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You should know how to obtain your Humana over-the-counter catalog if you are a member. Please keep in mind that OTC benefits are only available under specific Humana plans.
If your plan provides this benefit, you can use it to buy over-the-counter goods like first aid supplies, aspirin, allergy and cold medication, as well as many other things. With the mail-delivery service offered by Humana Pharmacy, you use your benefit allowance. You can view your Evidence of Coverage or Annual Notification of Change documents, which detail the benefits of your policy, by visiting myhumana.com and selecting “Documents & Forms” at the bottom of the page. From there, you can determine whether your plan has an OTC benefit allowance.
Call Humana Pharmacy at 1-855-211-8370 if you have any questions regarding how to use your OTC benefit. From Monday through Friday, 8 a.m. to 11 p.m., customer service representatives are on duty. Additionally, they’re accessible on Saturdays from 8 a.m. to 6:30 p.m. Eastern time.
You can order your OTC goods in a few different ways:
Purchase things online. For Humana Pharmacy, go here to create an online account. Once you have registered, go to “Shop Products” and pick “Over-the-Counter (OTC) Items.” There, you will find a list of the products you can order from your Humana over-the-counter catalog.
You can place a mail order. Simply complete and mail the Health and Wellness Products Order Form to the following address:
Humana Pharmacy PO Box 1197 Cincinnati, OH 45201-1197.
Your order can be sent to Humana through fax. Fax the completed pages of the order form to 1-800-379-7617 after downloading and filling it out.
The OTC benefit allowance is how much?
If your plan includes an OTC benefit, you must check to see how much your OTC benefit is each year. Because Humana modifies plan features every year in an effort to give their members the greatest possible value. By visiting Humana.com and logging into your Humana account, you can access this information. Go to the bottom of the page after logging into your account and selecting Documents & Forms. You can then check your Annual Notification of Change or Evidence of Coverage paperwork from there.
Here, you can view additional crucial plan details as well as the amount of your OTC benefit.
If your OTC order costs more than your benefit allocation, you are responsible for the difference. You have the option of paying with a credit card, money order, or cheque.
If the total of your order exceeds your benefit allowance, sales tax may be applicable.
The unused portion of your OTC benefit does not carry over to the following month or quarter if you do not use it.
7 OTC Product Categories Completely Covered by Insurance
Did you know that when patients provide a prescription, certain OTC drugs are fully covered by insurance plans?
Only when the patient obtains a prescription are insurers required by the Affordable Care Act to cover some OTC preventative drugs at 100% with no co-pays, co-insurance, or deductibles.
Additionally, starting on January 1, 2011, health care reform regulations permit distributions from health flexible spending accounts (FSAs) and health reimbursement accounts (HRAs) to cover the price of over-the-counter (OTC) medications or prescriptions when they are purchased with a prescription. For instance, OTC acid controllers, anti-diarrheals, cold sore cures, sleep aids, painkillers, and respiratory treatments are just a few examples of eligible prescribed OTC expenses that Aetna FSAs may cover.
According to the Internal Revenue Service, patients must show proof, such as a customer receipt provided by a pharmacy that reflects the date of sale and the payment, coupled with a copy of the prescription, in order to get these OTC expenses reimbursed from their employer’s health FSA or HRA.
Pharmacy Times contacted America’s largest health insurers to learn which OTC product categories they cover when the medications are age-, gender-, and condition-appropriate and prescribed by a licensed health care professional for preventive care purposes. By informing their patients of these potential medication cost savings, pharmacists can add value to patient counseling.
The following are the seven OTC product categories that UnitedHealthcare, Anthem, Aetna, Cigna, and Humana all provide full coverage:
1. Aspirin
The use of aspirin for the prevention of cardiovascular disease is covered by all 5 main health insurance companies for males aged 45 to 79 and for women aged 55 to 79, with Humana and Anthem extending coverage to women aged 45 to 79.
Since September 1, 2015, they have also included aspirin use for women of reproductive age to prevent preeclampsia during pregnancy.
2. Contraceptive
Some types of OTC birth control for women are covered by all 5 major health insurance companies.
According to Anthem, OTC products including female condoms and spermicides are covered; this benefit also extends to anyone under the age of 19.
According to UnitedHealthcare, this includes female condoms, Plan B and Plan B One-Step generics, as well as over-the-counter contraceptive foams, gels, and sponges.
Cigna claims to cover barrier methods of contraception like vaginal film and foam.
3. Supplemental Fluoride
Fluoride supplements for the prevention of dental cavities in children are covered by UnitedHealthcare, Anthem, Aetna, Cigna, and Humana, but each has different conditions for full coverage.
For children ages 0 to 6 whose water source lacks fluoride, UnitedHealthcare only specifies coverage for prescription fluoride pills or solution (not toothpaste or rinses).
Anthem mandates dental fluoride varnish to prevent tooth decay in children’s main teeth from birth to age 5, as well as over-the-counter fluoride pills for children from birth to age 6 years.
While Cigna only specifies fluoride supplementation for children aged 6 to 12 months, Aetna specifies oral fluoride for children aged 6 months to 5 years.
Last but not least, Humana recommends over-the-counter fluoride for kids between the ages of 6 months and 6 years whose major water supply is fluoridated.
4. Folic acid dietary supplements
For female patients of childbearing age, OTC folic acid supplementation is covered by all 5 major health insurers.
All women who are 55 years of age or younger are included in this category according to Anthem, however UnitedHealthcare and Cigna only cover products with folic acid doses between 400 and 800 mcg.
5. Supplementing with Iron
Like fluoride supplements, 100% coverage of iron supplementation for preventing anemia due to iron deficiency in children is subject to differing standards from each of the five major health insurers.
For kids between the ages of 0 and 12 months, both UnitedHealthcare and Anthem cover iron supplements, while UnitedHealthcare only covers liquid forms of the supplement.
While these supplements are covered by Cigna, Aetna, and Humana for infants aged 6 to 12 months, the latter two insurers also specify coverage for infants who are more at risk of anemia.
6. Tools for Quitting Smoking.
For those who are 18 years of age or older, all 5 major health insurance pay for OTC tobacco cessation drugs that have received FDA approval.
According to UnitedHealthcare, in order for patients to be eligible for the full coverage, their physician must inform the insurer that they are also receiving tobacco-cessation counseling. Additionally, OTC nicotine replacement gum, lozenges, and patches need prior authorization.
7. Supplementing with vitamin D.
Vitamin D supplements are covered by UnitedHealthcare, Anthem, Aetna, Cigna, and Humana for the prevention of falls in people 65 and older.
To be eligible for the full coverage, Humana stipulates that patients must reside in a residential care environment.
Coverage of Additional OTC ProductsIt should be noted that Aetna covers the following pregnancy-related preventative supplies:
Electric breast pumps that are not hospital-grade should only be used once every three years while nursing or whenever pregnant.
Anytime during pregnancy or after delivery for the duration of breastfeeding, manual breast pumpsif individuals become pregnant once more before becoming eligible for a new pump, breast pump supplies
Additionally, when OTC colonoscopy prep kits are required for routine colon screening, Anthem covers them.
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