If youre a Healthfirst Medicare Advantage plan member with an OTC Plus card, you have the flexibility to spend your benefit in moreways and at more places. Use your OTC Plus card to pay for non-prescription drugs, health-related items, healthy foods and even home Internet service.
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How do you activate your OTC Medicare card?
- Baking Staples (includes dry thickeners and flour and cornmeal, including nut and seed flours) (excludes sugar & salt; sugar & salt substitutes allowed)
- Bottled Water (carbonated/uncarbonated/unflavored with no added sugar)
- Dried & Canned Beans
- Dried Pasta
- Electrolyte-rich Sports Drinks (with no added sugar)
- Fresh & Frozen Fruit (with no added sugar)
What can I buy with my OTC Medicare card?
You can use your OTC card for covered items at participating local retailers, including:
- CVS.
- Walgreens.
- Duane Reade.
- Rite Aid.
- Dollar General.
- Family Dollar.
- Walmart.
What does the Medicare OTC card cover?
Over-the-counter drug cards can be used to buy various health and wellness products, as well as medications, vitamins, durable medical equipment, and more. Your Medicare Advantage insurance plan provider is in charge of reloading your Medicare OTC card each month depending on your plan's benefits.
What items are covered under the OTC card?
Which over-the-counter (OTC) items does EmblemHealth cover?Allergy, sinus, and combination liquids and tablets.Cough, cold, and flu liquids and tablets.Denture/dental care (floss, toothbrush, toothpaste, and denture care).Elevated toilet seats and accessories.Instant hand sanitizer.More items...•
What can you buy at Walmart with an OTC card?
What can you purchase with an OTC Card at Walmart?Denture-related products.Digestive medications.First-aid materials.Orthopedic support.Pain relievers.Sleep aids.Wart removal products.Cold and cough medications.More items...•
Can I use OTC card for groceries?
* This benefit gives our members credits to buy OTC products and covered groceries at many retailers. The credits are loaded on a prepaid card, which members can use to pay at checkout. They can spend all their credits on healthy food, all on OTC products or some of each.
What can you buy with over-the-counter benefits?
Over-the-Counter drug benefits The supplemental benefit of Over-the-Counter medications and supplies can help you save money on over 100 items like pain relievers, cold medications, dental care and first aid supplies.
Can you buy milk with OTC card?
OTC Food Benefit Card It can be used to purchase eligible food items such as fresh fruits and vegetables, milk, bread, eggs.
Can I withdraw cash from my OTC card?
Benefits to OTC Withdrawals / Cash Advances: The benefit to an OTC cash withdrawal is that you can withdraw a larger amount, up to $705 per transaction with the same withdrawal fee.
Does Amazon take OTC cards?
A: In order to purchase OTC medicines with an FSA or HSA card, you need a prescription — and this feature is not yet supported by Amazon. That said, you can use other payment methods to purchase these items on Amazon and then request reimbursement from your plan administrator.
Does target accept OTC card?
Participating retailers include: CVS, Discount Drug Mart, Dollar General, Family Dollar, HEB, Rite Aid, Walmart, Walgreens and other independent pharmacy locations. Note: CVS Pharmacies at Target do not accept OTC Network cards.
How do I get money on my OTC card?
Simply complete eligible healthy activities like an annual wellness visit, certain screenings or participating in a qualifying health program. Rewards you earn will be automatically added to your OTC plus Card, with no forms to fill out.
Can I buy protein powder with OTC card?
If the label head reads “Supplement Facts,” it is considered a supplement and cannot be purchased using EBT. If the label head reads “Nutritional Facts,” then the protein powder is classified as a food, and EBT benefits can be used to purchase the product.
Does CVS accept OTC card?
You can also go to any OTCHS-enabled participating CVS Pharmacy® store to use your benefit, where available. How do I use the OTC benefit? 1) In select CVS retail locations: You can pick up your OTC items at any OTC Health Solutions® (OTCHS) enabled store.
What is Medicare Advantage?
This Medicare Advantage Prescription Drug plan is for those who are eligible for both Medicare and who are receiving full Medicaid benefits or cost-sharing assistance from Medicaid. It offers a $0 monthly plan premium, prescription drug coverage, and no copays.
What is Medicare 65 Plus?
65 Plus Plan (HMO) This Medicare Advantage Prescription Drug plan is for those looking for hospital, medical, and prescription drug coverage all in one plan. It offers a $0 monthly plan premium, prescription drug coverage, and low or no copays, with more than what Original Medicare offers.
What is a complete care plan?
