STEWARD HEALTH CHOICE GENERATIONS (HMO SNP) 2019 …...Steward Health Choice Generations HMO SNP is a Health Plan with a Medicare contract and a contract with the state Medicaid program.

STEWARD HEALTH CHOICE GENERATIONS (HMO SNP)

2019 OVER-THE-COUNTER (OTC) BENEFIT CATALOG As a member of Steward Health Choice Generations, you have an Over-the-Counter (OTC) benefit every quarter (every three months). This benefit allows you to get OTC products you may need. Be sure to use your benefit amounts before the end of every quarter. Simply order online, mail your completed order form, or call 1-844-457-8938 (TTY: 711). Your order will be shipped directly to your door.

Get Over-the-Counter Products Every Quarter. Special Health Plan Benefit with no cost to you. Information on how to place your OTC order can be found in the catalog.

Remember to Keep this Catalog. You will want to reference this catalog each time you place your order.

ORDER GUIDELINES

You may place an order online using your Steward Health Choice Generations OTC website at stewardhcgenerationsotc.com. Remember to save your username and password to order again during your next benefit period.

ORDER ONLINE ORDER BY MAIL ORDER BY PHONE

You may place your order by mailing in the order form that comes with your catalog. If the end of the benefit period is approaching and you do not think your order form will be received in time, you may order online or call in your order.

If you have questions or would like to place an order over the phone, OTC Advocates are available Monday – Friday from 8:00 a.m. to 11:00 p.m., EST at 1-844-457-8938 (TTY: 711).

• For delivery, please allow 7 - 10 business days from the time your order is placed.

• You must use your full benefit amount in two (2) orders within a benefit period. Unused benefits will not roll over into the next quarter.

• Your order total may not exceed your benefit amount. Cash, checks, credit cards or money orders are not accepted under this OTC benefit.

• Your order total will be applied to the benefit period in which the order is received.

• OTC products are intended for member use only to help with a health or medical need. Steward Health Choice Generations prohibits the use of this benefit to order OTC items for family members and friends.

• Due to the personal nature of these products, returns are not accepted.

• Items in the 2019 OTC catalog may change throughout the year. For the most up-to-date listing of OTC products available, go to stewardhcgenerationsotc.com.

• OTC items are available through home delivery only. Products may not be purchased at a local retail pharmacy or through any source other than the Steward Health Choice Generations OTC benefit channels listed above.

Y0133_OTCCatalog2019248_C 2

http://stewardhcgenerationsotc.com

http://stewardhcgenerationsotc.com

* ‡ – See Page 3

NOTICES • If you disenroll from Steward Health Choice Generations, your OTC benefit will automatically

terminate.

• Steward Health Choice Generations HMO SNP is a Health Plan with a Medicare contract and a contract with the state Medicaid program. Enrollment in Steward Health Choice Generations HMO SNP depends on contract renewal.

• This information is available in other formats, such as Braille, large print, and audio.

• The health information provided in the catalog is general in nature and is not medical advice or a substitute for professional health care.

* Part B/D - Under certain circumstances some items may be covered under either Part B or Part D. When you are eligible to receive these items under Part B or Part D you may not purchase these items through your Part C supplemental OTC benefit. For your convenience, we’ve marked these items with an (*)

‡ Dual-purpose items are medicines and products that can be used for either a medical condition or for general health and well-being. In order to purchase these items under your plan, your personal physician must recommend them to you for a specific diagnosed condition. Please speak to your physician before ordering these items.

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2019 OVER–THE–COUNTER (OTC) PRODUCT

ORDER FORM

STEP 1 - COMPLETE YOUR INFORMATION BELOW Member ID (found on plan member ID card) Date of Birth

First Name Last Name MI

Street Number Street Name Apt/Suite #

City State Zip Code

Please check box if this is a new addressDaytime Phone Email (Optional)

@

STEP 2 - PRODUCT SELECTION

Cash, checks, credit cards or money orders are not accepted under this OTC benefit.

Item # Product Quantity Unit Price TOTAL

Subtotal from Other Side $ .

Total Order $ .

Please mail the completed form back in the postage-paid envelope provided or mail it to: OTC Servicing Center PO Box 267067 Weston, FL 33326 - 9895

If you place your order using an order form, your order total will be applied to the month in which we receive your form. For example, if you mail your order form on June 29th, but we receive it on July 1st, your order total will be applied to your July benefit, not your June benefit.

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20 $ . $

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STEP 2 - PRODUCT SELECTION (Continued)

Cash, checks, credit cards or money orders are not accepted under this OTC benefit.

Item # Product Quantity Unit Price

Subtotal $ .

Please mail the completed form back in the postage-paid envelope provided.

TOTAL

If you place your order using an order form, your order total will be applied to the month in which we receive your form. For example, if you mail your order form on June 29th, but we receive it on July 1st, your order total will be applied to your July benefit, not your June benefit.

