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Part of your UnitedHealthcare® health plan.
Y0066_150812_105106 Accepted
2016 Over-the-Counter Essentials
Online: Go to www.OTC-Essentials.com Mail: Fill out the Order Form and mail only the order form page in the postage paid envelope. Mail orders must be postmarked by March 31, June 30, September 30 and December 31 of each year.
Keep this catalog. You’ll need it to look up the health and wellness products you want to order.
Ordering is easy:
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Over-the-Counter (OTC) Essentials allows you to purchase health and wellness products from the enclosed product listing.
How to order:You can place an order by mailing the order form in the supplied postage paid envelope or by going to www.OTC-Essentials.com. If your total order exceeds your credit amount limit, please be sure to include a check or money order to pay the remaining amount due. Failure to submit payment in full will lead to a delay in shipment.
Welcome to Over-the-Counter Essentials
Online: Go to www.OTC-Essentials.com Mail: Fill out the Order Form and mail only the order form page in the postage paid envelope. Mail orders must be postmarked by March 31, June 30, September 30 and December 31 of each year.
Keep this catalog. You’ll need it to look up the health and wellness products you want to order.
Ordering is easy:
Stomach Remedies
Item # Product name Compare to Count Price
1878* Acid Reducer Tablets Pepcid AC® 30 $8.00
1881 Antacid Tablets Fruit TUMS® 150 $5.00
1890 Antacid Tablets Fruit Extra Strength TUMS® Extra Strength 96 $5.00
1884 Antacid Mint Maalox® Regular Strength 12 fl oz $5.00
1792 Gas Relief Softgels Ultra Strength Phazyme® 60 $8.00
1816 Antacid Plus Gas Relief Mylanta® Regular Strength 12 fl oz $5.00
1579 Bismuth Liquid Pepto-Bismol® 8 fl oz $4.00
1584 Stomach Relief Chewable Tablets Pepto-Bismol® 30 $4.00
1592 Loperamide Hydrochloride Anti-Diarrheal Imodium® A-D 4 fl oz $7.00
1603 Anti-Diarrheal Caplets Imodium® A-D 12 $4.00
1571 Natural Vegetable Laxative Tablets Senokot® 100 $10.00
1619 LaxaClear Powder Miralax® 4.1 oz $9.00
1624 Milk of Magnesia Phillips® 12 fl oz $5.00
1660 Enema Fleet® 3 pack $6.00
1558 Stool Softener Softgels Colace® 100 $9.00
* In certain circumstances some items on this page may be covered by the plan, or Original Medicare if you are not enrolled in the plan, and if item is determined to be medically necessary. Please check with your healthcare provider before ordering.
If your item is not in stock, an item of similar or greater value may be substituted in your order.Exchange Policy: If you receive a damaged item, please call FirstLine Medical immediately. The item will be exchanged for an identical item at no cost to you. Please note: only damaged products can be exchanged within 30 days of purchase, no other returns are allowed.This catalog contains a listing of all products offered through FirstLine Medical. Benefit Credit amounts vary by health plan and some products in this catalog may not be available to all members. The health information provided in the catalog is general in nature and is not medical advice or a substitute for professional health care. It is provided for your information and convenience only. UnitedHealthcare Insurance Company (UHIC) does not guarantee the accuracy or completeness of the information, and does not recommend or endorse the products which are referenced in the catalog.Note: Your OTC benefit only covers items listed in this catalog and does not cover alternative medicines, baby items, contraceptives, convenience items, cosmetics, food supplements, replacement items, attachments and peripherals.
2016 Over-the-Counter Essentials | 3
2016 Over-the-Counter EssentialsYour UnitedHealthcare health plan offers Over-the-Counter (OTC) Essentials that allows you to purchase health and wellness products from the enclosed catalog. Each quarter, $50 in Benefit Credits are loaded into your account to purchase health and wellness products. All orders are shipped right to you at no additional cost for shipping, handling and taxes.
