To place an OTC order over the phone call: 1-855-963-0400 – TTY 1-877-206-0500

MEMBER SERVICES Contact Line: Please first call the number found on the back of your member ID card for accurate and faster service. 

HealthSun Health Plans is a HMO plan with a Medicare contract. As part of your enrollment into the HealthSun MediMax, SunPlus Advantage, HealthAdvantage plans, you will have over-the-counter (OTC) benefit credit to spend every quarter. A monthly allowance amount is only available if your plan offers the Over-the-Counter (OTC) services as a benefit.

Their plans are designed to give offer:

  • Low-cost healthcare coverage.
  • Coverage for prescription drugs.
  • Access to doctors, nurses and specialists who all work together to help you feel better.
  • The benefits you need to take good care of yourself.
  • Extra benefits that are not covered by Medicare Part A or Part B – Original Medicare.

Their goal is to provide benefits or arrange for benefits to be provided to those who are eligible and enroll or sign up.

What is the Over the Counter Benefit?

It is an allowance or pre-set dollar amount that allows you to order OTC medications through CVS at no additional cost. This benefit will help with the cost of necessary health care items that are not covered as a medical or pharmacy expense under your plan.

Why use the Over-the-Counter (OTC) services 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’ home. 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.
  • Shipping is free — There are no shipping or handling fees.

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.

The OTC program makes it possible for 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 from the comfort of home by calling an order in or mailing it in. With this supplement benefit, their members can order items such as:

  • Cough and cold allergy medicines
  • Vitamins
  • Medicines for the eyes
  • Pain medicine
  • Products for the stomach and bowel
  • First aid care
  • Hygiene products
  • Mosquito spray
  • Mouth and teeth cleansing products
  • Skin care
  • & 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 4 ways that members of this program can submit their prescription orders:

  1. Eligible members can call over the phone: 1-855-963-0400 – TTY 1-877-206-0500
  2. Eligible members can fax the order in to: 786-477-4685
  3. Eligible members may email the order to: OTCClerks@healthsun.com
  4. Eligible members may mail the order in to:

1905 West 35th Street
Suite 105
Hialeah, FL 33012

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 begging of this article for direction or if you are not sure which is your Plan you can check your Member ID card or call customer service at 1-877-336-2069 – (TTY: 877-206-0500).

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. 

  • https://www.healthsun.com/members/prescriptions

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 to the Over the Counter Order Forms, follow the easy steps below. We have provided a quick guide below.

Important Useful Tips for creating / processing / submitting your order:

  • It is extremely important to be note that any and all unused benefits will expire; they will NOT roll over to the next benefit period. 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.
  • 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 to delete or remove items from your in order bring the order total back down to be within 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.

Over The Counter OTC Catalog / Catalogue Mail Order forms:

MAIL ORDER FORM:

  • If you are ordering by mail: Please follow the instructions to complete the order form. Mail it to the address listed on the form.

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: 1-855-562-8853 (TTY/TDD 711)

You can also get information about the Medicare program and Medicare health plans by visiting www.medicare.gov on the Web or by calling 1-800-MEDICARE (1-800-633-4227). TTY/TDD users should call 1-877-486-2048.

Medicare customer service representatives are available 24 hours a day, seven days a week to answer questions about Medicare.