2014 Healthfirst Medicare Over-the-Counter (OTC) Benefits
We want to help you get the most out of your Medicare OTC benefit.
> For a complete list of participating pharmacies and retailers go to www.otcnetwork.com/member or call our Member Services Representatives at 1-888-260-1010 (TTY/TDD 1-888-542-3821) 8 am to 8 pm, 7 days a week.
* Please note that clicking on these links will take you away from the Healthfirst website.
At Healthfirst, we understand that not all medications and health-related items our members need are behind the pharmacy counter. A daily health care regimen might include drugs and supplies available over-the-counter. We also understand that accessing these over-the-counter (OTC) items may be difficult for lower-income Medicare beneficiaries. Because of this, Healthfirst is offering members of certain plans a monthly benefit to use for certain eligible OTC items. Using your Healthfirst OTC Card, you can get the everyday items that are not included with your Medicare Part B or Part D prescription drug coverage.
If you are a member of a plan with an OTC benefit, you will receive a Healthfirst OTC card with a pre-funded monthly benefit allowance upon enrollment. With this allowance, you may purchase eligible OTC and health-related items (i.e. aspirin, cold & flu relief medications, and adhesive bandages) at any participating pharmacy.
Please note that not all over-the-counter and health related items are eligible for purchase. Please use the link above to view a list of eligible and non-eligible items. Dual-purpose items such as vitamins, minerals, supplements, diagnostic tools, (e.g., blood pressure monitors), hormone replacements, weight loss items, and items used to assist in weight loss can be purchased only after you discuss your need for them with your provider. These dual-purpose items are available only for a specific diagnosable condition.
2014 Over-the-Counter (OTC) Non-prescription Drug Coverage
You will receive an OTC card with a maximum limit up to the plan’s maximum for purchasing Healthfirst approved non-prescription, over-the-counter drugs and health-related items at participating pharmacy locations. See your Evidence of Coverage for more information or call plan for details.
While no prescription is needed prior to purchasing Healthfirst approved over-the-counter drugs and health-related items, some “dual purpose” items such as vitamins, minerals, supplements, hormone replacements, weight loss items, and diagnostic tools (i.e. blood pressure monitors) can only be purchased after a discussion with your provider who orally recommends the OTC item for a specific diagnosable condition.
OTC items may only be purchased for the enrollee, not for family members or friends.
- The OTC card is not a debit or credit card and cannot be converted to cash, nor can it be used to purchase Part B or Part D covered prescription drugs.
How to use your OTC Card 2014
You must activate your Healthfirst OTC card before your first use. To activate your OTC card, please call Card Services at 1-888-682-2400 (24 hours, 7 days a week) or go online to: https://www.otcnetwork.com/member (* Please note that clicking on these links will take you away from the Healthfirst website.).
You will need to provide:
- The OTC card number printed on the front of the card,
- Your Healthfirst Medicare Plan member ID card number, and
- Your birthdate (two digit month, two digit day, and four digit year; for example, 05/20/1930).
Simply take your activated Healthfirst OTC card with you to a participating pharmacy or retailer and select the eligible items you want to purchase. You do not need a prescription and do not need to go to the pharmacy window.
You can use your Healthfirst OTC card at any Rite Aid, Duane Reade, Walgreens, CVS, or Family Dollar location. In addition, you may continue to use Healthfirst OTC card at many neighborhood pharmacies.
For a complete list of participating pharmacies and retailers go to www.otcnetwork.com/member (* Please note that clicking on these links will take you away from the Healthfirst website.) or call our Member Services Representatives at 1-888-260-1010 (TTY/TDD 1-888-542-3821) 8 am to 8 pm, 7 days a week.
Take your eligible items to the front checkout lanes. Swipe your card at any register when you check out. Purchases for eligible items are automatically deducted from your card balance.
Things to Remember
- That OTC purchase(s) must be for your use only and cannot be used for family members or friends. Only you can use your Healthfirst OTC card to buy items that are on the approved OTC listings.
- The Healthfirst OTC card is not a debit or credit card and cannot be converted to cash.
- Unused balances expire at the end of each month. Any unused balances automatically expire at the end of the calendar year on December 31st, or upon disenrollment from the plan.
- The Healthfirst OTC Card cannot be used to purchase Part B or Part D covered items.
- Dual purpose items require a discussion with your provider prior to purchase.