998 Itchy Eye Drops Zyrtec.17 fl oz $13.00 Oral Care 5280 Battery Power Toothbrush 1 $14.00 5281 Replacement Heads for 5280 2 ct $8.00 4949 Toothbrush 1 $1.00 5063 Tongue Cleaner 1 $3.00 5177 Denture Adhesive Fixodent Original 2 oz $4.00 4968 Grande Denture Brush 1 $3.00 5059 Moisture Lip Balm SPF 15.15 oz $1.00 5082 Biotene Dry Mouth Spray 1.5 fl oz $10.00 5074 Mouth Moisturizer.5 oz $6.00 4961 Medicated Cold Sore Treatment Blistex.21 oz $3.00 3003 Oral Pain Relief Orajel Maximum Strength.33 oz $4.00

6 2016 Over-the-Counter Essentials 2016 Over-the-Counter Essentials 7 Oral Care 4985 Dental Floss Waxed Mint 100 yds $2.00 4878 Interdental Flossups 90 ct $3.00 4806 BrushPicks 275 ct $7.00 5095 Sensitive Toothpaste Sensodyne 4.3 oz $6.00 5083 Pepsodent Toothpaste Original 5.5 oz $2.00 5066 Aim Mint Gel 5.5 oz $2.00 Vitamins & Supplements 2982 Vitamin A 8,000 IU Tablets 90 $6.00 5612 Vitamin B-6 100 mg Tablets 100 $6.00 5627 Vitamin B12 500 mcg Tablets 100 $6.00 5634 Biotin 500 mcg Tablets 60 $7.00 5548 Vitamin C 500 mg Tablets 100 $4.00 5550 Vitamin C 500 mg Chewable Tablets 100 $7.00 5725 Vitamin D3 2000 IU Tablets 250 $12.00 2977 Vitamin E 200 IU Softgels 100 $8.00 3032 Calcium 600 mg Tablets 150 $6.00 5640 Chocolate Calcium Chews Regular 60 $9.00 5643 Chocolate Calcium Chews Sugar Free 60 $9.00 3048 Calcium Citrate + Vitamin D Caplets Citracal 100 $8.00 5811 Calcium 600 mg with Vitamin D Tablets Caltrate 600 + D 300 $13.00 First Aid 5150 First Aid Kit 1 kit $12.00 3034 Antiseptic Spray 3 oz $8.00 5166 flexseal Spray Bandage Cannot ship to P.O. boxes. 1.35 oz $8.00 5153 Adhesive 3/4" Bandages 80 ct $3.00 5160 Adhesive 2"x4" Bandages 50 ct $6.00 5191 Elastic Bandage 2"x5 yds 1 $2.00 5193 Elastic Bandage 3"x5 yds 1 $2.00 5197 Elastic Bandage 4"x5 yds 1 $3.00 5199 Elastic Bandage 6"x5 yds 1 $3.00 5265 Cotton Swabs 200 ct $3.00 5275 Cotton Balls 200 ct $2.00 5298 Cloth Tape 1"x10 yds 1 $5.00 5314 Gauze Sponges 10 ct $2.00 5316 Gauze Rolls 3 rolls $3.00 5367 Latex Water Bottle with Screw Top 2 qt $13.00 5370 Calamine Lotion 6 fl oz $5.00 5388 Hydrocortisone Cream 1% 1 oz $4.00 5455 Anti-Itch Cream Extra Strength Benadryl cream 1 oz $4.00 5462 Triple Antibiotic Ointment 1 oz $6.00 3080 Bacitracin with Zinc Ointment 1 oz $6.00 5820 CoQ10 100 mg Softgels 30 $15.00 5845 Chromium Picolinate 1000 mcg Tablets 100 $8.00 5853 Flax Seed Oil 1000 mg Softgels 60 $6.00 3016 Folic Acid 400 mcg Tablets 100 $6.00 2948 Ferrous Sulfate 325 mg Tablets Equivalent to 65 mg Iron 100 $5.00 5866 Omega-3 Fish Oil 1000 mg Softgels 90 $8.00 5754 Antioxidant Vitamins Tablets 60 $10.00 2960 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.

