Resources / Materials

Your current health plan offers an over-the-counter (OTC) benefit that lets you buy OTC health and wellness products. The catalog includes a list of OTC items that you can order and have mailed directly to your home.

There are three ways to order—in store, online, or by phone.  You can also download the new OTC Health Solutions App. The app is an easy and quick way to scan items in store, view your benefit information and items offered, process an order, review past orders, and look up account information. Ordering is easy. Just follow the steps in your plan's catalog.

Click on the OTC Catalog link below for all of your benefit details:

• Over-the-Counter Catalog

You can also connect to CVS® OTC Health Solutions to review products and store information.

• Covered Diabetes Testing Supplies - (PDF)

• Prescription Drug Claim Form-English (PDF)

• Express Scripts Mail Order Form-English (PDF) - Coming in December 2023
• Express Scripts Mail Order Form-Spanish (PDF) - Coming in December 2023

• List of Drugs (Formulary)

• List of Drugs Change Notice

• Drug Coverage Determination
• Drug Redeterminations (Appeals)

• Part D Prior Authorization Criteria Form

• Part D Step Therapy Criteria Form

• Appointment of Representative Form-English (PDF)
• Appointment of Representative Form Spanish (PDF)

• Member Handbook (PDF)

• How to request a Member Handbook by Mail?

• Summary of Benefits (PDF)

• Annual Notice of Changes - H0480-001 (PDF)

• Care Management Flyer (PDF)

• Health Link Waiver Program Flyer (PDF)

• Part B Step Therapy (PDF)

Your current plan offers an over-the-counter (OTC) benefit that lets you buy OTC health and wellness products. This catalog includes a list of OTC items that you can order to be mailed to your home. Check the catalog for your benefit details and item limits.

• Ordering is easy. Just follow the steps in your plan's catalog. 
• Over-the-Counter Catalog - English / Spanish (PDF)

Don't want to wait? You may be able to pick up your OTC products from a CVS® store near you.  Please note this does not include CVS® locations inside of Target stores.

Connect to the CVS® OTC Health Solutions to review available products and store information.

• Covered Diabetes Testing Supplies - (PDF)

• Prescription Claim Form - English (PDF)

• CVS Caremark Form - English (PDF)
• CVS Caremark Form - Spanish (PDF)

• Member Handbook (PDF)
• How to request a Member Handbook by Mail (PDF)

• Summary of Benefits (PDF)

• Annual Notice of Changes - H0480-001 (PDF)

• Provider and Pharmacy Directory Flyer (PDF)

• Care Management Flyer (PDF)

• Health Link Waiver Program Flyer (PDF)

• Part B Step Therapy (PDF)