Over the Counter Catalog - SilverSummit HealthPlan

Over-the-Counter Catalog Your Benefit and Inventory Availability Guide

Welcome to your SilverSummit Healthplan

Over-the-Counter Catalog

Stay healthy, save money.

As a commitment to your health and well-being, SilverSummit HealthPlan offers members an

additional quarterly benefit of $30 per household, for commonly used over -the-counter (OTC)

items. These items will be shipped directly to your home. Items listed in this brochure are cov-

ered at no cost to you within your maximum benefit of $30 in items per household per calendar

quarter All OTC items should only be used as directed. You should talk to your Primary Care Provider

(PCP) about how to use these items safely..

How to order online

You can now order your over-the-counter products through the secure portal on

SilverSummitHealthplan.com

1. Click “Pharmacy Information” from the secure portal man menu on SilverSummitHealthplan.com

2. Click the “Click here to view your health plan brochure” to see SilverSummit Healthplan’s OTC Cata-

log. Click “Shop for products” to begin an OTC order. You can enter a short description, the catalog

number, or select the search button to view available items.

3. Enter the quantity for each desired item and click the “add to cart” button.

4. Once your order is complete, click “place order” and then log out using the icon in the top right corner.

How to order by phone

Ordering is as easy as 1-2-3:

1. Have your SilverSummit Healthplan Member ID card with you. You will need your Member ID number.

2. Choose the items you would like to order and write down the item number. You will need this when

placing your order.

3. Call to place your order at 1-866-577-9010. Operators are available from 8 a.m.—8 p.m. EST,

Monday through Friday.

You may select items you need from the list below up to your benefit amount of $30 per household per calendar quarter.