Steward Health Choice Generations HMO SNP is a Health Plan with a Medicare contract and a contract with the state Medicaid program. Enrollment in Steward Health Choice Generations HMO SNP depends on contract renewal.

This information is available in other formats, such as Braille, large print, and audio.

Y0133_OTCCatalog2019248_C

stewardhcgenerationsotc.com2019 Over-The-Counter Benefit Catalog

ALLERGY, COLD, FLU, DECONGESTANT & SINUS

Allergy Relief Nasal Spray, 24-hr, Fluticasone Propionate

Item #: 1946 Packaging: 120 spray Strength: 50 mcg

$25.00

All-Nite Cold/Flu

Item #: 1361 Packaging: 4 oz Strength: 12.5 mg, 30 mg, 650 mg

$7.25

Cepacol Sore Throat Lozenges

Item #: 1360 Packaging: 16 ct Strength: -

$8.75

Cetirizine HCL Allergy Relief Item #: 1090

Packaging: 14 ct

Strength: 10 mg

$9.25

Children’s Dimaphen

Item #: 1426 Packaging: 4 oz Strength: 1 mg / 5 ml, 3 mg / 5 ml

$10.00

Children’s Diphenhydramine HCL

Item #: 1428 Packaging: 4 oz Strength: 12.5 mg / 5 ml

$7.25

Cough & Cold for High Blood Pressure


$7.50

Cough Drops, Cherry Item #: 1056 Packaging: 30 ct Strength: 5.8 mg

$5.50

4


ALLERGY, COLD, FLU, DECONGESTANT & SINUS (Continued)

Cough Drops, Sugar Free, Cherry

Item #: 1182 Packaging: 25 ct Strength: 5.8 mg

$6.25

Cough Drops, Honey Lemon Item #: 1833 Packaging: 30 ct Strength: -

$5.50

Cough Drops, Menthol Item #: 1834 Packaging: 30 ct Strength: -

$5.50

Cough Syrup, Expectorant Item #: 1054 Packaging: 4 oz Strength: 200 mg / 10 ml

$6.50

Cromolyn Sodium Allergy Nasal Spray

Item #: 1356 Packaging: 26 ml Strength: -

$14.75

Diabetic Tussin DM Item #: 1323 Packaging: 4 oz Strength: -

$11.75

Diphenhydramine Antihistamine

Item #: 1009 Packaging: 24 ct Strength: 25 mg

$6.25

Diphenhydramine Antihistamine


$7.25

5



Guaifenesin Cough Expectorant


$10.25

Irritation Relief Eye Drops Item #: 1806 Packaging: 15 ml Strength: -

$9.75

Loratadine Allergy Relief Item #: 1611 Packaging: 100 ct Strength: 10 mg

$16.25

Mucus Relief DM Expectorant & Cough Suppressant

Item #: 1178 Packaging: 30 ct Strength: 400 mg, 20 mg

$10.00

Mucus Relief DM Expectorant & Cough Suppressant, Extended Release

Item #: 1965 Packaging: 14 ct Strength: 1,200 mg, 60 mg

$16.00

Multi-Symptom Cold Formula

Item #: 1357 Packaging: 24 ct Strength: 10 mg, 5 mg, 325 mg

$9.25

Nasacort Item #: 1881 Packaging: 60 spray Strength: -

$24.25

Nasal Decongestant Spray, 12 Hour

Item #: 1091 Packaging: 1 oz Strength: 0.05%

$6.50

6



Nasal Spray, Saline Item #: 1052 Packaging: 1.5 oz Strength: 0.65%

$6.25

Personal Steam Inhaler Item #: 1792 Packaging: 1 ct Strength: -

$47.00

Sore Throat Lozenges, Cherry


$6.25

Sudogest PE Nasal & Sinus Decongestant


$8.75

Vapor Rub Item #: 1164 Packaging: 3.5 oz Strength: 4.7%, 1%

$6.25

ANTACIDS & ACID REDUCERS

Alka-Seltzer Item #: 1313 Packaging: 36 ct Strength: -

$10.75

Antacid / Anti-Gas Liquid Item #: 1006 Packaging: 12 oz Strength: -

$11.25

Antacid Chewables Item #: 1346 Packaging: 150 ct Strength: 500 mg

$8.25

7


ANTACIDS & ACID REDUCERS (Continued)

Effervescent Pain Reliever Item #: 1314 Packaging: 36 ct Strength: -

$8.25

Esomeprazole Magnesium, 24-hr Delayed Release Acid Reducer *


$20.00

Famotidine Acid Reducer * Item #: 1108 Packaging: 30 ct Strength: 10 mg

$7.25

Omeprazole Acid Reducer * Item #: 1970 Packaging: 42 ct Strength: 20 mg

$24.00

Omeprazole Acid Reducer, Delayed Release, Dissolvable


$24.00 *

Ranitidine Acid Reducer Item #: 1900 Packaging: 30 ct Strength: 75 mg

$8.25

Simethicone Anti-Gas Chewables


$9.00

ANTICANDIDAL (YEAST)