CompleteCare (HMO SNP) Plan Details. This Medicare Advantage Prescription Drug plan is for those eligible for Medicare and who are receiving full Medicaid benefits, and are eligible for a nursing home level of care. Healthfirst CompleteCare integrates Medicare and Medicaid benefits with added long-term care benefits, including all medical, ...
What is HMO plan?
This Medicare Advantage plan is for those looking for hospital and medical benefits who don’t need prescription drug coverage. It offers a $0 monthly plan premium and low or no copays, with more than what Original Medicare offers.
What is a copayment for a checkup?
A fee that you pay each time you go to the doctor, get a drug prescription filled, or get other services. Example: If your health plan has a $20 Primary Care Doctor (PCP) copayment, you must pay $20 for a checkup with your PCP. Extra Help.
What is deductible in insurance?
Deductible. The amount of money you must pay in covered expenses each year before your plan or program pays anything for certain covered services. The deductible may not apply to all services. There may be different deductibles for different services (e.g., medical vs. pharmacy). Not all plans require deductibles.
How often does a deductible reset?
Your deductible resets once every year.
What percent of Medicare beneficiaries are OTC?
In 2019, more than 51 percent of Medicare Advantage beneficiaries were enrolled in a plan with OTC benefits. 1. This is due in part to the Centers for Medicare and Medicaid Services (CMS) giving Medicare Advantage plan carriers more flexibility in the benefits that Medicare Advantage plans can offer. This opened the door for Medicare Advantage ...
What drugs does Medicare not cover?
Which drugs are not covered by Medicare? Medicare Part A and Part B typically do not cover the following over-the-counter drugs: Vitamins and minerals (except prenatal vitamins and fluoride preparations, in certain situations) Drugs used only for the relief of a cold or cold symptoms.
What are the benefits of Medicare Advantage?
Some of the other newly expanded Medicare Advantage benefits include (but aren’t limited to) things like: 1 Non-emergency transportation services (such as trips to the doctor’s office) 2 Caregiver support 3 Home remodeling for aging in place (such as adding bathroom grab bars) 4 Some home-based palliative care 5 Home meal delivery
Does Medicare Advantage cover OTC?
As it turns out, some Medicare Advantage (Medicare Part C) plans may provide allowances for OTC drugs and other products. Medicare Advantage plan availability and benefits may vary, depending on where you live and the plan you have. A licensed insurance agent can help you compare Medicare Advantage plans in your area that may provide coverage ...
Does Medicare cover prescriptions?
Original Medicare (Part A and Part B) doesn’t typically cover prescription medication. If it does, it’s in only limited circumstances. So do Medicare beneficiaries have any options for coverage of over-the-counter (OTC) medications? As it turns out, some Medicare Advantage (Medicare Part C) plans may provide allowances for OTC drugs ...
Does Medicare cover hair growth?
Drugs used for cosmetic purposes or hair growth. Prescription drugs that fall into the above categories may be covered by Medicare if they are being prescribed to treat other conditions and are ordered by your doctor. Speak with your health care provider for Medicare coverage information.
Does Medicare Advantage offer home delivery?
Some Medicare Advantage plans may also offer home delivery of over-the-counter drugs. The exact OTC allowances and other benefits of Medicare Advantage plans may vary. Some Medicare Advantage plans feature $0 premiums, though these types of plans may not be available where you live.
Staying on Track with Refills
Staying on track with your medications can be hard. Healthfirst can help make it easier.
Your OTC Allowance
If your Healthfirst plan includes an over-the-counter (OTC) allowance, we’ll send you a pre-funded Healthfirst OTC card. For information on how to activate your OTC card, how your allowance works, what you can buy with it, and more, click below:
Forms
You can find various forms, documents, and resources, listed by your plan.
Your Coverage
Get personalized information about your Healthfirst coverage by logging in to your secure account.
Contact Us
We’re here to help you get the support you need. If you’d like more help, please contact us.
Coverage Decisions, Appeals, and Complaints for Medicare Members
For Medicare Advantage members, you can find information and forms related to coverage determinations, appeals, and complaints here.
What is a grievance on HealthFirst?
Complaints, also known as grievances, can be about any problem you have with your Healthfirst Medicare Plan or one of our providers. It does not pertain to the payment of or approval of benefits or prescription drugs, which are called determinations (see section on medical and prescription determinations).
What is a determination in healthfirst?
A determination is a decision Healthfirst makes about your benefits, coverage, or the amount we will pay for medical service or prescription drugs. A prescription drug determination may be requested when a drug you take is not on the formulary, or you wish to use a drug in a way that is not covered.