Prescriptions are not required for these items

Item # Description Compare to OTC Price

ANALGESICS

1 Ibuprofen 200mg tab (50 Tabs) Advil® 6.00$

2 Naproxen Sod 220mg tab (50 Tabs) Aleve® 9.00$

3 Aspirin 325mg tab (100 Tabs) Bayer® 5.00$

4 Aspirin ec 325 mg tab (100 Tabs) Bayer® 6.00$

5 Aspirin EC 81 mg (120 Tabs) Bayer® 5.00$

6 Acetaminophen 500mg tab (100 Tabs) Tylenol® 6.00$

7 Mentholated Ointment (3oz tube) Bengay® 6.00$

128 Phenazopyridine tab (30ct) Azo® 13.00$

174 Acetaminophen Pain Relief PM (50ct) Tylenol PM® 7.00$

175 Acetaminophen (100ct) 325mg Tylenol® 4.00$

226 Aspirin Chewable (36ct) Bayer Chewable® 2.00$

327 Migraine Tablet (24ct) Excedrin® Migraine 24ct 10.00$

ANTI-DIARRHEALS

11 Loperamide 2mg cap (12 capsules) Imodium® 5.00$

12 Bismuth Mixture (8oz liquid) Pepto-Bismol® 8.00$

120 Lactase Enzyme Major® 10.00$

130 Loperamide 1mg/7.5ml Susp (4 oz.) Major® 8.00$

ANTACIDS

8 Simethicone 80mg tab (100 tabs) Mylanta Anti-Gas® 6.00$

9 Calc Carb 500mg Chewable (150 tabs) Tums® 6.00$

10 Heartburn Relief 10mg tab (30ct) Pepcid AC® 9.00$

97 Omeprazole 20mg (14ct) Prilosec® 19.00$

139 Mylanta Antacid Max Strenght Classis (12oz) MYLANTA® 15.00$

140 Simethicone 125 mg Chewable (60 ct.) Gas-X® 8.00$

163 Effervescent Pain Relief (36ct) Alka-Seltzer® 11.00$

164 BeanAid Capsules (30ct) Beano® 6.00$

205 Heartburn Relief Tablets (100ct) Gaviscon® 12.00$

206 Antacid Calcium Smooth (60ct) TUMS® 8.00$

207 Motion Sickness Tablets (12ct) Dramamine® 4.00$

209 Pink Bismuth Chewable (30ct) Pepto-Bismol® 4.00$

ANTIFUNGALS

13 Clotrimazole 1% vag cream (1.5 oz) GYNE-Lotrimin® 9.00$

14 Tolnaftate 1% (0.5oz) Tinactin® 7.00$

98 Monistat 3-day Vaginal Cream (3pk) MONISTAT® 20.00$

ANTI-HEMORRHOIDALS

15 Hemorrhoidal Ointment (2 oz) Preparation H® 8.00$

118 Hemorrhoid Pads (100ct) Geritrex® 10.00$

119 Hemorrhoid Relief Supp. (12ct) Preparation H® 7.00$


CHILDREN'S PRODUCTS

16 Baby Teething Pain Relief, Benzocaine Free, (0.18 oz) Baby Orajel® 9.00$

17 Diaper Rash Ointment (4 oz) Desitin® 9.00$

18 Simethicone Drops (30ml) Mylanta Drops® 7.00$

19 Multivitamin Drops (50ml) Poly-Vi-Sol® 8.00$

20 Ibuprofen 100mg/5ml susp (4 oz) Mortin® 9.00$

21 Acetaminophen Liquid (4 oz) Tylenol® 6.00$

22 Acetaminophen Chewable 80 mg (30 tabs) Tylenol Chewable® 5.00$

23 Acetaminophen Child/Infant 1 fl oz (30ml) Tylenol Drops® 6.00$

73 Baby Wipes (72 wipes) Pampers Baby Wipes® 6.00$

89 Ibuprofen Jr 100mg. Chew (24ct) IBUPROFEN JR® 9.00$

90 Ibuprofen Child Susp Drops 50mg/1.25ml (15ml) IBUPROFEN CHILD DROPS® 13.00$

92 Loratadine 5mg/5ml Soln (120ml) Major® 11.00$

93 Loratadine 10mg Quick Dissolve (60ct) Major® 12.00$

108 Children's Toothpaste (4.6 oz.) AquaFresh Kids® 7.00$

131 Thermometer Rectal Mercury Free Rg Med (1ea) Childrens Rectal Thermometer® 12.00$

150 Baby Shampoo (10.2 oz) Johnson + Johnson® 10.00$

151 Baby Lotion (10.2 oz) Johnson + Johnson® 9.00$

152 Baby Oil (14 oz) Johnson + Johnson® 11.00$

154 Infant or Child Dosing Syringe/Teaspoon (5ML) (1ea) Care Touch® 1.00$

155 Infant Nasal Syringe (1ea) Doubro® 6.00$

237 Baby - Cabinet Lock (1ct) Safety First® 5.00$

257 Sunscreen Lotion, Babies, SPF-50 (6oz) Coppertone® 15.00$

271 Children's Toothbrush (1ct) Toothbrush 4.00$

272 Org Dairy DHA Baby Powder Formula (360g) ages 1yr+ Enfamil® 19.00$

273 Org Lactorelief Baby Powder Formula (360g) ages 1+ Enfamil® 19.00$

274 Organic Soy Baby Powder Formula (360g) ages 2+ Enfamil® 19.00$

275 Similac Expert Care Neosure Preemi Baby Formula (13.1oz) Similac® 19.00$

