In this section
Over-the-Counter Medication Benefits
KelseyCare Advantage provides members with access to approved over-the-counter (OTC) products. The approved KelseyCare Advantage OTC products cover a wide range of over-the-counter needs such as allergy relief products, cough and cold medicine, antacids, pain relievers, vitamins and minerals, first aid products and more.
2022 Over-the-Counter Medication Benefits
KelseyCare Advantage provides members of with access to approved over-the-counter items through the OTC benefit. The OTC benefit offers you an easy way to get generic over-the-counter health and wellness products by going to any OTC Health Solutions-enabled CVS Pharmacy store. You can also order by phone at 1-888-628-2770 (TTY: 711) or online at https://www.cvs.com/otchs/kelseycareadvantage. You order from a list of approved OTC items, and OTC Health Solutions will mail them directly to your home address. Approved OTC products will be detailed in the OTC catalog. Confirm that you are reviewing the most current OTC catalog.
For additional information about KelseyCare Advantage plans and the OTC benefit contact us at 713-442-CARE (2273) Toll-free: 1-866-535-8343 (TTY: 711). For all other OTC benefit related or order related questions contact: 1-888-628-2770 (TTY: 711).
Frequently Asked Questions
How much is my OTC benefit?
The amount depends on your benefit plan. Check your plan documents or call OTC Health Solutions at 1-888-628-2770 (TTY: 711).
How often can I use my OTC benefit?
Your OTC benefit can be utilized multiple times throughout the benefit period. Quarterly benefit periods are distributed as follows:
- Quarter 1 (January, February and March)
- Quarter 2 (April, May and June)
- Quarter 3 (July, August and September)
- Quarter 4 (October, November and December)
Can I carry over unused benefit amount to the next benefit period?
Unused benefit amounts do not roll over to the next benefit period.
Can I order more than my benefit amount?
You cannot exceed your benefit amount online or by phone. However, you may exceed your benefit amount at an OTC Health Solutions-enabled CVS Pharmacy store and pay the difference out of pocket.
Are all items available at the stores?
Not all items are available in stores. Items marked with a “8” in the catalog can only be ordered over the phone or online.
How long will it take to receive my order?
You will receive your order within 14 days after it was placed.
Can I cancel my order once it has been placed?
Orders can only be cancelled within ONE HOUR after being processed.
How do I confirm my order was placed?
Once the order has been completed, you will receive a confirmation number. Always make sure to receive and keep your confirmation number.
Can I track my order?
You can opt in to receive tracking information via email or text; simply advise an agent when placing your order.
How can I receive another copy of this catalog?
You will receive a digital version of the catalog with every tracking email/text. You can also print a copy from the plan web page.
Where can I get additional information about the products?
In this catalog you will find SKU numbers that can be used at https://www.cvs.com to search for product images and obtain additional product information such as ingredients.
How will the items be shipped?
Items are shipped via USPS to your home at no charge to you. Please allow up to 14 days for delivery. If you have not received your items within 14 days after ordering, please call: 1-888-628-2770 (TTY: 711), Monday to Friday, 9 AM to 8 PM CST.
- There is no limit on the number of items you may order. There is, however, a quantity limit of three per any single item for monthly benefits or nine per any single item for quarterly benefits. There are some select products that have special limits and these are marked by a “★” or “◼” in this catalog
- In order to purchase certain vitamin and mineral supplements, your physician must recommend it to you for a specific diagnosed condition. These are called “dual-purpose items” which are marked with a “♦” Please speak with your physician before ordering these type of items.
- Products in this catalog are intended for personal use and may be ordered only for the enrollee.
2021 Over-the-Counter Medication Benefits
KelseyCare Advantage provides members with access to approved over-the-counter (OTC) products. The OTC Benefit provides members with $25 every quarter which can be used towards purchasing approved over-the-counter items through select pharmacy locations. Unused amounts do not carry over to the next quarter or the next calendar year. The approved KelseyCare Advantage OTC products cover a wide range of over-the-counter needs such as allergy relief products, cough and cold medicine, antacids, pain relievers, vitamins and minerals, first aid products and more.