Benefit Credits expire at the end of each quarter and cannot be redeemed for cash. You cannot apply future credits to your order and each order must total at least $30 in Benefit Credits. Only products in the catalog are covered under this benefit and items offered under this plan benefit may only be used by the plan member.
How to order:You can place an order by mailing the order form in the supplied postage paid envelope or by going to www.OTC-Essentials.com. If your total order exceeds your credit amount limit, please be sure to include a check or money order to pay the remaining amount due. Failure to submit payment in full will lead to a delay in shipment.
If you have questions around products or delivery, please call FirstLine Medical customer service at 1-877-795-4521 (TTY: 711), 7 a.m. – 7 p.m. Monday – Friday, CT and 7 a.m. – 4 p.m. Saturday, CT.
This order form is for the 2016 benefit year. Please do not submit your first order until after January 1, 2016. If you need additional order forms, you can go to our website to download or you can call FirstLine Medical customer service.
FirstLine Medical is the supplier of all products within this mailing. UnitedHealthcare Insurance Company manages FirstLine Medical through its affiliate OptumRx.
Plans are insured through UnitedHealthcare Insurance Company or one of its affiliated companies, a Medicare Advantage organization with a Medicare contract. Enrollment in the plan depends on the plan’s contract renewal with Medicare.
This information is not a complete description of benefits. Contact the plan for more information. Limitations, co-payments, and restrictions may apply. Benefits, premium and/or co-payments/ co-insurance may change on January 1 of each year.
Pain Management
Item # Product name Compare to Count Price
2716 Aspirin 81 mg Enteric Coated Bayer® Low Strength Aspirin 120 $5.00
2680 Aspirin 81 mg Chewable Tablets 36 $2.00
2664 Pain Relief 325 mg Tablets Regular Strength Tylenol® 100 $8.00
2703 Pain Relief PM Extra Strength Tylenol® PM 50 $6.00
2588 Ibuprofen 200 mg Coated Tablets Advil® 100 $8.00
2760 All Day Relief Aleve® 100 $9.00
2352 Pain Reliever Plus Excedrin® 100 $11.00
2610 Motion Sickness Tablets Dramamine® Original 12 $3.00
2366 Fast Freeze™ Roll On BioFreeze™ 3 oz $10.00
2357 Mineral Freez Gel Mineral Ice® 8 oz $7.00
2388 Capsaicin Pain Relief Cream Capzasin™ 2 fl oz $12.00
3097 Muscle and Joint Gel Vanishing Scent Bengay® 3 oz $5.00
3113 Muscle Rub Ultra Strength Bengay® 3 oz $8.00
2753 Medicated Pads Tucks® 100 $7.00
3138 Hemorrhoidal Ointment Preparation H® 2 oz $8.00
3099 Miconazole Vaginal Cream Monistat® 7 1.59 oz $11.00
Cold, Cough & Allergy
Item # Product name Compare to Count Price
2972 Medicated Chest Rub Vicks® Vaporub® 3.53 oz $5.00
3001 Day/Night Combo Pack Tylenol® Cold Multi-Symptom Day & Night 20 $6.00
3082 Cough Drops — Honey Lemon Halls® Regular 2 packs 30 ct $3.00
3081 Cough Drops — Black Cherry — Sugar-Free Halls® Sugar-Free 2 packs 25 ct $4.00