285 Premium Baby Moisturizing Cream (5oz) CERAVE BABY MOISTURIZING LOTION® 9.00$

330 Preemi Diapers up to 10lbs (20pk) Pampers® 12.00$

331 Premium Diapers S Size 1, 8 to 14lbs (20pk) Pampers® 12.00$

332 Premium Diapers M Size 2, 12 to 18lbs (34pk) Pampers® 12.00$

333 Premium Diapers M Size 3, 16 to28 lbs (34pk) Pampers® Swaddlers Diapers MED Size 3 12.00$

334 Premium Diapers L Size 4, 22 to 37 lbs (24pk) Pampers® 12.00$

335 Premium Diapers XL Size 5, 27+ lbs (22pk) Pampers® 12.00$

336 Premium Diapers XXL Size 6, 35+ lbs (18pk) Pampers® 12.00$

337 Pull-Up Diapers Trainer 2T-3T (26pk) Pull-Ups® 19.00$



348 Children's Electrolyte Powder Packet (6ct), Cherry Flavored Pedialyte® Electrolyte - Cherry 12.00$

349 Children's Electrolyte Powder Packet (6ct), Grape Flavored Pedialyte® Electrolyte - Grape 12.00$

350 Children's Electrolyte Powder Packet (6ct), Orange Flavored Pedialyte® Electrolyte - Orange 12.00$

351 Children's Electrolyte Powder Packet (6ct), Strawberry Lemonade Pedialyte® Electrolyte - Strawberry Lemon 12.00$

352 Baby - Toilet Lock (1ea) Safety First® Baby - Toilet Lock 9.00$

359 Baby Wipes, Travel Size Huggies® Travel Wipes 1.00$


CONTRACEPTIVES

55 Condoms (3-pack) TROJAN ENZ NON LUBE® 4.00$

121 VCF Contraceptive Foam (0.6 oz.) VCF CONTRACEPTIVE FOAM® 15.00$

122 VCF Contraceptive Film (9ct) VCF CONTRACEPTIVE FILM® 12.00$

125 Gynol II Contraceptive Jelly XStr (2.85 oz.) GYNOL II CONTRACEPTIVE JELLY® 17.00$

COUGH / COLD / ALLERGIES

24 Diphenhydramine 25mg caps (24 ct.) Benadryl® 5.00$

25 Diphenhydramine elixir (4 oz.) Benadryl® 5.00$

26 Sore throat lozenge (18 ct) Cepacol® 5.00$

27 Medicated chest rub (3.5oz) Vicks VapoRub® 7.00$

28 Guiafenesin syrup (4oz) Robitussin CF® 5.00$

29 Oxymetazoline 0.05% (0.5 oz) Afrin Nasal Spray® 5.00$

30 Loratadine 10mg tab (30tabs) Claritin® 10.00$

91 Nasal Saline Spray .65% (44ml) Ocean® 4.00$

96 Cetirizine 10mg Tab (30 ct) Zyrtec® 9.00$

165 Nighttime Cold & Flu (16ct) NyQuil® 5.00$

166 Sore Throat Spray (6oz) Chloraseptic® 6.00$

167 Cough & Cold (HBP) (16ct) Coricidin® 12.00$

168 Cold Sore Treatment (.23oz) Abreva® 17.00$

169 Honey Lemon Cough Drops (30ct) Halls® 6.00$

210 Cold Flu & Sore Throat Max (8oz) Mucinex® 10.00$

211 Tussin DM (4oz) Robitussin DM® 5.00$

212 Nasal Decongest Pseudo Free (18ct) Sudafed PE® 6.00$

213 Chest Congest/Mucus Relief (60ct) Mucinex® 9.00$

214 Daytime Cold/Flu Pseudo Free Soft Gels (16ct) DayQuil® 5.00$

215 Sinus Acetaminophen (24ct) Tylenol Sinus® 6.00$

216 Childs Cold Cough & Sore Throat (4oz) Mucinex® 12.00$

217 Fluticasone Nasal Spray (.5oz) Flonase® 15.00$

218 Air Shield Orange Tablets (10ct) Airborne® 7.00$

286 Cold and Allergy Elixir (4oz) Dimetapp® Cold and Allergy Elixir 10.00$

287 Children's Mucinex® (4oz) Children's Mucinex® 8.00$

345 Multi-Symp Severe Cold/Flu (6ct) Thera-Flu®, Multi-Symp Severe Cold-Lemon 9.00$

347 Neti Pot Kit, Sinus Cleanser (1kt) SinuCleanse® Neti Pot 10.00$

388 Green Tea, Multi Flu/Severe Cold Honey Lemon TheraFlu® 9.00$

DAILY LIVING AIDS

145 Reacher Arm Device - 26.5" (1ea) Reaching Aid FabLife® 15.00$

245 Food aid bumper (1ct) McKesson® 12.00$

248 PILL BOTTLE OPENER AID (1ct) Cap Opener 9.00$

279 PILL CRUSHER (1ea) ACU-LIFE® 7.00$

342 Long Handle Bath Sponge (1ea) Long Handle Bath Sponge 9.00$

343 Cane, 1-leg Adjustable 29-38 (1ea) Cane, 1-leg Adjustable 29”–38” 14.00$

372 PILL GLIDE SWALLOWING SPRAY, (1oz) Pill Glide® 10.00$

405 Toothpaste Squeezer Toothpaste Squeezer 3.00$

411 Letter Opener Quill Letter Opener 2.00$


DAILY LIVING AIDS CONT.