Approved over-the-counter products are detailed in the OTC catalog. These products can be purchased at Kelsey Pharmacies or they can be mailed to your residence. For questions about this benefit, please contact KelseyCare Advantage Member Services at 713-442-9452 or toll-free at 1-866-534-0557 (TTY users can call 711) from 8 a.m. to 5 p.m. Monday through Friday. To make an order or purchase, please contact your local Kelsey Pharmacy.
Approved OTC products will be detailed in the OTC catalog. Confirm that you are reviewing the most current OTC catalog. These products can be purchased in-store, or over the phone for in-store pick up or mail. delivery.
Using Your OTC Benefit
- Review the OTC catalog for the list of approved over-the-counter products.
- Visit a Kelsey-Pharmacy in-person or contact your local Kelsey Pharmacy location to place an order. Phone numbers, hours of operation and addresses are provided on the back cover.
- Your quarterly allowance is $25, which includes sales tax as applicable. Unused amounts will not roll over to the next quarter or year.
- If the total cost of your order is higher than the provided allowance, you will be responsible for paying the difference out of pocket before your order is processed. A Kelsey Pharmacy associate will assist with processing the remaining balance via phone or you can pay the remaining balance at Kelsey Pharmacy.
How to Order
Orders can be submitted over the phone for mail delivery or in-store pick up, or items can be purchased in participating Kelsey Pharmacies.
Call a participating Kelsey Pharmacy by 4 p.m. Monday through Friday to have your order mailed the following business day. Ordered products are delivered through standard mail and may take 7-10 business days for delivery. You will not be charged for any costs associated with mail delivery.
Call your local Kelsey Pharmacy by 4 p.m. Monday through Friday to have your order prepared for in- store pick up after 1 p.m. the following business day. Items that are not picked up at the designated store within 14 days of order preparation will be returned to stock. Holidays and weekends may affect hours of operation and delivery schedules.
Locate and confirm the operating hours of your local Kelsey Pharmacy by calling the pharmacy or visiting www.kelsey-seybold.com/pharmacy ahead of your visit.
Visit your nearest Kelsey Pharmacy and look for items with a “KCA Approved” OTC sticker for in-store purchases. Store associates can assist with finding specific approved products.
If a mail ordered item is defective, please contact Kelsey Pharmacy (phone numbers are provided on the back cover of this catalog) to discuss replacement options. No other returns or refunds will be granted for over-the- counter (OTC) purchases.
Due to the personal nature of these products, no other returns or refunds will be granted for over-the- counter (OTC) purchases. Lost or stolen OTC items are not refundable and will not be replaced.
Under specific circumstances, such as an instance where you forget to use your allowance when purchasing approved OTC products at participating Kelsey Pharmacies, you can contact us (phone numbers are provided on the back cover of this catalog) to determine if you qualify for reimbursement.
Reimbursement requests will be reviewed by a dedicated team and you will be informed of the final decision.
To be eligible for reimbursement:
- You are required to have proof of purchase of an approved OTC product as detailed in this catalog at a participating Kelsey Pharmacy.
- You must have an available balance of your quarterly allowance at the time of purchase.
- You must have been eligible for the OTC benefit at the time of purchase.
Send us your request for payment, along with your bill and documentation of any payment you have made. It’s a good idea to make a copy of your bill and receipts for your records.
Mail your request for payment together with any bills or receipts to us at this address:
Attn: Member Services
P.O. Box 841569 Pearland, TX 77584-9832
You must submit your claim to us within 12 months of the date you received the over-the-counter product. For further questions you can contact us at the phone numbers provided on the back cover of this catalog
- The preapproved products as listed in this catalog are non-prescription drugs, also known as OTC drugs, and health-related items that are not covered by Medicare Part A, Part B or Part D, and are a part of a supplemental medical benefit provided by KelseyCare Advantage annually. Some items, under certain circumstances, may be covered under either Part B or Part D, these items are identified throughout the catalog. When you receive these items under Part B or Part D, you may not purchase these items through your OTC benefit.
- The items covered by the benefit are limited to items that are consistent with CMS guidance. The list of approved OTC products may change at any time. Please note that the KelseyCare Advantage OTC benefit cannot be used towards the purchase of any items that are not on the list of approved products in this catalog.
- Products that are covered by this supplemental benefit are for the eligible member, OTC items may be purchased for the eligible member only. Medicare prohibits the use of this benefit to order OTC products for family members and friends.