PHC Florida

Robert Heglar
AHF Provider

Over-the-Counter Pharmacy Benefit

You can order up to $25 worth of over-the-counter (OTC) pharmacy items each month.  OTC items are available through AHF Pharmacy’s Fulfillment Center.  You can order items in whatever amounts you want up to $25 per month.  There is no cost for your order or delivery.  If you don’t use or use up your benefit in a given month, you can’t apply it to future months.

Instructions are on 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, fax or phone it into to the AHF Pharmacy Fulfillment Center on the form.  You can also take it to any AHF Pharmacy for processing.  If you want us to send you more order forms, contact Member Services.

This list of OTC items is effective July 1, 2017.  It may change during the year.  Item unit/size and price are on the Over-the-Counter Pharmacy Order Form.  If you have any questions, contact Member Services.

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 Caplets Adhesive Tape
Advil Tablets Alcohol Swabs
Aleve Caplets Band-Aids
Excedrin Condoms
Antacids and Acid Reducers Cotton Balls
Mylicon Cotton Swabs
Prilosec (Limit two per month) Ice Bag
Tums Tablets Johnson & Johnson Gauze
Zantac Tablets Oral Thermometer
Anti-Arthritis Pill Box
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 Herbals
Antidiarrheals and Laxatives — If you bleed, check with your PCP first. —
Colace Softgels CoQ-10
Dulcolax Suppositories Ginkgo Biloba
Dulcolax Tablets Insect Repellent
Imodium Caplets OFF! Deep Woods Spray
Pepto-Bismol Liquid OFF! Active Sweat-Resistant Spray
Miralax Lactose Intolerance
Anti-Itch Lotions and Cream Lactaid
Calamine Lotion Pediculosis
Aveeno Anti-Itch Lotion RID Extra Strength Shampoo
Children’s Products Sleeping Aids
Orajel Baby Tylenol PM
Balmex Ointment Sun Protection
Mylicon Gas Relief Drops Coppertone Sport Sunblock Lotion
Poly-Vi-Sol Multivitamin Drops Topical Steroids
Motrin Suspension For Children Cortaid Cream
Tylenol Children’s Grape Elixir Vitamins and Minerals
Tylenol Children’s Grape Tablets — If pregnant or in reproductive years, check with your PCP before using any supplements. —
Tylenol Infant Drops B-Complex with B-12 Tablets
Glycerin Suppositories – Children Centrum Tablets
Cold Remedies Flintstones
Mucinex Magnesium
Afrin Nasal Spray Stuart Prenatal Tablets
Chloraseptic Vitamin C Tablets
Robitussin Syrup Vitamin E Softgels
Vicks Vitamin A
Dental Care Caltrate 600
Anbesol Therapeutic M.
Mouthwash
Toothbrush
Toothpaste
Waxed Dental Floss


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.

 

The benefit information provided is a brief summary, not a complete description of benefits.  Limitations and restrictions apply.  Benefits, formulary, and/or pharmacy network may change.

AHCA 062614 PHC MMA Form 17.0