Clotrimazole 7-Day Treatment Vaginal Cream (with applicator)

Item #: 1115 Packaging: 45 gm Strength: 1%

$15.00

8


ANTICANDIDAL (YEAST) (Continued)

Miconazole 3-Day Treatment Vaginal Cream (with applicator)

Item #: 1117 Packaging: 1 kit Strength: 2%

$16.25

Tioconazole 1-Day Treatment Vaginal Cream (with applicator)

Item #: 1119 Packaging: 1 ct Strength: 6.50%

$21.25

ANTI-DIARRHEAL, LAXATIVES & DIGESTIVE HEALTH

Beano Item #: 1316 Packaging: 30 ct Strength: -

$11.25

Bisacodyl Enteric Coated Laxative


$8.50

Bismatrol Chewable Tablets Item #: 1045 Packaging: 30 ct Strength: 262 mg

$6.25

ClearLax Unflavored Powder Item #: 1969 Packaging: 8.3 oz Strength: 17 g

$14.00

Docusate Sodium Stool Softener


$10.50

Enema Item #: 1733 Packaging: 4.5 oz Strength: -

$6.25

9


ANTI-DIARRHEAL, LAXATIVES & DIGESTIVE HEALTH (Continued)

Ex-Lax Item #: 1124 Packaging: 8 ct Strength: 15 mg

$9.25

Glycerin Suppository Item #: 1125 Packaging: 25 ct Strength: 2 gm

$6.25

Lactase Capsules Item #: 1067 Packaging: 60 ct Strength: 9000 FCC Units

$13.75

Loperamide HCL Anti-Diarrheal *


$7.25

Methylcellulose Fiber Therapy

Item #: 1354 Packaging: 16 oz Strength: -

$13.25

Milk of Magnesia Item #: 1011 Packaging: 12 oz Strength: 400 mg

$7.25

Natural Vegetable Laxative Item #: 1340 Packaging: 13 oz Strength: -

$13.25

Natural Vegetable Laxative Item #: 1967 Packaging: 30.4 oz Strength: -

$18.00

10


ANTI-DIARRHEAL, LAXATIVES & DIGESTIVE HEALTH (Continued)

Natural Vegetable Laxative, Sugar free


$15.00

Pepto-Bismol Cherry Item #: 1317 Packaging: 12 oz Strength: 525 mg / 30 ml

$13.00

Pink Bismuth Item #: 1318 Packaging: 8 oz Strength: 525 mg / 30 ml

$8.25

Polycarbophil Fiber Tablets Item #: 1012 Packaging: 90 ct Strength: 625 mg

$11.75

Senna Plus Stool Softener Plus Laxative

Item #: 1130 Packaging: 60 ct Strength: 8.6 mg, 50 mg

$7.75

ANTI-FUNGAL & ANTI-ITCH

Bactine Solution Item #: 1142 Packaging: 4 oz Strength: -

$10.25

Caldyphen Clear Lotion Local Analgesic

Item #: 1144 Packaging: 6 oz Strength: 1%

$9.25

Clotrimazole Antifungal Athlete’s Foot Cream

Item #: 1047 Packaging: 1.5 oz Strength: 1%

$9.00

11


ANTI-FUNGAL & ANTI-ITCH (Continued)

Diphenhydramine HCL / Zinc Acetate Anti-Itch Cream


$6.50

Hydrocortisone 1% Cream Item #: 1074 Packaging: 1 oz Strength: 1%

$6.50

Medicated Antifungal Foot Powder Spray

Item #: 1874 Packaging: 4.6 oz Strength: -

$11.75

Miconazole Nitrate 2% Antifungal Cream


$7.50

Terbinafine HCL Antifungal Cream

Item #: 1046 Packaging: .5 oz Strength: 1%

$11.00

Tolnaftate Antifungal Cream Item #: 1064 Packaging: 1.25 oz Strength: 1%

$6.75

COLD SORE & MEDICATED LIP PRODUCTS

Abreva Item #: 1152 Packaging: 2 gm Strength: 10%

$30.00

Blistex Lip Ointment Item #: 1256 Packaging: 6 gm Strength: -

$6.50

12


COLD SORE & MEDICATED LIP PRODUCTS (Continued)