8 2016 Over-the-Counter Essentials First Aid 5655 Hydrogen Peroxide 4 fl oz $1.00 5657 Hydrogen Peroxide 16 fl oz $2.00 5664** Alcohol Prep Pads 200 ct $4.00 5672 70% Isopropyl Alcohol Cannot ship to P.O. boxes. 16 fl oz $3.00 5680 Petroleum Jelly Vaseline 13 oz $5.00 5691 Hand Sanitizer Alcohol Free 7.5 oz $10.00 5470 Digital Thermometer 1 $8.00 Therapeutic Skin Care 5695 Sunscreen Lotion SPF 30 Coppertone 8 oz $7.00 5697 Sunscreen Lotion SPF 50 Coppertone 8 oz $9.00 5707 Aloe Vera Gel 16 oz $7.00 5736 Remedy Nourishing Skin Cream 8 oz $12.00 5740 Remedy Skin Repair Cream 4 oz $8.00 5744 Remedy Skin Protectant Cream 4 oz $10.00 5752 Soothe & Cool Antifungal Cream 5 oz $12.00 Leg & Foot Care 5801 Bunion Guard 1 $10.00 5823 S Toe Protector size Small 1 $7.00 5823 L Toe Protector size Large 1 $7.00 5823 XL Toe Protector size X-Large 1 $7.00 5834 Lamb s Wool Padding Dr. Scholl's 1 $6.00 5817 Corn Cushions Dr. Scholl's 9 ct $3.00 5799 Medicated Corn Removers Dr. Scholl's 9 ct $5.00 5788 Medicated Foot Powder Gold Bond 4 oz $6.00 5862 Antifungal Cream 1% Lotrimin AF.5 oz $7.00 2016 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: 9.5 11 Men s Shoe Size: 8.5 10 Women s Shoe Size: 11.5 13 Men s Shoe Size: 10.5 12 Women s Shoe Size: 7 9 Men s Shoe Size: 6 8 Women s Shoe Size: 9.5 11 Men s Shoe Size: 8.5 10 Women s Shoe Size: 11.5 13 Men s Shoe Size: 10.5 12 7041 Remedy Olivamine Calazime 4 oz $10.00 7060 Soothe & Cool Cornstarch Body Powder 4 oz $4.00 7062 Soothe & Cool Cornstarch Body Powder 14 oz $8.00 7057 Remedy Phytoplex Nourishing Cream 8 oz $10.00 7076 Aloe Touch Disposable Washcloths 100 ct $8.00 7088 Sanitizing Wipes Cannot ship to P.O. boxes. 160 ct $13.00 7313 Washable Bed Pad 34" x 36" 1 $18.00 7325 Disposable Bladder Control Pad 5.5" x 10.5" 28 Pack $8.00 7330 Disposable Bladder Control Pad 6.5" x 13.5" 28 Pack $11.00 2074 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.

10 2016 Over-the-Counter Essentials Incontinence Order Form 2236 M** FitRight Ultra Disposable Underwear size Medium Waist size: 28 40" $18.00 2236 L** FitRight Ultra Disposable Underwear size Large Waist size: 40 56" $18.00 2236 XL** FitRight Ultra Disposable Underwear size X-Large Waist size: 56 68" $18.00 2240 S Light & Dry Washable Men s Brief size Small Waist size: 30 33" 1 brief $18.00 2240 M Light & Dry Washable Men s Brief size Medium Waist size: 34 36" 1 brief $18.00 2240 L Light & Dry Washable Men s Brief size Large Waist size: 37 40" 1 brief $18.00 2240 XL Light & Dry Washable Men s Brief size X-Large Waist size: 41 45" 1 brief $18.00 2240 XXL Light & Dry Washable Men s Brief size XX-Large Waist size: 46 52" 1 brief $18.00 2172 S Light & Dry Washable Women s Brief size Small Waist size: 22 26" 1 brief $17.00 2172 M Light & Dry Washable Women s Brief size Medium Waist size: 26 29" 1 brief $17.00 2172 L Light & Dry Washable Women s Brief size Large Waist size: 30 33" 1 brief $17.00 2172 XL Light & Dry Washable Women s Brief size X-Large Waist size: 34 36" 1 brief $17.00 2172 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 $45.00 2345 Bath Mat 29" x 13.4" 1 $20.00 2298 Tub and Stair Safety Treads $5.00 2359 Raised Toilet Seat 250 lbs Capacity 1 $30.00 2377 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!