PHC California

Rachel Sakai
AHF Provider

Over-the-Counter Benefit Option

The following OTC items are available for order through AHF Pharmacy’s Fulfillment Center.  You may order items in whatever increment you’d like up to $200 total for the plan year.  There is no cost to you for your order or its delivery.  Instructions to order OTC items are included in the Over-the-Counter Pharmacy Order Form.  To place an order, download and print the Over-the-Counter Pharmacy Order Form.  Complete the form and send or fax it or phone it into our Member Services Department as instructed on the form.  If you would like us to send you more order forms, please contact Member Services.

This list of OTC items is effective April 13, 2020 and may change during the year.   Item unit/size and approximate value (price) are listed in the Over-the-Counter Pharmacy Order Form.

Allergy Prevention and Treatment/Antihistamines Ear Care
Claritin Ear Syringe
Benadryl Tablets Debrox Ear Wax Removal Drops
Benadryl Elixir Eye Care
Sudafed PE Dry Eye Drops
Analgesics/Antipyretics/NSAIDS Visine Drops
Bayer Aspirin Fiber Supplements
Bayer EC Aspirin (Adult Regimen) Metamucil
Bengay First Aid/Medical Supplies
Capsaicin Ace Bandage
Tylenol Extra Strength Tablets Adhesive Tape
Advil Tablets Alcohol Swabs
Aleve Caplets Band-Aids
Excedrin Blood Pressure Monitor
Antacids and Acid Reducers Cotton Balls
Mylicon Cotton Swabs
Prilosec (Limit two per month) Hibiclens
Tums Tablets Ice Bag
Zantac Tablets Johnson & Johnson Gauze
Anti-Arthritis Oral Thermometer
Glucosamine/Chondroitin Healing Ointments
Antibiotics (Topical) Aquaphor Skin Healing Ointment
Neosporin Ointment Eucerin
Anticandidals (Yeast) / Antifungals Hemorrhoidal Preparations
Gyne-Lotrimin Cream Preparation H
Tinactin Cream Incontinence Supplies
Antidiarrheals and Laxatives Adult Diapers Small/Medium
Colace Softgels Adult Diapers Large
Dulcolax Suppositories Insect Repellent
Dulcolax Tablets OFF! Deep Woods Spay
Imodium Caplets OFF! Active Sweat-Resistant Spray
Pepto-Bismol Liquid Lactose Intolerance
Miralax Lactaid
Anti-Itch Lotions and Cream Pediculosis
Calamine Lotion RID Extra Strength Shampoo
Aveeno Anti-Itch Lotion Sun Protection
Cold Remedies Coppertone Sport Sunblock Lotion SPF 30
Mucinex Topical Steroids
Afrin Nasal Spray Cortaid Cream
Chloraseptic Vitamins and Minerals
Robitussin Syrup B-Complex with B-12 Tablets
Vicks Centrum Tablets
Dental Care Stuart Prenatal Tablets
Anbesol Vitamin C Tablets
Mouthwash Vitamin E Softgels
Toothbrush Vitamin A 10,000 IU
Toothpaste Caltrate 600
Waxed Dental Floss Therapeutic M.

 

If you have any questions about the OTC benefit options, please contact Member Services.


You will need the Adobe Acrobat Reader program to view the above forms. To download this free program click here or use the link above – the link will open a new window and take you to the Adobe website.

DHCS 030716 PHC Form 1.0