412 Key Turner Apex Key Turner 3.00$

413 Door Knob Gripper Safety1St Door Knob Gripper 6.00$

414 Lamp Switch Turner Carex Lamp Switch Turner 3.00$

416 Magnifying Glass Insterin Magnifying Glass 4.00$

420 Tub and Stair Safety Treads Probasics Tub And Stair Safety Treads 3.00$

421 Anti-Slip Safety Tread Aids 3M 4.00$

422 Button and Zipper Puller Carex Button And Zipper Puller 5.00$

423 Jar Opener/Faucet Gripper Dura-Grip 3.00$

DIABETES CARE

136 Glucose Tablet Fast Acting (10ct) Dex4® 6.00$

137 GNP Glucose Raspberry (50ct) Dex4® 12.00$

141 Sharps Container (1ea) Medline® 6.00$

192 Diabetic Skin Lotion (4.5oz) Gold Bond® 13.00$

295 Diabetic Socks Unisex Size 9-11 White Crew (3pr) Dr. Scholls® Diabetic Crew Sock 12.00$

296 Diabetic Socks Unisex Size 10-13 White Crew (3pr) Dr. Scholls® Diabetic Crew Sock 12.00$

299 Diabetic Socks Unisex Size 9-11 Black Crew (3pr) Dr. Scholls® Diabetic Crew Sock 12.00$

300 Diabetic Socks Unisex Size 10-13 Black Crew (3pr) Dr. Scholls® Diabetic Crew Sock 12.00$

EYE CARE

31 Tetrahydrozoline drops (0.5 oz) Visine Original® 4.00$

61 Lubriciating Eye Drops (0.5 oz.) Visine Tears® 7.00$

219 Eye Itch Relief (.5oz) Zaditor® 11.00$

241 EYEGLASS REPAIR KIT (1kit) Repair Kit 4.00$

249 ADVANCED EYE RELIEF EYE WASH (4oz) Gericare® 7.00$

353 Eyeglasses Sport Strap, Silicone, Anti-Slip (1set) Silicone Sport Strap 3.00$

360 Reading Glasses, Diopter +1.00, (1 pair) Foster Grant Readers® 8.00$












407 Eyeglass Cleaner Bausch & Lomb Eyeglass Cleaner 3.00$

FIRST AID CREAMS AND OINTMENTS

32 Calamine lotion (6 oz) Caldryl® 7.00$

33 Hydrocrtsne 1% crm (1 oz. tube) Cortizone® 4.00$

34 Triple antibiotic oint (0.5 oz. tube) Neosporin® 5.00$

60 Medicated lip balm (0.35 oz. tube) Chapstick® 2.00$

78 Psoriasis Cream (8 oz.) Eucerin Cream® 12.00$


FIRST AID CREAMS AND OINTMENTS CONT.

