MEMBER SERVICES Contact Line: Please first call the number found on the back of your member ID card for accurate and faster service.
Healthfirst Health Plan, Inc. offers HMO plans that contract with the Federal Government. This company understands that some of the medications and health-related items their members may need may not require a prescription. If you’re a member of a plan with an OTC benefit, you will receive a Healthfirst OTC card in the mail. It will be a pre-funded card. The amount depends on the monthly allowance provided upon enrollment. Once you receive the card, you’ll need to activate it.
2020 Healthfirst Plans with OTC Benefits:
Life Improvement Plan (HMO SNP) – $140 per month ($1,680 per calendar year) for purchase of OTC items (approved non-prescription drugs and health-related items).
CompleteCare (HMO SNP) – $150 per month ($1,800 per calendar year) for purchase of OTC (approved non-prescription drugs and health-related items) and selected grocery items.
Coverage options may vary depending upon your location. Their goal is to provide benefits or arrange for benefits to be provided to those who are eligible and enroll or sign up.
What can you buy / order / purchase with an OTC Card?
You may buy approved OTC nonprescription drugs and health-related items (such as aspirin, cold/flu medicine, and bandages) at any participating pharmacy. If you are a CompleteCare member, you can purchase selected grocery items in addition to the nonprescription, health-related items.
Why use the Over the Counter Supplies benefit?
• You Will Save Money — Members can get OTC items they need without spending money out of pocket. Get an allowance per each quarter to use on a wide range of health-related items such as cold remedies and personal care items. • Easy Access — OTC orders are delivered straight to members’ homes. No need to drive anywhere. • Save Your Time — One less trip to the pharmacy means members get to spend more time on what matters most.
No Extra Costs!
These products are all provided at no extra cost but by using a credit / pre-determined allowance provided under the benefit. The orders will be shipped to their home at no extra charge.
Currently HealthFirst works with OTC Network to allow their members to take advantage of their OTC benefits. The Counter online program makes it possible for millions of current eligible plan members to easily order items using their home delivery services. Members who are eligible for this health benefit program are able to order over-the-counter products online from the comfort of home by going online, calling an order in or mailing it in. With this supplement benefit, their members can order items such as:
Cough and cold allergy medicines
Medicines for the eyes
Products for the stomach and bowel
First aid care
Mouth and teeth cleansing products
& a lot more!
These products are all provided at no extra cost when part of an eligible plan. They simply use credits / a pre-determined allowance provided under the benefit. The orders are shipped to their home at no extra charge. There are two was that members of this program can submit their prescription orders:
Eligible members can go online (see below on how to set up an account). This is the fastest, easiest, and most convenient way to order 24/7.
Eligible members can call over the phone: 1-888-260-1010
TTY English: 1-888-542-3821
TTY Español: 1-888-867-4132
Where can you use your Healthfirst OTC Card?
You can use your Healthfirst OTC card at any Duane Reade, Walgreens, CVS, or Family Dollar location.
DO YOU QUALIFY?
You will need to make sure you check your plan’s Summary of Benefits of your personal current plan to confirm if a plan offers this benefit. If it does, you must also check the plan’s specific OTC allowance frequency, as it can be either monthly or quarterly. The allowance amount varies and depends on the plan. You may call the number provided at the beginning of this article for direction.
Only some plans include a quarterly allowance. The credits can be used to pay for select over-the-counter medications and supplies, including allergy medication, digestive health treatments, first aid supplies, pain relievers, and more. If your plan includes this benefit, review your Evidence of Coverage to find your exact quarterly allowance amount.
NOTE: please visit the site directly to verify the details and obtain more information.
NOTICE: This information is not a complete description of benefits available. Contact the company directly for more information about their plans.
If you need to access the sign in or registration page, follow the easy steps below. We have provided a quick guide for you to find out how you can sign in to a current account or activate a new online account and gain access to manage it online. Be sure you have your personal information on hand.
What you need to register / sign in to a HealthFirst OTC Network account online:
Member ID information
Below are the steps you need to follow to register for a new online account:
Visit: https://www.otcnetwork.com/member in your internet browser on your device.
You’ll need to provide:
The OTC card number printed on the front of the card
Your Healthfirst Medicare Plan Member ID card number
Your birthdate (two-digit month, two-digit day, and four-digit year; for example, 05/20/1930)
Continue to move forward and provide all the required information until you receive a successful registration confirmation.
If you successfully registered you will receive an email verification showing that all is good with your registration. You will now have full access to your online account and can begin taking advantage of the HealthFirst OTC Network online pharmacy benefits that your plan includes if you qualify.
Important Useful Tips for creating / processing / submitting your order:
You must activate your Healthfirst OTC card before you can use it. Visit : https://healthfirst.org/over-the-counter-otc-benefits/#card-activation to learn more OR to activate, please call Card Services at 1-888-682-2400 (24 hours a day, 7 days a week).
Any and all unused benefits will expire; they will NOT roll over to the next benefit period. Also, you will not be allowed to request a partial or submit multiple orders. Because of this, you will need to make sure to submit a complete order of all the items you need for the benefit period when submitting your order online or over the phone. Again, any unused balance will automatically expire at the end of each month or upon disenrollment from the plan.
You are not allowed to order more than your allotted benefit amount. For example: if your total benefit is $10 and your order total is $10.95, you will have to delete or remove items from your order to bring the order total back down to be within the allotted benefit amount in order to submit the request. You will need to make sure that the total amount due is within your allotted monthly benefit amount.
OTC items may only be purchased only 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.
It cannot be used to purchase Part B or Part D covered prescription drugs.
If you still have questions about your plan, you may call the phone number found on the back of your health plan member card.
General contact number is: 1-844-243-5176 or TTY at 711