3360 DM Cough Syrup — Sugar-Free Robitussin® DM Sugar-Free 16 fl oz $9.00
3364 DM Cough Syrup — Sugar-Free Robitussin® DM Sugar-Free 4 fl oz $6.00
3375 CF Cough & Cold Robitussin® Cough & Cold CF 4 fl oz $8.00
2837 Sore Throat Lozenges Cepacol® 18 $5.00
3119 Sore Throat Spray — Menthol Chloraseptic® 6 fl oz $5.00
2943 Sore Throat Spray — Cherry Chloraseptic® 6 fl oz $5.00
Eye & Ear Care
Item # Product name Compare to Count Price
3232 Earwax Treatment Drops Debrox® .5 fl oz $6.00
5124 Eye Drops AC Visine® AC .5 fl oz $4.00
3346 Artificial Tears Visine® Tears .5 fl oz $6.00
2998 Itchy Eye Drops Zyrtec® .17 fl oz $13.00
Oral Care
Item # Product name Compare to Count Price
5280 Battery Power Toothbrush 1 $14.00
5281 Replacement Heads for 5280 2 ct $8.00
4949 Toothbrush 1 $1.00
5063 Tongue Cleaner 1 $3.00
5177 Denture Adhesive Fixodent® Original 2 oz $4.00
4968 Grande Denture Brush 1 $3.00
5059 Moisture Lip Balm SPF 15 .15 oz $1.00
5082 Biotene Dry Mouth Spray 1.5 fl oz $10.00
5074 Mouth Moisturizer .5 oz $6.00
4961 Medicated Cold Sore Treatment Blistex® .21 oz $3.00
3003 Oral Pain Relief Orajel® Maximum Strength .33 oz $4.00
Cold, Cough & Allergy
Item # Product name Compare to Count Price
3204* All Day Allergy Tablets Zyrtec® 30 $10.00
3202* All Day Allergy Tablets Zyrtec® 90 $18.00
3235* Allergy Relief Tablets Claritin® 30 $8.00
3167 Allergy Tablets — 4 Hour Chlor-Trimeton® 24 $6.00
2969 Children's Allergy Children’s Benadryl® Allergy Liquid 4 fl oz $6.00
3282 Allergy Relief Tablets Benadryl® Allergy Ultratab® 24 $6.00
3193 Allergy Relief Tablets Benadryl® Allergy Ultratab® 100 $10.00
3355 Mucus Relief Tablets 100 $12.00
3370 Nasal PE Tablets Sudafed® PE Nasal Decongestant 36 $6.00
3216 Nasal Spray Afrin® 1 fl oz $6.00
3244 Saline Nasal Spray Ocean® 3 fl oz $5.00
4 | 2016 Over-the-Counter Essentials 2016 Over-the-Counter Essentials | 5
* In certain circumstances some items on this page may be covered by the plan, or Original Medicare if you are not enrolled in the plan, and if item is determined to be medically necessary. Please check with your healthcare provider before ordering.
First Aid
Item # Product name Compare to Count Price
5150 First Aid Kit 1 kit $12.00
3034 Antiseptic Spray 3 oz $8.00
5166 flexSEAL Spray BandageCannot ship to P.O. boxes. 1.35 oz $8.00
5153 Adhesive 3/4" Bandages 80 ct $3.00
5160 Adhesive 2"x4" Bandages 50 ct $6.00
5191 Elastic Bandage 2"x5 yds 1 $2.00
5193 Elastic Bandage 3"x5 yds 1 $2.00
5197 Elastic Bandage 4"x5 yds 1 $3.00
5199 Elastic Bandage 6"x5 yds 1 $3.00
5265 Cotton Swabs 200 ct $3.00
5275 Cotton Balls 200 ct $2.00
5298 Cloth Tape 1"x10 yds 1 $5.00
5314 Gauze Sponges 10 ct $2.00
5316 Gauze Rolls 3 rolls $3.00
5367 Latex Water Bottle with Screw Top 2 qt $13.00
5370 Calamine Lotion 6 fl oz $5.00
5388 Hydrocortisone Cream 1% 1 oz $4.00
5455 Anti-Itch Cream Extra Strength Benadryl® cream 1 oz $4.00
5462 Triple Antibiotic Ointment 1 oz $6.00