Carmex Item #: 1255 Packaging: 7.5 gm Strength: -

$6.50

Herpecin-L Lip Balm Item #: 1153 Packaging: .1 oz Strength: 1%

$11.25

Releev Cold Sore Treatment Item #: 1359 Packaging: 6 ml Strength: 0.13%

$25.00

DENTAL & DENTURE CARE

Biotene Dry Mouth Oral Rinse Item #: 1817 Packaging: 16 oz Strength: -

$13.75

Biotene Dry Mouth Spray Item #: 1818 Packaging: 1.5 oz Strength: -

$11.75

Denture Brush Item #: 1747 Packaging: 1 ct Strength: -

$6.75

Denture Cleaning Tablets Item #: 1032 Packaging: 40 ct Strength: -

$6.25

Efferdent Plus Mint Tablets Item #: 1653 Packaging: 36 ct Strength: -

$9.75

13


DENTAL & DENTURE CARE (Continued)

Effergrip Denture Cream Adhesive


$8.75

Effergrip Denture Cream Adhesive

Item #: 1187 Packaging: .75 oz Strength: -



Item #: 1454 Packaging: 7 gm Strength: 20%

Item #: 1286 Packaging: .5 oz Strength: 20%



$11.25

Fixodent $7.75

Interdental Flossups $6.25

Orajel Medicated Mouth SoreSwabs

$11.25

Orajel Pain Relief $12.25

Oral Pain Relief $8.25

Polident Denture Cream $9.25

14



Polident Overnight Item #: 1892 Packaging: 84 ct Strength: -

$12.75

Reach Waxed Dental Floss - Mint

Item #: 1455 Packaging: 55 yd Strength: -

$5.50

Reach Waxed Dental Floss - Unflavored

Item #: 1902 Packaging: 55 yd Strength: -

$5.50

Tongue Cleaner Item #: 1746 Packaging: 1 ct Strength: -

$6.75

Toothbrush, Colgate, Adult Medium


$6.25

Toothbrush, Colgate, Adult Soft


$6.25

Toothbrush, Rechargeable Item #: 1450 Packaging: 1 ct Strength: -

$38.00

Toothbrush, Soft 2-pack Item #: 1948 Packaging: 2 ct Strength: -

$8.00

15



Toothbrush, Tek Pro, Angled Soft


$4.50

Toothpaste, Colgate Item #: 1831 Packaging: 4 oz Strength: -

$7.00

Toothpaste, Crest Sensi-Relief


$9.00

Toothpaste, Fluoride Item #: 1914 Packaging: 6.4 oz Strength: -

$7.00

Toothpaste, Pepsodent Item #: 1414 Packaging: 5.5 oz Strength: -

$6.50

Toothpaste, Sensitive Teeth Item #: 1903 Packaging: 4.3 oz Strength: -

$8.00

DIABETES

Toothpaste, Ultrabrite Advanced Whitening


$7.00

Water Jet Item #: 1744 Packaging: 1 ct Strength: -

$45.00

16


DIABETES (Continued)

Water Jet Replacement Tips Item #: 1743 Packaging: 5 ct Strength: -

$18.00

Diabetic Skin Relief Foot Cream

Item #: 1956 Packaging: 3 pair Strength: -


$15.25

Diabetic Socks, Black, Medium 3-pack $9.00

Diabetic Socks, Black, Large 3-pack


$9.00

Diabetic Socks, Black, X-Large 3-pack


$9.00

Diabetic Socks, White, Medium 3-pack


$9.00

Diabetic Socks, White, Large 3-pack


$9.00

Diabetic Socks, White, X-Large 3-pack


$9.00

17


DIABETES (Continued)

Ultra Soft Padded Diabetic Sock, Black, Medium 2-pack


$11.00

Ultra Soft Padded Diabetic Sock, Black, Large 2-pack


$11.00

Ultra Soft Padded Diabetic Sock, Black, X-Large 2-pack


$11.00

Ultra Soft Padded Diabetic Sock, White, Medium 2-pack


$11.00

Ultra Soft Padded Diabetic Sock, White, Large 2-pack


$11.00

Ultra Soft Padded Diabetic Sock, White, X-Large 2-pack


$11.00

EAR CARE

Cotton Tipped Swabs Item #: 1742 Packaging: 300 ct Strength: -

$6.25

Ear Wax Removal Drops Item #: 1190 Packaging: 15 ml Strength: 6.50%

$9.75

18


EAR CARE (Continued)