79 Eczema Cream (2 oz.) Exederm Cream® 13.00$

110 Wart Medication (0.5 oz.) Compound W® 8.00$

116 Freezone Corn Remover Liq (0.31 oz.) Freezone® 10.00$

147 Swimmer's Ear Drops (1 oz.) Swim-EAR® 8.00$

220 Anti-Itch Cream (1oz) Benadryl® 5.00$

221 Bacitracin (1oz) Bacitracin® 6.00$

FIRST AID SUPPLIES

35 Athletic bandage (3in) FUTURO Elastic® 7.00$

36 Adhesive tape (10yds) First-Aid Tape® 3.00$

37 Band-aids (60ct) Band-Aid Sheer® 4.00$

38 Earwax Drops - Carbamide Peroxide (0.5oz) Murine® 6.00$

39 Gauze pads (10 pads) Johnson + Johnson® 3.00$

40 Cotton swab (170ct) Q-Tips® 4.00$

41 Oral thermometer (1 each) THERMOMETER 60-SEC DIGITAL® 6.00$

42 Alcohol swabs (100 pads) BD® 4.00$

43 Ice bag 9 inch (1ea) Ice Bag® 9.00$

80 Ear Thermometer (1 each) Ear Thermometer® 25.00$

85 Hydrogen Peroxide Sol (16oz) Swan® 5.00$

107 Hot/Cold Patches (5ct) Icy Hot® 11.00$

117 Cotton Balls (70ct) Johnson + Johnson® 6.00$

149 Personal First Aid Kit (70+ pc) First Aid Kit® 14.00$

158 Rubbing Alcohol 70% isoporpyl (16 oz) Swan® 6.00$

160 Rubbing Alcohol - Wintergreen (70% isoporpyl 16 oz) Swan® 6.00$

178 Bandage Antibiotic One Size (20ct) Band-Aid Antibiotic® 8.00$

179 Bandage Clear Assort. Sizes (30ct) Band-Aid® 7.00$

180 Iodine (1oz) Betadine® 5.00$

181 First Aid Antiseptic Merthiolate (2oz) De La Cruz® 10.00$

182 Anti-Itch Gel (3.5oz) Benadryl® 12.00$

183 Hot/Cold Multi Compress (1ea) Ace® 20.00$

184 Petroleum Jelly (13oz) Vaseline® 7.00$

185 Butterfly Closures (12ct) Curad Butterfly Closures® 7.00$

186 Gauze Roll 2" X 2 yds (1ct) Kendall® 4.00$

376 Burn Gel Liquid Alocane Burn Aid® 5.00$

INCONTINENCE SUPPLIES

173 Pads-Bladder Control (20ct) Poise® 10.00$

228 UNDERWEAR UNISEX SMALL ADULT DIAPER 22"-36" Waist (22ct) Depends® 14.00$

229 UNDERWEAR UNISEX MED ADULT DIAPER 32"-44" Waist (20ct) Depends® 14.00$

230 UNDERWEAR UNISEX LARGE ADULT DIAPER 45"-58" Waist (18ct) Depends® 14.00$

231 UNDERWEAR UNISEX XLARGE ADULT DIAPER 59"-64" Waist (14ct)Depends® 14.00$

288 Disposable Bed Underpads (10ct) Prevail® Disposable Bed Underpads 9.00$


LAXATIVES

44 Dss 100mg (100 cap softgel) Colace® 6.00$

45 Bisacodyl suppository (sup 12) Dulcolax® 4.00$

46 Bisacodyl tab (100 tabs) Dulcolax Tabs® 5.00$

47 Glyc suppost- child (sup 12) FLEET GLYCERIN SUPPOSITORY® 3.00$

82 Iron+ Stool Softener (30 tabs) Ferro-Sequels® 10.00$

106 Adult Glycerin Supp (12ct) Fleet® 6.00$

114 Fiber Tablets (36ct) Metamucil® 11.00$

115 Fiber Gummies (120ct) Flintstones Gummies® 17.00$

208 Daily Fiber Sugar Free (10oz) Metamucil® 8.00$

266 MILK OF MAGNESIA SUS (12oz) Phillips® 6.00$

384 Enema, Saline Laxative Fleet® 3.00$

MEDICAL ALERT BRACELETS

100 Diabetic Medical Alert Bracelet (1ea) MEDICAL ALERT BRACELET - DIABETIC 7.00$

101 Epileptic Medical Alert Bracelet (1ea) MEDICAL ALERT BRACELET - EPILEPTIC 7.00$

102 Asthmatic Medical Alert Bracelet (1ea) MEDICAL ALERT BRACELET - ASTHMATIC 7.00$

103 Penicillin Medical Alert Bracelet (1ea) MEDICAL ALERT BRACELET - PENICILLIN 7.00$

104 Codeine Medical Alert Bracelet (1ea) MEDICAL ALERT BRACELET - CODEINE 7.00$

105 Peanut Allergy Medical Alert Bracelet (1ea) MEDICAL ALERT BRACELET - PEANUT 7.00$

354 Bipolar Disorder Medical Alert Bracelet, Privacy (1ea) Silicone Medical Alert Bracelet 7.00$

355 Psychosis Disorder Medical Alert Bracelet, Privacy (1ea) Silicone Medical Alert Bracelet 7.00$

356 Autistic Spectrum Medical Alert Disorder Bracelet, Privacy (1ea) Silicone Medical Alert Bracelet 7.00$

MISCELLANEOUS ITEMS

56 Pill box - 7 days (1 each) Pill Box® 4.00$

77 Sugar Substitute (100 packs) Sweet N Low® 6.00$

124 Liquid Laundry Detergent POD, 16ct Tide POD® 8.00$

138 Cutter Skin Sensation (6oz) CUTTER SKIN SENSATION® 10.00$

142 Blood Pressure Digital Wrist Cuff (1ea) SmartHeart® 25.00$

148 Peak Flow Meter (Breathing Device) (1ea) Peak Flow Meter® 25.00$

157 Bathroom Scale (1ea) Bathroom Scale 25.00$

161 Sharps Container, (1 Gallon Size) Kendall® 10.00$

172 Moleskin Padding (2ct) Dr. Scholl's® 5.00$

187 Tablet Cutter (1ea) Tablet Cutter® 6.00$

223 Mosquito Repellant Deet Free (100ml) OFF! Repellant® 11.00$

224 Blood Pressure Monitor, Manual Pump (1ea) Manual Blood Pressure Monitor 24.00$

227 FACE MASK, Single Use (10pk) MedLine® 8.00$

244 REUSABLE ICE PACK (1ct) Ice Pack 14.00$

246 FLASHLIGHT, LED W/BATTERIES (1ct) Flashlight 14.00$

270 VAPORIZER 1 GALLON (1ct) Vicks® 25.00$

281 Anti Snore Nasal Strip SM/MED (30ct) Breathe Right® SM/MED 30CT® 13.00$

282 Anti Snore Nasal Strip LRG (30ct) Breathe Right® LRG 30CT® 13.00$

289 Anti-Embolism Stockings SM (Knee Height) (1pr) Anti-Embolism Stockings SM 12.00$

290 Anti-Embolism Stockings MED (Knee Height) (1pr) Anti-Embolism Stockings MED 12.00$

291 Anti-Embolism Stockings LG (Knee Height) (1pr) Anti-Embolism Stockings LG 12.00$

292 Anti-Embolism Stockings XL (Knee Height) (1pr) Anti-Embolism Stockings XL 12.00$


MISCELLANEOUS ITEMS CONT.

