Over The Counter Benefit
User Manual: Over-the-Counter-Benefit
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15 West 65th St. New York, NY 10023 ] Welcome to the GuildNet Gold Plus FIDA Plan MMP-POS OTC Card! Use for select over-the-counter items not found on the Plan's drug list. The list of eligible items is on the back of this card carrier. You may now use this card to pay for eligible OTC items at the participating stores listed below left. Card Number: xxxx xxxx xxxx xxxx xxxx GuildNet Gold Plus FIDA Plan Participant Services: 1- 800-815-0000/ TTY 1-800-662-1220 Monday through Sunday 8 am to 8 pm Your card will only work for eligible items. Simply swipe your card at time of payment at the regular point-of-sale terminal. Step One - Activation: Your card requires activation prior to use at participating retailers. You can activate your card by calling 1-866-862-2400 or by visiting card services on the web at www.myotccard.com. For assistance with card activation, please contact Participant Services at 1-800-815-0000 / TTY: 1-800-662-1220. Step Two - Visit a Participating Store: You may use your card at participating stores. You do not need a prescription and do not need to go to the pharmacy window. Remember to take your card with you when you go to any of the listed stores, as you will need the card to pay for your eligible items. Step Three – Pay at the Front of the Store: Take your eligible items and go to the main store check out lanes. When you check out, swipe the card for payment. Eligible items (up to the balance amount on the card) are covered. You can use any remaining balance for another purchase before the end of the month). H0811_GN192 OTC Card V2_Approved Welcome to the convenience of the OTC Network Card! Eligible Items Bandages band-aids liquid bandages elastic bandages Surgical bandages Contact Lens Care Cough Drops Dental Floss Denture Adhesives Denture Cleaners Diagnostic Products thermometers Diuretics & Weight Loss Drys (Epsom Salts & Boric Acid in First Aid) First Aid Kits First Aid Tape Interdental, Gum Care Lip Care, Medicated Medical Compression Supports Sleep Aids Toothbrushes Toothpaste Weight Control Items on the Drug List (covered with your Plan ID card and Provider's Rx) Pain relief Cold & Allergy Relief Corn and Wart removers Sebex Topical Shampoo A&D ointment Anti-Itch Sprays and Creams Dr. Smith's topical ointment Secura Protective Creams Topical analgesics Sun Protection (SPF 15+) Trixaicin Topical cream Benzoyl Peroxide products BP Topical Products Acne products (check Drug List) Topical Anesthetics Topical Antibacterials Topical Antifungals Topical Antivirals (Abreva) Topical Corticosteroids Lice Treatment Vitamins (check list) Smoking cessation products Nasal Sprays Ear Wax Removal Drops Antidiarrheals, Antacids & other Gastrointestinal Agents Non-Eligible Items Baby medicines Chapstick / Lip balm Contraceptives Cosmetic products of any kind Cleansers or soaps Convenience items; scales, fans, magnifying glasses, foot insoles, gloves Dehydration drinks Dry skin moisturizers/lotions Deodorants Dietary supplements Feminine products Food products or supplements Grooming devices Hair color / hair products Herbal supplements Mouthwash Shampoo Teeth whitening products If you have any questions about your GuildNet Gold Plus FIDA Plan OTC Card, please visit our website at www.guildnetny.org or call 1-800-815-0000. TTY users call 1-800-662-1220. For OTC card services, including checking your balance and finding an accepting retailer call 1-888-682-2400, or go to www.otcmember.com. GuildNet Gold Plus FIDA Plan is a managed care plan that contracts with both Medicare and the New York State Department of Health (Medicaid) to provide benefits of both programs to Participants through the Fully Integrated Duals Advantage (FIDA) Demonstration. Benefits, List of Covered Drugs, and pharmacy and provider networks may change from time to time throughout the year and on January 1 of each year. Limitations and restrictions may apply. For more information, call GuildNet Gold Plus FIDA Plan Participant Services or read the GuildNet Gold Plus FIDA Plan Participant Handbook. You can get this information for free in other formats, such as Braille or large print. Call 1-800815-0000. The call is free. You can get this information for free in other languages. Call 1-800-815-0000 or TTY/TDD 1800-662-1220, Monday through Sunday, 8am to 8pm. The call is free. Usted puede obtener esta información en otros idiomas gratis. Llame al 1-800-815-0000 o TTY/TDD al 1-800-662-1220, de lunes a domingo de 8am a 8pm. La llamada es gratis.” Queste informazioni sono disponibili gratuitamente in altre lingue. Chiamare il numero verde 1800-815-0000 o 1-800-662-1220 mediante un telefono testuale per non udenti (TTY/TDD), da lunedì a domenica, dalle 8 alle 20. La chiamata è gratuita. 您可以免費獲得本信息的其他語言版本。請撥打 1-800-815-0000 或聽障／語障人士專線 (TTY/TDD) 1-800-662-1220，星期一至星期日上午 8 時至晚上 8 時。撥打該電話免費。 Вы можете бесплатно получить эту информацию на других языках. Позвоните по телефону 1-800-815-0000 и TTY/TDD 1-800-662-1220. Служба работает с понедельника по воскресенье с 08:00 до 20:00 ч. Звонок бесплатный. Ou kapab jwenn enfòmasyon sa yo gratis nan lòt lang. Rele nimewo 1-800-815-0000 oswa TTY/TDD 1-800-662-1220, lendi jiska dimanch, depi 8am jiska 8pm. Koutfil la gratis. 다른 언어로 작성된 이 정보를 무료로 얻으실 수 있습니다. 월요일 - 일요일 오전 8시부터 오후 8시 사이에 1-800-815-0000번이나 TTY/TDD 1-800-662-1220번으로 전화주세요. 통화는 무료입니다. The State of New York has created a participant ombudsman program called the Independent Consumer Advocacy Network (ICAN) to provide Participants free, confidential assistance on any services offered by GuildNet Gold Plus FIDA Plan. ICAN may be reached toll-free at 1-844614-8800 or online at icannys.org.
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