Over-the-Counter. (OTC) Items. Benefit

Over-the-Counter (OTC) Items Benefit Get up to $120 in FREE over-the-counter (OTC) items each year! That’s $10 each month! Para solicitar este ...
Author: Victor Ellis
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Over-the-Counter

(OTC) Items

Benefit

Get up to

$120 in FREE over-the-counter (OTC) items each year!

That’s $10 each month!

Para solicitar este documento en español o para escuchar la traducción, llame al Servicio al Cliente al 1-877-389-9457 (TTY/TDD: 1-877-247-6272).

It’s EASY to get your items. Just follow these steps:

1 Choose what you and your family need. 2 Call Member Services with your order. 3 The toll-free phone number is

1-877-389-9457 (TTY/TDD: 1-877-247-6272).

4 Or visit our website at

kentucky.wellcare.com, log into the member portal and place your order.

That’s it! Your order will be mailed to your home at NO CHARGE to you! For more information, call 1-877-389-9457 (TTY/TDD: 1-877-247-6272).

Item

Generic Comparable

ALLERGY PREVENTION AND TREATMENT 1 Loratadine 10mg Tablets 2 Cetirizine 10mg Tablets 3 Diphenhydramine 25mg Capsules 137 Chlorpheniramine 4mg Allergy Tablets ANALGESICS/ANTIPYRETICS 4 Aspirin 325mg Tablets 5

Aspirin Enteric Coated 81mg Tablets

6

Enteric Coated Aspirin 325mg Tablets

7

Acetaminophen 325mg Tablets

8

Acetaminophen 500mg Tablets

9 Pre-Menstrual Relief Tablets 136 Pain Relief PM ANTACIDS AND ACID REDUCERS 10

Gas Relief 80mg Tablets

11 12

Omeprazole 20mg Calcium Carbonate 500mg Tablets

– Amount is for each head of household, not each family member. – If you do not use your $10 in a month, it does not carry over to the next month. – Items, quantities and prices may change depending on availability. OTC Items Benefit | 1

Brand Description

Qty

Cost

Claritin® Zyrtec® Benadryl® Chlor-Trimeton Tablets

10 14 24 24

$5.00 $7.00 $4.00 $3.00

Bayer® Aspirin Bayer EC® Aspirin (Adult Regimen) Ecotrin® Tablets Tylenol® Regular Strength Tablets Tylenol® Extra Strength Caplets Midol® Tylenol PM

100

$3.00

120

$5.00

60

$4.00

100

$6.00

50

$5.00

24 24

$7.00 $3.00

100

$8.00

14 150

$10.00 $4.00

Mylanta® Gas 80mg Tablets Prilosec® Tums® Tablets

– Brand items may be supplied in place of generic items. – The brand names of the OTC items listed are trademarks of their respective owners.

OTC Items Benefit | 2

Item

Generic Comparable

13 Ranitidine HCL 75mg Tablets 14 Famotidine 10mg Tablets 15 Gas Relief (Extra Strength) Tablets ANTI-ARTHRITICS 16

Acetaminophen 650mg Tablets

Glucosamine 1500mg/Chondroitin 1200mg ANTICANDIALS (YEAST) Clotrimazole Vaginal 1% Cream—1 18 Application ANTIDIARRHEALS AND LAXATIVES 20 Docusate Sodium 100mg Capsules 21 Adult Glycerin Suppositories 22 Bisacodyl 10mg Suppositories 23 Bisacodyl 5mg Tablets 24 Loperamide 2mg Capsules 25 Antinausea Liquid 17

26

Bismuth Subsalicylate 262mg Tablets

Brand Description

Qty

Cost

30 18 30

$8.00 $6.00 $5.00

50

$6.00

60

$9.00

Gyne-Lotrimin®

6oz

$8.00

Colace® Softgels Fleet® Adult Suppositories Dulcolax® Suppositories Dulcolax® Tablets Imodium® Caplets Emetrol® Pepto-Bismol® Chewable Tablets