310 NV - SilverSummit Health Brochure -$

326 Ear Syringe (1ea) Apex® Ear Syringe 6.00$

346 Night Light (1ea) Night Light 4.00$

357 KN-95 Face Mask, Single (1ea) MedLIne® 3.00$

358 KN-95 Face Mask (5pk) MedLine® 15.00$

400 Shopping Bag Carrier, Folding Pull Cart Shopping Bag Carrier 25.00$

406 Rain Bonnet Dofmanpacific Rain Bonnet 2.00$

408 Eye Brow Trimmer Noxzema Eye Brow Trimmer 2.00$

409 Spacer Vortex Spacer 14.00$

410 Anti-Nausea Band Acu Strap Sea Bands For Nausea Vomiting 3.00$

415 Kitchen Scale Dial Peachtree Scale Dial 10.00$

417 Medical Appointment Calendar Brownline Medical Appointment Calendar 5.00$

418 Travel Health Folder 7 Pocket Penadflex Travel Health Folder 7 Pocket 7.00$

419 COVID 19 Care Package AcariaHealth 25.00$

ORAL CARE

66 Toothbrush (Medium) (1ea) Colgate® 2.00$

67 Denture Tabs (40 tabs) Efferdent® 6.00$

68 Denture Adhesive (CRM 1.4 oz) Poligrip® 6.00$

86 Waxed Dental Floss (1 each) Johnson + Johnson® 2.00$

109 Adult Toothpaste (6 oz.) UltraBright® 6.00$

111 Mouthwash (8 oz.) Listerine® 8.00$

112 Toothache Gel Regular Non-Infant Form (0.25 oz.) Anbesol® 10.00$

170 Sensitive Tooth Paste White (4.5oz) Sensodyne® 9.00$

171 Flosser Picks (90ct) Flosser Picks® 6.00$

177 Denture Cleanse Tab A/B Mint (40ct) Polident® 7.00$

265 DENTURE ADHESIVE THERMOPLASTIC CUSION GRIP® 20.00$

373 Dental Care Kit Dentek® 5.00$

380 Water Jet, Battery Operated WaterPik® 25.00$

PERSONAL CARE

48 Lice Treatment Kit w/Comb (4oz) RID® 9.00$

69 Facial Tissues, 3pack (10 Per Pack) Kleenex® 4.00$

70 Baby Powder (4 oz.) Johnson + Johnson® 4.00$

71 Bar Soap (4ea) Ivory Bar Soap® 8.00$

72 Nail Clipper (1 each) Revlon® 4.00$

74 Latex Gloves - Medium (100 by weight) Latex Glove® 12.00$

75 Sunblock SPF 30 (4 oz.) Coppertone® 9.00$

76 Hand Sanitizer (8 oz.) Purell® 5.00$

84 Lotion, Cocoa Butter, Non-Medicated (8.5oz) PALMERS LOTION® 9.00$

88 Insect Repellent Pump Tech Labs (6oz) OFF! Repellant® 10.00$

127 Flushable Wipes (42ct) COTTONELLE® 8.00$

129 Insect Repellent Liquid Spray (6oz) Cutter Insect Repellant® 10.00$

143 Lice Comb (1ea) Lice Comb® 3.00$

144 Hair Comb, Standard (2ea) Hair Comb, Standard® 1.00$

156 Disposable Gloves, VINYL (Latex Free) (100ct) Vinyl Gloves (Latex Free) 15.00$


PERSONAL CARE CONT.