Ear Wax Removal System with Rubber Bulb

Item #: 1363 Packaging: 15 ml Strength: 6.50%

$8.75

Swim-Ear Ear Drops Item #: 1910 Packaging: 1 oz Strength: -

$8.75

EYE CARE

Artificial Tears Drops Item #: 1192 Packaging: .5 oz Strength: -

$6.50

Artificial Tears Ointment Item #: 1194 Packaging: 3.5 gm Strength: -

$10.25

Clear Eyes Eye Drops Item #: 1199 Packaging: .2 oz Strength: -

$7.00

Redness Relief Eye Drops Item #: 1061 Packaging: 15 ml Strength: 0.05%

$5.25

Stye Eye Ointment Item #: 1906 Packaging: 3.5 gm Strength: -

$16.25

19


FIRST AID & MEDICAL SUPPLIES

Adhesive Bandages * Item #: 1344 Packaging: 60 ct Strength: -

$6.50

Adjustable Transfer Bench Item #: 1764 Packaging: 1 ct Strength: -

$75.00

After Bite Relief Item #: 1803 Packaging: .5 oz Strength: -

$10.25

Alcohol Pads * Item #: 1200 Packaging: 100 ct Strength: 70%

$4.75

Antiseptic Skin Cleanser Item #: 1808 Packaging: 8 oz Strength: -

$11.25

Antiseptic Towelettes Item #: 1201 Packaging: 100 ct Strength: -

$7.50

Bacitracin Ointment Item #: 1020 Packaging: 1 oz Strength: 500 U / gm

$7.50

Band-Aid Clear Comfort-Flex Bandage, Assorted Sizes *


$9.25

20


FIRST AID & MEDICAL SUPPLIES (Continued)

Bath Bench with Back Item #: 1728 Packaging: 1 ct Strength: -

$65.00

Bath Bench without Back Item #: 1727 Packaging: 1 ct Strength: -

$55.00

Bath Mat, Non-Skid Item #: 1459 Packaging: 1 ct Strength: -

$18.00

Bath Tub Safety Rail Item #: 1730 Packaging: 1 ct Strength: -

$37.00

Conforming Stretch Gauze Sterile Bandages -3” x 4.1 yd *


$7.00

Cotton Balls Item #: 1763 Packaging: 200 ct Strength: -

$5.50

Cushion, Foam Ring Item #: 1732 Packaging: 1 ct Strength: -

$22.00

Cushion, Gel / Foam Seat Item #: 1466 Packaging: 1 ct Strength: -

$40.00

21



Cushion, Lumbar Item #: 1731 Packaging: 1 ct Strength: -

$25.00

Elastic Bandage - 2” x 4.5 yd *


$5.75

Elastic Bandage - 3” x 5 yd *


$6.25



$6.75



$7.75

First Aid Kit, 20 piece Item #: 1947 Packaging: 1 ct Strength: -

$8.00

First Aid Kit, 75 Pieces Item #: 1215 Packaging: 1 ct Strength: -

$13.25

First Aid Kit, 175 Pieces Item #: 1738 Packaging: 1 ct Strength: -

$18.25

22



Folding Cane Ergonomic Handle *


$21.00

Hot/Cold Pack, 1 small & 1 large


$9.75

Humidifier, Ultra-Sonic Cool Mist


$65.00

Hydrogen Peroxide Item #: 1228 Packaging: 16 oz Strength: 3%

$6.75

Ice Bag - 9” Item #: 1761 Packaging: 1 ct Strength: -

$8.75

Insect Repellant Spray - Deet Item #: 1867 Packaging: 2 oz Strength: 30%

$10.25

Isopropyl Alcohol, Wintergreen


$8.00

Johnson & Johnson Gauze Pad - 2” x 2” *


$7.25

23



Lantiseptic Skin Protectant Ointment


$13.25

Liquid Bandage Item #: 1872 Packaging: .45 oz Strength: -

$7.25

Neosporin Plus Item #: 1326 Packaging: .5 oz Strength: -

$12.00

Nitrile Exam Gloves Item #: 1840 Packaging: 100 ct Strength: -

$12.00

Pain Relief Mask Item #: 1762 Packaging: 1 ct Strength: -

$7.00

Povidone Iodine Solution Antiseptic


$10.25

Raised Toilet Seat Item #: 1729 Packaging: 1 ct Strength: -

$35.00

Shower Mat, Non-Skid Item #: 1460 Packaging: 1 ct Strength: -

$20.00

24



Tape, Paper Surgical - 1” x 10 yd *


$6.25

Tape, Paper Surgical - 2” x 10 yd *


$7.25

Tape, Silk Surgical - 1” x 10 yd *


$7.25

Tape, Silk Surgical - 2” x 10 yd *


$8.25

Tape, Transparent Surgical - 1” x 10 yd *


$5.75

Tape, Transparent Surgical - 2” x 10 yd *


$6.75

Thermometer, Digital 60 seconds


$6.75

Thermometer, Digital Ear Item #: 1285 Packaging: 1 ct Strength: -

$25.00

25



Thermometer, Flexible Tip, Digital 10 seconds


$11.25

Thermometer, Talking Ear and Forehead


$46.00

Toilet Safety Rails Item #: 1779 Packaging: 1 set Strength: -

$50.00

Triple Antibiotic Ointment Item #: 1014 Packaging: 1 oz Strength: -

$7.00

FOOT CARE

Callus Remover Pads Item #: 1238 Packaging: 6 ct Strength: -

$7.25

Corn Remover Pads Item #: 1236 Packaging: 9 ct Strength: -

$7.25

Medicated Foot Powder Item #: 1240 Packaging: 5 oz Strength: -

$8.25

Moleskin Sheets Plus Item #: 1782 Packaging: 4 ct Strength: -

$7.25

26


FOOT CARE (Continued)