60 50 12 25 12 4oz

$8.00 $4.00 $6.00 $5.00 $5.00 $7.00

30

$4.00

Dramamine® Motion Sickness

12

$4.00

Benadryl® Cream

1oz

$4.00

Bengay®

1.25oz

$3.00

Neosporin® Ointment Lotrimin® AF

0.5oz 0.5oz

$5.00 $6.00

Zantac® Tablets Pepcid® Gas-X® Extra Strength Tylenol® Arthritis Pain Tablets Glucosamine/Chondroitin DS®

MOTION SICKNESS MEDICATION 28

Dimenhydrinate 50mg Tablets

TOPICAL OINTMENTS AND CREAMS 29 Diphenhydramine Anti-Itch Cream Menthol 10%/Methyl Salicylate 15% 30 Cream 31 Triple Antibiotic Ointment 32 Clotrimazole 1% Cream OTC Items Benefit | 3

OTC Items Benefit | 4

Item

Generic Comparable

Brand Description

Qty

Cost

Tolnaftate 1% Cream Tinactin® Cream Hydrocortisone 1% Maximum Strength 35 Cortaid® Cream Cream 134 Capsaicin Cream Zostrix Cream 135 Benzoyl Peroxide Cream 10% Clearasil 10% Cream COLD, FLU, DECONGESTANT AND SINUS REMEDIES Oxymetazoline Hydrochloride 0.05% 36 Afrin® Nasal Spray Solution 37 Saline Nasal Spray Ocean® Nasal Spray 38 Throat Lozenges—Assorted Flavors Halls® Cough Drops 39 Guaifenesin 100mg/5ml Robitussin® Syrup Robitussin® Sugar-Free 40 Guaifenesin 100mg/5ml—Sugar-Free Syrup 41 Vicks Vaporub® Vicks Vaporub® Acetaminophen 325mg/ 42 Dextromethorphan 10mg/Phenylephrine DayQuil® Caplets 5mg Tablets Acetaminophen 325mg/ 43 Dextromethorphan 15mg/Doxylamine NyQuil® Caplets 6.25mg Tablets ASA 325mg/Sodium Bicarbonate 44 Alka-Seltzer® 1916mg/Citric Acid 1000mg Tablets 45 Guaifenesin 600mg Tablets Mucinex® Guaifenesin 600mg/Dextromethorphan 46 Mucinex-DM® 30mg Tablets COLD, FLU, DECONGESTANT AND SINUS REMEDIES 47 Phenylephrine HCL 10mg Tablets Sudafed® PE Tylenol® Sinus and 48 APAP Sinus Congestion Congestion Tablets

0.5oz

$6.00

0.5oz

$4.00

1 1

$6.00 $6.00

1oz

$5.00

1.5oz 30 4oz

$3.00 $2.00 $5.00

4oz

$5.00

3.53oz

$6.00

20

$6.00

12

$4.00

20

$5.00

30

$9.00

30

$10.00

18

$4.00

24

$5.00

33

OTC Items Benefit | 5

OTC Items Benefit | 6

Item

Generic Comparable

DENTAL/DENTURE CARE 49 Benzocaine 20% Oral Anesthetic 50 Denture Adhesive Cream 51 Toothbrush 52 Fluoride Toothpaste 53 Waxed Dental Floss EAR CARE 54 Ear Syringe 55 Carbamide Peroxide (6.5%) Solution EYE CARE Polyvinyl Alcohol 0.5%/Povidone 0.6% 56 Lubricant Eye Drops 57 Tetrahydrozoline HCl 0.05% FIBER SUPPLEMENTS 58 Psyllium Husk, Approximately 0.52g FIRST AID/MEDICAL SUPPLIES 59 Athletic Bandage 60 Adhesive Tape—1/2 Inch x 5 Yards 61 Alcohol Swabs 62 Bandages—Assorted 63 Butterfly Closures 64 Cotton Balls 65 Cotton Swabs 66 Ice Bag Stretch Gauze Bandage—2 Inches x 5 67 Yards 68 Oral Thermometer 69