3080 Bacitracin with Zinc Ointment 1 oz $6.00
Oral Care
Item # Product name Compare to Count Price
4985 Dental Floss — Waxed Mint 100 yds $2.00
4878 Interdental Flossups 90 ct $3.00
4806 BrushPicks 275 ct $7.00
5095 Sensitive Toothpaste Sensodyne® 4.3 oz $6.00
5083 Pepsodent Toothpaste — Original 5.5 oz $2.00
5066 Aim Mint Gel 5.5 oz $2.00
Vitamins & Supplements
Item # Product name Compare to Count Price
2982‡ Vitamin A 8,000 IU Tablets 90 $6.00
5612‡ Vitamin B-6 100 mg Tablets 100 $6.00
5627‡ Vitamin B12 500 mcg Tablets 100 $6.00
5634‡ Biotin 500 mcg Tablets 60 $7.00
5548‡ Vitamin C 500 mg Tablets 100 $4.00
5550‡ Vitamin C 500 mg Chewable Tablets 100 $7.00
5725‡ Vitamin D3 2000 IU Tablets 250 $12.00
2977‡ Vitamin E 200 IU Softgels 100 $8.00
3032‡ Calcium 600 mg Tablets 150 $6.00
5640‡ Chocolate Calcium Chews — Regular 60 $9.00
5643‡ Chocolate Calcium Chews — Sugar Free 60 $9.00
3048‡ Calcium Citrate + Vitamin D Caplets Citracal® 100 $8.00
5811‡ Calcium 600 mg with Vitamin D Tablets Caltrate® 600 + D 300 $13.00
5820‡ CoQ10 100 mg Softgels 30 $15.00
5845‡ Chromium Picolinate 1000 mcg Tablets 100 $8.00
5853‡ Flax Seed Oil 1000 mg Softgels 60 $6.00
3016‡ Folic Acid 400 mcg Tablets 100 $6.00
2948‡ Ferrous Sulfate 325 mg Tablets Equivalent to 65 mg Iron 100 $5.00
5866‡ Omega-3 Fish Oil 1000 mg Softgels 90 $8.00
5754‡ Antioxidant Vitamins Tablets 60 $10.00
2960‡ Diabetes Glucose Tablets 50 $6.00
‡ Members may order these item(s) after discussing the item(s) with their physician who recommends the item(s) for a specific condition. Debate exists on the merits of these supplements, so it is important that you speak with your doctor before taking supplements, especially if you have a serious medical condition. These statements have not been evaluated by the Food and Drug Administration.
If your item is not in stock, an item of similar or greater value may be substituted in your order.Exchange Policy: If you receive a damaged item, please call FirstLine Medical immediately. The item will be exchanged for an identical item at no cost to you. Please note: only damaged products can be exchanged within 30 days of purchase, no other returns are allowed.This catalog contains a listing of all products offered through FirstLine Medical. Benefit Credit amounts vary by health plan and some products in this catalog may not be available to all members. The health information provided in the catalog is general in nature and is not medical advice or a substitute for professional health care. It is provided for your information and convenience only. UnitedHealthcare Insurance Company (UHIC) does not guarantee the accuracy or completeness of the information, and does not recommend or endorse the products which are referenced in the catalog.Note: Your OTC benefit only covers items listed in this catalog and does not cover alternative medicines, baby items, contraceptives, convenience items, cosmetics, food supplements, replacement items, attachments and peripherals.
