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Over-the-Counter (OTC) Benefit

Use your allowance to shop for wellness products and healthy groceries.

There are three convenient ways to place an order. Choose the way that works best for you.

1. Shop Online

 

Orders can be placed using the Online Catalog:

  • To order certain vitamins, it is advised that you talk to your doctor before you place an order.
    These are called “dual-purpose items” which are marked with a “➤”.
  • Items in the catalog are for personal use and can only be ordered for the member.
  • View the downloadable catalog for instructions to create an online account before visiting the Online Catalog. Links to the downloadable catalogs are at the top of this webpage

2. Order by Phone

Orders can be placed by calling 1-888-628-2770 (TTY/TDD 711).

Step 1: Select your products from the OTC Catalog.

Step 2: Call 1-888-628-2770 (TTY/TDD 711).

For a speedy checkout, please have your OTC Health Solutions® (OTCHS) member ID and order ready when placing your order by phone. You can speak to a live agent Monday to Friday, from 9 AM to 8 PM local time. You can also order 24/7 via our automated interactive voice response (IVR) system.

3. In-store

Step 1: Visit a participating OTC Health Solutions-enabled store and shop for approved items that are in the catalog. Look for the OTCH indicator on the product shelf sticker to ensure a product is approved. To find your nearest location, go to:

Step 2: At checkout, inform the cashier you have OTC Health Solutions.

Step 3: Give them your first name, last name, and date of birth or present them with the barcode in the OTC Health Solutions App.

Orders for each benefit period must be placed by 11:59 PM ET of the last day of the benefit period.

Orders can only be cancelled within 30 minutes after being processed.

Please review the order frequency limits located in the FAQs to avoid missing benefit amounts.

Frequently Asked Questions About OTC Benefits

What is Medicare Advantage?

Medicare Advantage, or Medicare Part C, is a Medicare-contracted plan provided by private insurance companies that offers original Medicare benefits as well as additional benefits that Medicare does not cover.

Simpra Advantage offers two types of Medicare Advantage Special Needs Plans – Special Needs Plan members are still in the Medicare
Program (which means they do NOT lose their Medicare coverage)

Where can I find my member ID number?

It can be found on the front of your health plan ID card.

What is the (OTC) benefit?

The benefit lets you get over-the-counter items by going to any allowed stores. You can also order by phone at 1-888-628-2770 (TTY/TDD: 711) Monday to Friday, from 9 AM to 8 PM local time or online at https://www.cvs.com/benefits. You order from a list of approved items, and it will be sent to your address.

What is my quarterly allowance for OTC items?

The amount depends on your benefit plan. Check your Plan Summary of Benefits or call OTC Health Solutions at 1-888-628-2770 (TTY/TDD 711).

How often can I use my OTC benefit?

The number of times you can use your benefit to order by phone or online varies by plan. Please consult your plan catalog.

Quarterly benefit periods are distributed as follows:

  • Quarter 1 (January, February and March)
  • Quarter 2 (April, May and June)
  • Quarter 3 (July, August and September)
  • Quarter 4 (October, November and December)
Can I carry over unused benefit amount to the next benefit period?

Your quarterly (three month) benefit amount may be used in the quarter it is received. Any unused portion of the quarterly benefit may be carried into the following quarter; however, if the unused portion is not used during that quarter, it will expire. Please note, any unused benefit amount from the last quarter of the year (October, November, December) will not carry over to the next plan year.

Can I order more than my benefit amount?

You can’t order more than your benefit amount online or by phone. However, you may go over your benefit amount at any participating store and pay the difference out of pocket.

Are all items available at the stores?

Not all items are available in stores. Items marked with a “🚚” in the catalog can only be ordered over the phone or online.

Is there a limit on the number of items I can order?

There is no limit on the number of items you may order. You can order up to nine of the same item, per quarter. There are some items that have special limits. These are marked with a “★” or “■” in the catalog.

How long will it take to receive my order?

Most orders will arrive in less than 5 business days. It may take longer during peak volume periods as well as for orders that have hazardous items. If you have not received your order within 14 days please call OTC Health Solutions at 1-888-628-2770 (TTY/TDD: 711) Monday to Friday, from 9 AM to 8 PM local time.

Can I cancel my order once it has been placed?

Orders can only be cancelled within 30 minutes after being placed. To cancel an order, you can use the automated IVR system or talk to an agent.

How do I confirm my order was placed?

Once the order is placed, you will receive an order number. Access to order history is also available in the portal/app. Always keep your order number.

Can I track my order?

You can use our automated IVR system to track an order. If your phone number or email was added to your account, you will also receive email/ text updates. You can also view tracking information through our OTCHS portal/app.

How can I receive another copy of this catalog?

You will get a digital copy of the booklet when you receive status updates through email or text. You can also order a copy using our automated IVR system, talking to an agent, or by printing one from the plan web page. A digital copy will also be available in the support section of the portal/app.

Where can I get additional information about the products?

In your catalog, you will find SKU numbers (product numbers) that can be used at cvs.com to search for product images and obtain additional product information such as ingredients.

How will the items be shipped?

Items are shipped via UPS to your home at no charge to you.

What is the return policy?

Due to the personal nature of the products, no returns or exchanges are allowed. If you haven’t received your order or if you received a defective or damaged item, please call OTC Health Solutions within 30 days of placing your order. If your item is not in stock, an item of similar or greater value may be substituted in your order.

Can I return items and receive cash as reimbursement?

No, you receive an allowance from your health plan to spend on eligible OTC items, there are no cash reimbursements allowed through the program.

What is the IVR used for?

You can always use our automated IVR system 24/7 to:

  • Place an order
  • Track an order
  • Cancel an order
  • Hear benefit information
  • Order a booklet
What are dual-purpose items?

“Dual-purpose items” are marked with a “u” in the catalog. It is advised that you talk to your doctor before you place an order for these items.

Can I order items for someone other than the member?

Items in the catalog are for personal use and can only be ordered for the member.

Who can I call if I have questions?

You may call OTC Health Solutions at 1-888-628-2770 (TTY/TDD: 711) from 9 AM to 8 PM local time Monday through Friday.