Plan

Frequency

OTC items by mail order

OTC items in retail store

OTC items and Healthy Foods

OTC Card

ConnectiCare Passage Plan 1 (HMO)

Every three months

     

ConnectiCare Choice Plan 2 (HMO)

Every month

     

ConnectiCare Choice Plan 3 (HMO)

Every three months

     

ConnectiCare Choice Part B Saver (HMO)

Every three months

     

ConnectiCare Flex Plan 3 (HMO-POS)

Every three months

     

ConnectiCare Choice Dual Basic (HMO D-SNP)

Every three months

     

ConnectiCare Choice Dual Vista (HMO D-SNP)

Every month

     

ConnectiCare Choice Dual (HMO D-SNP)

Every month

See your Evidence of Coverage or Cost Sharing Guide for the OTC amount you get with your plan or call ConnectiCare Medicare Connect Concierge for help. OTC benefit amounts must be used within your benefit frequency and will not roll over.

2022 ConnectiCare Choice Dual (HMO D-SNP) Members
Eligible OTC and Healthy Food Benefit

Eligible food categories include:

  • Cereal (hot and cold).
  • Dairy products (milk, cheese, butter).
  • Dry foods (beans, fruit, pasta).
  • Eggs and egg substitutes.
  • Fresh food boxes (mixed produce, all vegetable, diabetic and other choices).
  • Frozen food.
  • Fruits & vegetables.
  • Juice.
  • Meat (poultry, beef, sausage, lunch meat).
  • Rice and whole grains.
  • Soup.
  • And more!

 

Ways to get healthy food eligible items:

  1. GA Foods, online at www.gafoods.com/connecticare or call (888) 446-2836 for healthy food and produce; or
  2. FarmBoxRx, online www.farmboxrx.com/connecticare or call (888) 416-3589 for fresh food box choices include mixed produce, all vegetable, and diabetic choices.

How to get your eligible items once you activate your OTC card:


At participating retail locations, including CVS, Family Dollar, Rite Aid, Walgreens, Walmart, and many others. Check participating locations at otcnetwork.com or call Connect Concierge and we will find a location near you.


Retail list of covered OTC items:
English   Español

 

By mail – just fill out and send the mail-order form below to ConveyBenefits.

List of covered OTC items by mail, phone and online and mail order form coming soon.

 

Visit ConveyBenefits.com/connecticare to select your covered items and complete the checkout process.

 

Call ConveyBenefits at 

855-858-5940 (TTY: 711), 

Monday to Friday, 8 am to 8 pm

2022 ConnectiCare Choice Dual Basic*, 2022 ConnectiCare Choice Dual Vista*, 2022 ConnectiCare Passage Plan 1*, 2022 ConnectiCare Choice Plan 2*, 2022 ConnectiCare Choice Plan 3*, 2022 ConnectiCare Part B Saver*, and 2022 ConnectiCare Flex Plan 3* plan members get covered OTC items by mail-order only and do not receive an OTC card.

*OTC benefits do not include healthy foods

Here are ways to order your items for your mail order only OTC benefit:

 

Visit connecticare.com/mailOTC to select your covered items and complete the checkout process.

 

By mail – just fill out and send the mail-order form below to NationsOTC.

List of covered OTC items by mail, phone and online and mail order form:

English  Español

 

Call NationsOTC at

 877-239-2942 (TTY: 711),

Monday to Friday, 8 am to 8 pm


Mail order items should be received in the mail within two to five business days from the time of receipt of your order. If the total amount of your order is more than your OTC balance, you will be asked for an alternate method of payment. You can use a credit card online or over the phone, and a check when using mail order.

 


 

How to get reimbursed:

We ask that you use your benefit in one of the ways listed above. If you are unable, you can request a refund using the below form. Simply mail your completed paper claim form to us with a copy of the receipt(s) for the covered item(s) you bought. We will send you a refund check in the mail.

Reimbursement Form

 


If you have any questions, please see your Evidence of Coverage or Cost Sharing Guide for the OTC allowance amount you get with your plan or call ConnectiCare Medicare Connect Concierge at 800-224-2273 (TTY: 711), 8 am to 8 pm, seven days a week.