2016 Over-the-Counter Essentials | 76 | 2016 Over-the-Counter Essentials
Leg & Foot Care
Item # Product name Sizing Count Price
5878 WS Jobst® Sensifoot™ Diabetic Sock — color White size Small
Women’s Shoe Size: 7–9 Men’s Shoe Size: 6–8 1 pair $20.00
5878 WM Jobst® Sensifoot™ Diabetic Sock — color White size Medium
Women’s Shoe Size: 9.5–11 Men’s Shoe Size: 8.5–10 1 pair $20.00
5878 WL Jobst® Sensifoot™ Diabetic Sock — color White size Large
Women’s Shoe Size: 11.5–13 Men’s Shoe Size: 10.5–12 1 pair $20.00
5878 BLS Jobst® Sensifoot™ Diabetic Sock — color Black size Small
Women’s Shoe Size: 7–9 Men’s Shoe Size: 6–8 1 pair $20.00
5878 BLM Jobst® Sensifoot™ Diabetic Sock — color Black size Medium
Women’s Shoe Size: 9.5–11 Men’s Shoe Size: 8.5–10 1 pair $20.00
5878 BLL Jobst® Sensifoot™ Diabetic Sock — color Black size Large
Women’s Shoe Size: 11.5–13 Men’s Shoe Size: 10.5–12 1 pair $20.00
Incontinence
Item # Product name Sizing Count Price
7041 Remedy® Olivamine Calazime 4 oz $10.00
7060 Soothe & Cool® Cornstarch Body Powder 4 oz $4.00
7062 Soothe & Cool® Cornstarch Body Powder 14 oz $8.00
7057 Remedy® Phytoplex Nourishing Cream 8 oz $10.00
7076 Aloe Touch Disposable Washcloths 100 ct $8.00
7088 Sanitizing WipesCannot ship to P.O. boxes. 160 ct $13.00
7313 Washable Bed Pad 34" x 36" 1 $18.00
7325 Disposable Bladder Control Pad 5.5" x 10.5" 28 Pack $8.00
7330 Disposable Bladder Control Pad 6.5" x 13.5" 28 Pack $11.00
2074 M FitRight® Extra Adult Disposable Brief — size Medium Waist size: 32–42" 1 pack
of 20 $19.00
2074 R FitRight® Extra Adult Disposable Brief — size Regular Waist size: 40–50" 1 pack
of 20 $19.00
2074 L FitRight® Extra Adult Disposable Brief — size Large Waist size: 48–58" 1 pack
of 20 $19.00
2074 XL FitRight® Extra Adult Disposable Brief — size X-Large Waist size: 57–66" 1 pack
of 20 $19.00
First Aid
Item # Product name Compare to Count Price
5655 Hydrogen Peroxide 4 fl oz $1.00
5657 Hydrogen Peroxide 16 fl oz $2.00
5664** Alcohol Prep Pads 200 ct $4.00
5672 70% Isopropyl AlcoholCannot ship to P.O. boxes. 16 fl oz $3.00
5680 Petroleum Jelly Vaseline® 13 oz $5.00
5691 Hand Sanitizer — Alcohol Free 7.5 oz $10.00
5470 Digital Thermometer 1 $8.00
Therapeutic Skin Care
Item # Product name Compare to Count Price
5695 Sunscreen Lotion SPF 30 Coppertone® 8 oz $7.00
5697 Sunscreen Lotion SPF 50 Coppertone® 8 oz $9.00
5707 Aloe Vera Gel 16 oz $7.00
5736 Remedy® Nourishing Skin Cream 8 oz $12.00
5740 Remedy® Skin Repair Cream 4 oz $8.00
5744 Remedy® Skin Protectant Cream 4 oz $10.00
5752 Soothe & Cool® Antifungal Cream 5 oz $12.00
Leg & Foot Care
Item # Product name Sizing Count Price
5801 Bunion Guard 1 $10.00
5823 S Toe Protector — size Small 1 $7.00
5823 L Toe Protector — size Large 1 $7.00
5823 XL Toe Protector — size X-Large 1 $7.00
5834 Lamb’s Wool Padding Dr. Scholl's® 1 $6.00
5817 Corn Cushions Dr. Scholl's® 9 ct $3.00
5799 Medicated Corn Removers Dr. Scholl's® 9 ct $5.00
5788 Medicated Foot Powder Gold Bond® 4 oz $6.00
5862 Antifungal Cream 1% Lotrimin® AF .5 oz $7.00
**Some items on this page may be covered by the plan, or Original Medicare if you are not enrolled in the plan, and if item is determined to be medically necessary. Please check with your physician before ordering.