Flexible Tip Thermometer OTC Items Benefit | 7

Brand Description

Qty

Cost

0.5oz 2.4oz 1 6.4oz 1

$5.00 $4.00 $2.00 $3.00 $2.00

Ear Syringe 3oz Debrox® Ear Wax Removal 0.5oz

$4.00 $7.00

Murine® Tears

0.5oz

$5.00

Visine® Drops

0.5oz

$4.00

Metamucil®

90

$9.00

Ace® Bandage Adhesive Tape Alcohol Swabs Band-Aids® Butterfly® Closures Cotton Balls Q-Tips® Cotton Swabs Ice Bag Johnson & Johnson® Gauze Oral Thermometer Flexible Tip Thermometer

1 1 100 30 10 100 200 1

$3.00 $2.00 $3.00 $2.00 $2.00 $2.00 $3.00 $5.00

1

$2.00

1

$6.00

1

$10.00

Anbesol® Fixodent® Toothbrush Colgate® Waxed Dental Floss

OTC Items Benefit | 8

Item 70

Generic Comparable Thermometer Probe Covers

71 Menthol 5% Patches FIRST AID/MEDICAL SUPPLIES 72

Corn and Callus Remover

73

Salicylic Acid (17% w/w) Liquid

HEMORRHOIDAL PREPARATIONS Mineral Oil 46.6%/Pramoxine HCL 1%/ 74 Zinc Oxide 12.5% Mineral Oil 14%/Petrolatum 71.9%/ 75 Phenylephrine 0.25%/Shark Oil 3% Cream 76 Witch Hazel 50% Pads HEADACHE RELIEF Acetaminophen 250mg/Aspirin 250mg/ 78 Caffeine 65mg Tablets Acetaminophen 500mg/ 79 Diphenhydramine Citrate 38mg Tablets ANTI-INFLAMMATORY 80 Ibuprofen 200mg FC Tablets 81 Naproxen Sodium 220mg Caplets 82 Ibuprofen 200mg Liquid Gel Caps PEDICULICIDES Lice Treatment Maximum Strength 83 Shampoo 84 Lice Comb

OTC Items Benefit | 9

Brand Description

Qty

Cost

30

$3.00

5

$6.00

0.33oz

$5.00

0.31oz

$7.00

0.7oz

$4.00

Preparation H® Ointment

2oz

$8.00

Tucks® Medicated Pads

100

$8.00

Excedrin® Migraine

24

$4.00

Excedrin® PM Tablets

50

$6.00

Advil® Tablets Aleve® Caplets Advil® Liquid Gel Caps

50 50 20

$5.00 $6.00 $5.00

4oz

$10.00

1

$5.00

Thermometer Probe Cover Icy Hot® Patches—Large Dr. Scholl’s® Corn and Callus Remover Compound W® Wart Remover Tucks® Hemorrhoidal Ointment

Rid® Extra Strength Shampoo Lice Comb

OTC Items Benefit | 10

Item

Generic Comparable

SLEEPING AIDS 85 Diphenhydramine 25mg Capsules VITAMINS AND MINERALS 86 B-Complex/B-12 Vitamins 87

Adult Multi-Vitamin Tablets

88 89 90

Prenatal Vitamins Vitamin C 500mg Tablets Vitamin E 400 IU Caplets

91

Vitamin A 10,000 IU Caplets

92 Elemental Iron 65mg Tablets 93 Folic Acid 500mcg Tablets 94 Magnesium 250mg Tablets 95 Zinc 50mg Tablets 96 Synthetic Vitamin B-1 100mg Tablets VITAMINS AND MINERALS 97

Synthetic B-12 500mcg Tablets

98

Synthetic Vitamin B-6 100mg Tablets Calcium Carbonate 600mg/Vitamin D 99 400 IU Tablets 100 Calcium Carbonate 600mg Tablets CHILDREN’S PRODUCTS 101 Orajel Baby

Brand Description

Qty

Cost

Unisom® Sleep Tablets

16

$5.00

B-Complex/B-12 Vitamins Centrum® Multi-Vitamin Tablets Stuart Prenatal® Vitamins Vitamin C 500mg Tablets Vitamin E 400 IU Caplets Vitamin A 10,000 IU Caplets Feosol® Folic Acid 400mcg Tablets Magnesium 250mg Tablets Zinc 50mg Tablets Vitamin B-1 100mg Tablets