Toe Separator Item #: 1783 Packaging: 6 ct Strength: -

$9.00

HEMORRHOIDAL PREPARATIONS

Hemorrhoidal Ointment Item #: 1066 Packaging: 2 oz Strength: -

$8.25

Hemorrhoidal Suppository Item #: 1247 Packaging: 12 ct Strength: -

$7.75

Pre-moist Hemorrhoid Pads Item #: 1364 Packaging: 100 ct Strength: -

$8.50

Preparation H Cream Item #: 1248 Packaging: 26 gm Strength: -

$14.25

Preparation H Medicated Wipes


$13.00

INCONTINENCE SUPPLIES

A & D Ointment Item #: 1300 Packaging: 2 oz Strength: -

$8.25

27


INCONTINENCE SUPPLIES (Continued)

Adult Briefs, Medium - 32” to 44” *


$17.25

Adult Briefs, Large - 45” to 58” *


$17.25

Adult Briefs, X-Large - 59” to 64” *


$17.25

Attends Discreet Men’s Guard


$13.25

Attends Discreet Men’s Shield


$13.25

Attends Discreet Women’s Moderate Bladder Control Pad


$13.25

Attends Discreet Women’s Maximum Bladder Control Pad


$14.25

Attends Discreet Women’s Ultimate Bladder Control Pad


$15.25

28



Attends Discreet Women’s Panty Liner


$9.25

Attends Discreet Women’s Ultrathin Pad


$10.25

Barrier Cream Item #: 1302 Packaging: 4 oz Strength: -

$9.75

Bladder Control Shaped Pad, Moderate Absorbency *


$15.75

Bladder Control Shaped Pad, Heavy Absorbency *


$17.25

Bladder Control Shaped Pad, Maximum Absorbency *


$17.25

Disposable Underwear, Medium - 34” to 44” *


$13.75

Disposable Underwear, Large - 44” to 58” *


$13.75

29



Disposable Underwear, X-Large - 58” to 68” *


$13.75

Flushable Wipes Item #: 1928 Packaging: 24 ct Strength: -

$8.00

Underpad, Disposable -23” x 24” *


$13.25

Underpad, Disposable -23” x 36” *


$11.25

Underpad, Disposable - 30” x 30” *


$9.25

IN-HOME DIAGNOSTICS

Blood Pressure Monitor, Desktop Automatic ‡


$28.00

Blood Pressure Monitor, Desktop Talking ‡


$38.00

Blood Pressure Monitor, Wrist ‡


$21.25

30


IN-HOME DIAGNOSTICS (Continued)

Blood Pressure Monitor, Wrist Talking ‡


$31.25

Finger Pulse Oximeter ‡ Item #: 1505 Packaging: 1 ct Strength: -

$28.25

Heart Rate Monitor Watch ‡ Item #: 1771 Packaging: 1 ct Strength: -

$40.00

MOTION SICKNESS

Dramamine Chewables, Orange


$9.75

Driminate Antiemetic Item #: 1263 Packaging: 12 ct Strength: 50 mg

$6.50

Meclizine HCL Antiemetic Item #: 1366 Packaging: 100 ct Strength: 12.5 mg

$10.00

PAIN RELIEVERS & FEVER REDUCERS

Acetaminophen Item #: 1001 Packaging: 100 ct Strength: 325 mg

$6.25


$6.75

31


PAIN RELIEVERS & FEVER REDUCERS (Continued)