2016 Over-the-Counter Essentials | 98 | 2016 Over-the-Counter Essentials
**Some items on this page may be covered by the plan, or Original Medicare if you are not enrolled in the plan, and if item is determined to be medically necessary. Please check with your physician before ordering.
Incontinence
Item # Product name Sizing Count Price
2236 M** FitRight® Ultra Disposable Underwear — size Medium Waist size: 28–40" 1 pack of 20 $18.00
2236 L** FitRight® Ultra Disposable Underwear — size Large Waist size: 40–56" 1 pack of 20 $18.00
2236 XL** FitRight® Ultra Disposable Underwear — size X-Large Waist size: 56–68" 1 pack of 20 $18.00
2240 S Light & Dry Washable Men’s Brief — size Small Waist size: 30–33" 1 brief $18.00
2240 M Light & Dry Washable Men’s Brief — size Medium Waist size: 34–36" 1 brief $18.00
2240 L Light & Dry Washable Men’s Brief — size Large Waist size: 37–40" 1 brief $18.00
2240 XL Light & Dry Washable Men’s Brief — size X-Large Waist size: 41–45" 1 brief $18.00
2240 XXL Light & Dry Washable Men’s Brief — size XX-Large Waist size: 46–52" 1 brief $18.00
2172 S Light & Dry Washable Women’s Brief — size Small Waist size: 22–26" 1 brief $17.00
2172 M Light & Dry Washable Women’s Brief — size Medium Waist size: 26–29" 1 brief $17.00
2172 L Light & Dry Washable Women’s Brief — size Large Waist size: 30–33" 1 brief $17.00
2172 XL Light & Dry Washable Women’s Brief — size X-Large Waist size: 34–36" 1 brief $17.00
2172 XXL Light & Dry Washable Women’s Brief — size XX-Large Waist size: 37–40" 1 brief $17.00
Bath Safety
Item # Product name Size/Capacity Count Price
2334 Tub Safety Bar 250 lbs Capacity 1 $45.00
2345 Bath Mat 29" x 13.4" 1 $20.00
2298 Tub and Stair Safety Treads 1 pack $5.00
2359 Raised Toilet Seat 250 lbs Capacity 1 $30.00
2377 Toilet Safety Rails 300 lbs Capacity 1 $40.00
10 | 2016 Over-the-Counter Essentials
If your item is not in stock, an item of similar or greater value may be substituted in your order.
Exchange Policy: If you receive a damaged item, please call FirstLine Medical immediately. The item will be exchanged for an identical item at no cost to you. Please note: only damaged products can be exchanged within 30 days of purchase, no other returns are allowed.
This catalog contains a listing of all products offered through FirstLine Medical. Benefit Credit amounts vary by health plan and some products in this catalog may not be available to all members.
The health information provided in the catalog is general in nature and is not medical advice or a substitute for professional health care. It is provided for your information and convenience only. UnitedHealthcare Insurance Company (UHIC) does not guarantee the accuracy or completeness of the information, and does not recommend or endorse the products which are referenced in the catalog.
Note: Your OTC benefit only covers items listed in this catalog and does not cover alternative medicines, baby items, contraceptives, convenience items, cosmetics, food supplements, replacement items, attachments and peripherals. Thank you for your order!
Member ID # ____________________________________________________________________________ (See front of health insurance card.)
Member Name ___________________________________________________________________________
Shipping Address 1 _______________________________________________________________________
Shipping Address 2 (Apt./Room#/Facility Name) _______________________________________________
City _____________________________________________ State ________ ZIP Code _________________
Responsible Party (if applicable) ____________________________________________________________
Daytime Phone of Member or Responsible Party ( ______________ ) ____________________________
Fill out each section of the order form completely and mail in the envelope provided.
30OTC2016
Item # Size Color Product Description Quantity Price TOTAL
$0 — Shipping, handling and taxes
TOTALX $Order total must be at least $30 in Benefit Credits.Items may only be purchased for plan members.
Order Form
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