100

$6.00

100

$9.00

100 100 100

$10.00 $4.00 $7.00

100

$4.00

100 100 100 100 100

$7.00 $5.00 $3.00 $5.00 $4.00

100

$6.00

100

$5.00

Caltrate® 600 + D

60

$6.00

Caltrate® 600

60

$5.00

Orajel® Baby

0.33oz 1.4oz gel 1oz 0.5oz

$6.00

Vitamin B-12 500mcg Tablets Vitamin B-6 100mg Tablets

102 Tooth and Gum Cleanser

Tooth and Gum Cleanser

103 Diaper Rash Ointment 104 Salicylic Acid 17% w/v 0.5oz Liquid

Balmex® Ointment Duofilm®

OTC Items Benefit | 11

OTC Items Benefit | 12

$6.00 $3.00 $7.00

Item

Generic Comparable

105 Gas Relief Drops 106 Baby Poly Vitamin Drops 50ml 107 Children’s Chewable Multi-Vitamins 108 Children’s Ibuprofen Suspension 100mg 109 110 111

Junior Strength Pain Ibuprofen Chewable Tablets 100mg Junior Strength Pain Relief Apap Chewable Tablets 160mg Acetaminophen Children’s Elixir 160mg/5ml

112

Acetaminophen Chewable Tablets

113

Children’s Cold and Allergy Elixir 5ml

114

Infant Ibuprofen Oral Suspension 50mg

115

Acetaminophen Children’s Elixir 30ml

116

Childen’s Glycerin Suppositories

Diphenhydramine Liquid 5ml—Alcohol Free OTHER ITEMS 120 Condoms 121 Pill Box 122 Throat Lozenges 123 Hand Sanitizer Wipes 124 Feminine Hygiene Wipes 117

OTC Items Benefit | 13

Brand Description

Qty

Cost

Mylicon® drops Poli-Vi-Sol® Drops Flintstones® MultiVitamins Motrin® Suspension for Children

1oz 50ml

$10.00 $7.00

100

$7.00

4oz

$6.00

Motrin® Jr. Strength

24

$5.00

Tylenol® Jr. Strength

24

$5.00

Tylenol® Children’s Elixir

4oz

$5.00

30

$5.00

4oz

$5.00

1

$7.00

1oz

$5.00

25

$2.00

Benadryl® Elixir

4oz

$4.00

Condoms Pill Box Chloraseptic® Hand Sanitizer Wipes Feminine Hygiene Wipes

3 1 18 24 12

$2.00 $2.00 $2.00 $4.00 $2.00

Tylenol® Children’s Chewable Tablets Dimetapp® Cold and Flu Elixir Motrin® Infant Drops Dye Free Tylenol® Infant Drops Children’s Glycerin Suppositories

OTC Items Benefit | 14

Item 125

Generic Comparable Premium Medium Baby Diapers

126 Premium Large Baby Diapers 127

Premium Extra Large Baby Diapers

128 SPF 30 Sunblock 129 Preference Facial Tissue OTHER ITEMS 130 Pregnancy Test 131 Fever Strip Thermometer  132 Premium Baby Wipes 133

Premium Antibacterial Hand Soap

138

Dry Skin Therapy Moisturizing Cream

OTC Items Benefit | 15

Brand Description Premium Medium Baby Diapers Premium Large Baby Diapers Premium Extra Large Baby Diapers SPF 30 Sunblock Preference Facial Tissue Pregnancy Test Fever Strip Thermometer  Pampers Baby Wipes Soft Soap Antibacterial Soap Eucerin Cream

Qty

Cost

18

$8.00

16

$8.00

14

$8.00

1 1

$6.00 $2.00

1 1 1 pkg

$8.00 $3.00 $3.00

1

$3.00

1

$8.00

OTC Items Benefit | 16

KY017502_CAD_OTC_ENG State Approved 01062012 WC012012218

P.O. Box 43800 Louisville, KY 40253

©WellCare 2011 KY_12_11

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