$7.75

Aleve Item #: 1104 Packaging: 100 ct Strength: 220 mg

$17.25

Arthritis Hot Pain Relief Cream


$9.25

Arthritis Pain Reliever Item #: 1311 Packaging: 100 ct Strength: 650 mg

$17.00

Aspercreme Item #: 1924 Packaging: 1.25 oz Strength: -

$8.50

Aspirin Item #: 1095 Packaging: 100 ct Strength: 325 mg

$6.75

Aspirin, Enteric Coated Item #: 1096 Packaging: 100 ct Strength: 325 mg

$7.25

Aspirin, Enteric Coated, Low Dose


$6.50

32



Aspirin, Low Dose, Chewables


$6.25

Bayer Back & Body Pain, Extra Strength

Item #: 1720 Packaging: 24 ct Strength: 500 mg, 32.5 mg

$10.25

Capsaicin External Analgesic Item #: 1367 Packaging: 2 oz Strength: 0.025%

$10.25

Children’s Acetaminophen Chewables


$6.75

Cold/Hot Menthol Medicated Patch

Item #: 1944 Packaging: 5 ct Strength: 5%

$10.00

Heating Pad, 12” X 15” * Item #: 1861 Packaging: 1 ct Strength: -

$23.25

Heating Pad, X-Large, 12” x 24” *


$35.00

Heating Pad Wrap For Shoulder, Neck, and Back, 25” x 26” *


$55.00

33



HeatWraps - Back & Hip Item #: 1859 Packaging: 2 ct Strength: -

$10.75

HeatWraps - Neck, Shoulder, & Wrist


$10.75

Ibuprofen Item #: 1004 Packaging: 100 ct Strength: 200 mg

$7.25

Lidocaine Patch Item #: 1871 Packaging: 5 ct Strength: 4%

$17.00

Menthol Gel Item #: 1923 Packaging: 8 oz Strength: 2%

$9.25

Migraine Relief

Item #: 1365 Packaging: 100 ct Strength: 250 mg, 250 mg, 65 mg

$9.25

Naproxen Item #: 1097 Packaging: 100 ct Strength: 220 mg

$10.25

Pain Reliever, PM - Extra Strength

Item #: 1332 Packaging: 100 ct Strength: 500 mg, 25 mg

$11.75

34



Pain Relieving Muscle Rub Item #: 1475 Packaging: 2 oz Strength: 2.50%

$6.25

Salonpas Pain Relief Patches Item #: 1739 Packaging: 5 ct Strength: -

$12.75

Thermacare Lower Back & Hip


$13.25

Thermacare Menstrual Relief Item #: 1913 Packaging: 3 ct Strength: -

$13.25

Wellpatch Migraine Item #: 1261 Packaging: 4 ct Strength: -

$10.75

PERSONAL CARE

Ammonium Lactate Moisturizing Lotion


$11.00

Hand Sanitizer Item #: 1065 Packaging: 8 oz Strength: -

$5.00

SLEEP AIDS

Nasal Strips, Medium Item #: 1724 Packaging: 30 ct Strength: -

$14.25

35


SLEEP AIDS (Continued)

Nasal Strips, Large Item #: 1725 Packaging: 30 ct Strength: -

$14.25

Sleep Tablets Item #: 1276 Packaging: 50 ct Strength: 25 mg

$6.75

SMOKING CESSATION

Nicotine Patch, Step 1 ‡ Item #: 1369 Packaging: 14 ct Strength: 21 mg / 24 hr

$41.00


$41.00


$41.00

SUPPORTIVE ITEMS

Ankle Support Item #: 1225 Packaging: 1 ct Strength: -

$10.25

Arthritis Gloves, Small Item #: 1767 Packaging: 1 pair Strength: -

$25.00

Arthritis Gloves, Medium Item #: 1766 Packaging: 1 pair Strength: -

$25.00

36


SUPPORTIVE ITEMS (Continued)

Arthritis Gloves, Large Item #: 1765 Packaging: 1 pair Strength: -

$25.00

Back Support Elastic - 24” to 46”


$21.25

Back Support Elastic with Lumbar


$30.00

Compression Knee High Socks, Men’s Black, Medium (Shoe Size 8 - 10) ‡

Item #: 1398 Packaging: 1 pair Strength: 15 - 20 mmHg

$19.25

Compression Knee High Socks, Men’s Black, Large (Shoe Size 10.5 - 12) ‡


$19.25

Compression Knee High Socks, Men’s White, Medium (Shoe Size 8 - 10) ‡


$19.25

Compression Knee High Socks, Men’s White, Large (Shoe Size 10.5 - 12) ‡


$19.25

Compression Knee High Socks, Women’s Black, Small (Shoe Size 4-5)


$18.25

37



Compression Knee High Socks, Women’s Black, Medium (Shoe Size 5.5 - 7.5)


$18.25

Compression Knee High Socks, Women’s Black, Large (Shoe Size 8 - 10.5)


$18.25

Compression Knee High Socks, Women’s Nude, Small (Shoe Size 4 - 5)


$18.25

Compression Knee High Socks, Women’s Nude, Medium (Shoe Size 5.5 - 7.5)


$18.25

Compression Knee High Socks, Women’s Nude, Large (Shoe Size 8 - 10.5)