159 Epsom Salt (Magnesium sulfate) 16 oz Sunmark Epsom ® 7.00$

162 Hand Sanitizer (2oz Flip Lid) Purell® 2.00$

190 Acne Treatment 10% (1.5oz) Rugby® 6.00$

191 Oil Free Acne Wash (6oz) Neutrogena® 10.00$

222 Odor Control Spray Powder (4oz) Odor-Eaters® 5.00$

232 Antibacterial Wipes (30ct) Wet Ones® 4.00$

234 BABY NAIL CLIPPER SET (1Set) Nail Clipper® 10.00$

236 BABY OUTLET COVER (8ct) Outlet Cover® 5.00$

238 HAIR BRUSH & COMB SET (1ct) Hair Brush 3.00$

239 HAIR PICK, MINI PLASTIC (1ct) Hair Pick 1.00$

240 NAIL FILE (1ct) Nail File 2.00$

242 SHOE HORN (1ct) Shoe Horn 5.00$

243 SHOWER CAP (1ct) Shower Cap 1.00$

247 EAR PLUGS (3pr) 3M Ear Plugs® 1.00$

250 Wrist brace one size (1ct) ACE® 9.00$

251 Elbow brace ADJUSTABLE (1ct) ACE® 14.00$

252 Ankle brace ADJUSTABLE (1ct) ACE® 15.00$

253 Back support One Size ADJUSTABLE (1ct) ACE® 20.00$

254 ELASTIC KNEE SUPPORT ADJUSTABLE (1ct) ACE® 12.00$

255 Hand support S/M (1ct) ACE® 10.00$

256 Hand support L/XL (1ct) ACE® 10.00$

258 DEODORANT, MEN'S, NON-MEDICATED, STICK (1.7oz) Degree® 5.00$

259 BODY WASH, CUCUMBER (8oz) Dove® 5.00$

260 ALOE GEL (6oz) Fruit of the Eath® 6.00$

261 DANDRUFF SHAMPOO (13.5oz) Head & Shoulders® 8.00$

262 DEODORANT, WOMEN'S, NON-MEDICATED, STICK (1.4oz) Lady Speed Stick® 5.00$

263 DANDRUFF A-D 1% SHAMPOO (7oz) Nizoral® 15.00$

268 ARTHRITIS BALM RUB CREAM (4oz) Tiger Balm® 15.00$

269 ARTHRITIS BALM PATCH (5ct) Tiger Balm® 10.00$

276 SHAMPOO, HAIR, REGULAR (12.5oz) V05® 5.00$

277 CONDITIONER, HAIR REGULAR (12.5oz) V05® 5.00$

278 TWEEZERS (1ea) Revlon Tweezers® 5.00$

328 Antibacterial Bar Soap, 3.5oz (1bar) Dove® Antibact Bar Soap 6.00$

329 Antibacterial Liquid Hand Soap Pump (7.5oz) SoftSoap® Pump 5.00$

374 Travel Adult Wipes Cottonelle Travel Adult Wipes® 1.00$

377 Pedometer Omron Pedometer® 9.00$

378 Ear Syringe Apex Ear Syringe® 3.00$

381 Heating Pad, Dry Heat, 12x15 Sunbeam Heating Pad® 20.00$

390 DisposeRX DisposeRX® 4.00$

391 Shopping Bag Carrier, Jumbo Carabiner Coghlans® Biner Carry Handle 5.00$

401 Gloves (Large), Latex, Powder Free MedLine 12.00$

402 Gloves (Small), Latex, Powder Free MedLine 12.00$

403 Shoe Insert, Foam Men Dr. Scholls Comfort 3.00$

404 Shoe Insert, Foam Women Dr. Scholls Comfort 3.00$


SLEEP AIDS

94 Melatonin 5mg Tab (60 ct) Nature's Bounty® 12.00$

132 Melatonin 1mg Tablet (60ct) Nature Made® 8.00$



135 Melatonin 10mg Capsules (60ct) Nature Made® 19.00$

225 Sleep Aid (32ct) Tylenol Simply Sleep® 10.00$

SMOKING CESSATION

57 Nicotine Polacrilex Gum 2mg (50 pieces) Nicorette® 15.00$

58 Nicotine Polacrilex Gum 4mg (50 pieces) Nicorette® 15.00$

VITAMINS, MINERALS & SUPPLEMENTS

49 Calc carb 600mg tab (60 tabs) Caltrate 600+D® 6.00$

50 Multivitamin w/minerals (130 tabs) One A Day® 10.00$

51 Child chew vitamin (100 tabs) Flintstones® 7.00$

52 Vitamin A 10000u caps (100 sofgels) Nature's Bounty® 5.00$

53 Vitamin C 500mg tabs (100 tabs) Nature Made® 5.00$

54 Vitamin E 400iu gels (100 gels) Nature's Bounty® 9.00$

59 Sr. Vitamin w/ minerals (60 tabs) Centrum Silver® 11.00$

62 Vitamin D 400IU (100 tabs) Nature's Bounty® 7.00$

63 Glucosamine / Chrondritin (50 tabs) Osteo Bi-Flex® 12.00$

64 Iron Supplement 325mg (100 tabs) Feosol® 4.00$

65 Omega-3 Fish Oil (60 softgels) Puritan® 7.00$

81 Folic Acid Tabs 400mcg (100 tabs) Nature Made® 6.00$

83 MultiVitamin Liquid w/ Iron (4 oz.) GERITOL® 8.00$

87 Lactose Chewable Tab (32 tabs) Lactaid® 9.00$

176 Calcium Supplement Gummy (50ct) Nature's Bounty® 13.00$

193 Coenzyme Q-10 50mg (30ct) Spring Valley® 13.00$

194 Magnesium 500mg (100ct) Nature's Bounty® 8.00$

195 Zinc Gluconate 50mg (100ct) Nature's Potent® 7.00$

196 Biotin 10000Mc Soft Gel (60ct) Nature's Bounty® 22.00$

197 Vitamin B12 500 mcg (60ct) Nature's Bounty® 10.00$

198 B Complex Plus Vitamin C (125ct) Nature's Bounty® 7.00$

199 Potassium Gluconate 550Mg (100ct) Nature's Bounty® 7.00$

200 Vitamins B-6 (100ct) Nature's Bounty® 6.00$

201 Adult Daily Women's 50+ Advanced (50ct) One A Day® 12.00$

202 Adult Daily Men's 50+ Advanced (50ct) One A Day® 12.00$

203 Lutein Soft Gels (30ct) Ocuvite® 19.00$

264 STRESS B WITH ZINC TABLET (60ct) Nature Made® 9.00$

283 Calcium 250mg + Vit D3 500IU Child Gummy (60ct) Calcium 250mg + Vit D3 500IU Child Gummy® 13.00$

284 Vitamin C Child Gummy, 125mg (60ct) Vitamin C Child Gummy® 13.00$

340 Acidophilus Lactobacilli Tabs (100ct) Simply Natural® 9.00$

341 Omega + DHA Gummy (100ct) Omega + DHA Gummy® 16.00$

344 Dietary Supplement - Powder (4pk) Scandishake Dietary Supplement - Powder 15.00$

375 Melatonin Gummy 5 mg Vitafusion® 10.00$

379 Chewable Prenatal Vitamin + DHA, 90ct Vitafusion® 16.00$


VITAMINS, MINERALS & SUPPLEMENTS CONT.

382 Coconut Oil 1000mg Softgel Vita Pure® 10.00$

383 Echinacea, 400 mg. 60ct Natures Bounty® 8.00$

385 Flaxseed 1000mg Nature Made® 10.00$

386 Garlic Oil 500mg Natures Blend® 5.00$

387 Ginseng Complex, 100mg. Natures Bounty® 10.00$

389 Cod Liver Puritans Pride® 9.00$

WOMEN'S PERSONAL CARE

99 Tampon, w/applicator (18ct) Kotex® 10.00$

126 Feminine Cleansing Cloth (32ct) SUMMER'S EVE® 9.00$

146 Teenage Feminine Panty Liner Pad w/Wings (14pk) Kotex Pads® 10.00$

153 Breastfeeding Cream (0.25 oz) Lansinoh® 5.00$

188 Maxi Pad Liner (24ct) Always® 9.00$

189 Menstrual Pain Relief (20ct) Midol® 10.00$

233 Pregnancy Test Kit, (2ct) First Response® 12.00$

235 PRENATAL VITAMIN TABLET (100ct) Nature Made® 7.00$

280 NURSING PAD. BREAST PAD, DISPOSABLE (60ea) LANSINOH® 10.00$

392 Maxi Pad, Super Max With Wings StayFree® 5.00$

393 Maxi Pad, Super Absorbency StayFree® 5.00$

394 Maxi Pad, Night Wing StayFree® 5.00$

The cost of any items you order will be applied to your maximum OTC benefit of $30 in items per household per calendar quarter.

Items and prices are subject to change. If you need more information or help, please call SilverSummit HealthPlan Member Services at 1-844-366-2880. TTY users should call 1-844-804-6086. Hours of operation are 8 a.m. to 5 p.m., Monday through Friday.

All OTC items should only be used as directed. You should talk to your Primary Care Provider (PCP) if you have any questions about how to use these items safely.

SilverSummit HealthPlan is a health plan that contracts with Nevada Medicaid to provide benefits to enrollees.

This is not a complete list. The benefit information is a brief summary, not a complete description of benefits. For

more information contact the plan or read the Member Handbook.

ATENCIÓN: Si habla español, tiene a su disposición servicios gratuitos de

asistencia lingüística. Llame al 1-844-366-2880 (TTY: 1-844-804-6086) de 8 a. m.

a 5 p. m., lunes a viernes.

www.SilverSummitHealthPlan.com© 2020 SilverSummit HealthPlan. All rights reserved.

Order up to $30 in items per calendar

quarter!

ATTENTION: If you do not speak English, language assistance services, free of charge, are available to you. Call 1-844-366-2880 (TTY: 1-844-804-6086) from 8 a.m. to 5 p.m., Monday through Friday. The call is free.

Documents

Over the Counter Catalog - SilverSummit HealthPlan