$18.25

Elbow Support Item #: 1224 Packaging: 1 ct Strength: -

$16.25

Knee Stabilizer Item #: 1465 Packaging: 1 ct Strength: -

$23.25

Knee Support, Elastic, Small Item #: 1481 Packaging: 1 ct Strength: -

$12.25

38



Knee Support, Elastic, Medium


$12.25

Knee Support, Elastic, Large Item #: 1483 Packaging: 1 ct Strength: -

$12.25

Knee Support, Elastic, Small with Stays


$22.50

Knee Support, Elastic, Medium with Stays


$22.50

Knee Support, Elastic, Large with Stays


$22.50

Night Wrist Support Smart Glove


$28.25

Protective Arm Sleeve - Small Item #: 1897 Packaging: 1 pair Strength: -

$21.25

Protective Arm Sleeve - Large Item #: 1898 Packaging: 1 pair Strength: -

$24.25

39



Protective Arm Sleeve - X-Large


$27.25

Wrist Splint Item #: 1230 Packaging: 1 ct Strength: -

$18.25

Wrist Support Item #: 1227 Packaging: 1 ct Strength: -

$16.25

THERAPEUTIC SKIN & SUN CARE

Aloe Vera Cream Item #: 1070 Packaging: 8 oz Strength: -

$6.25

Calamine Lotion Item #: 1821 Packaging: 6 oz Strength: -

$7.75

Moisturizing Body Lotion with Aloe


$7.00

Scar Gel Item #: 1852 Packaging: 50 gm Strength: -

$14.25

Sunscreen Lotion SPF 30 Item #: 1284 Packaging: 3.5 oz Strength: -

$8.25

40


VITAMINS & MINERALS

Airborne Immune Support Chewables ‡


$14.25

Biotin Gummy ‡ Item #: 1820 Packaging: 60 ct Strength: 5,000 mcg

$12.50

Calcium + Vitamin D ‡ Item #: 1373 Packaging: 60 ct Strength: 600 mg / 400 IU

$7.00

Calcium + Vitamin D Gummy ‡

Item #: 1823 Packaging: 60 ct Strength: 500 mg, 1000 IU

$13.75

Calcium Carbonate Supplement Tablets ‡


$7.25

Centrum Silver Chewables ‡ Item #: 1420 Packaging: 60 ct Strength: -

$20.00

Chromium Picolinate ‡ Item #: 1825 Packaging: 100 ct Strength: 1000 mcg

$11.75

Coenzyme Q-10 ‡ Item #: 1828 Packaging: 30 ct Strength: 100 mg

$17.00

41


VITAMINS & MINERALS (Continued)

Daily Multiple Vitamin Tablets with Minerals ‡


$7.25

Daily Multivitamin Gummy ‡ Item #: 1972 Packaging: 120 ct Strength: -

$13.00

Ferrous Gluconate Iron Supplement ‡


$8.00

Ferrous Sulfate Iron Supplement ‡


$6.50

Fiber Tablets ‡ Item #: 1155 Packaging: 60 ct Strength: 500 mg

$11.25

Fish Oil, Soft Gels ‡ Item #: 1741 Packaging: 60 ct Strength: 1000 mg

$9.25

Flaxseed ‡ Item #: 1849 Packaging: 100 ct Strength: 1000 mg

$10.75

Folic Acid ‡ Item #: 1850 Packaging: 100 ct Strength: 800 mcg

$6.50

42



Glucosamine / Chondroitin ‡ Item #: 1003 Packaging: 60 ct Strength: 250 mg, 200 mg

$13.25

Glucosamine Joint / Muscle ‡ Item #: 1114 Packaging: 60 ct Strength: 500 mg

$12.25

Iron ‡ Item #: 1417 Packaging: 110 ct Strength: 27 mg

$8.25

Magnesium ‡ Item #: 1418 Packaging: 110 ct Strength: 250 mg

$7.50

Magnesium Oxide ‡ Item #: 1377 Packaging: 100 ct Strength: 250 mg

$8.25

Melatonin ‡ Item #: 1879 Packaging: 100 ct Strength: 5 mg

$11.75

Niacin ‡ Item #: 1394 Packaging: 100 ct Strength: 500 mg

$9.50

Niacin, No Flush ‡ Item #: 1930 Packaging: 60 ct Strength: 500 mg

$15.00

43



Omega & DHA Gummy ‡ Item #: 1976 Packaging: 120 ct Strength: 275 mg, 50 mg

$14.00

One Daily Men’s Multivitamin ‡


$11.75

One Daily Women’s Multivitamin ‡


$11.75

Senior Multivitamin ‡ Item #: 1392 Packaging: 90 ct Strength: -

$10.25

Vitamin A ‡ Item #: 1379 Packaging: 100 ct Strength: 10,000 iu

$7.50

Vitamin B-1 ‡ Item #: 1016 Packaging: 100 ct Strength: 100 mg

$7.50

Vitamin B-12 ‡ Item #: 1389 Packaging: 100 ct Strength: 500 mcg

$7.25

Vitamin B-12 ‡ Item #: 1381 Packaging: 100 ct Strength: 1000 mcg

$9.25

44



Vitamin B-12, Sublingual ‡ Item #: 1974 Packaging: 30 ct Strength: 5000 mcg

$10.00

Vitamin B-6 ‡ Item #: 1380 Packaging: 100 ct Strength: 50 mg

$7.25

Vitamin B-Complex ‡ Item #: 1382 Packaging: 100 ct Strength: -

$9.25

Vitamin B-Complex Gummy ‡ Item #: 1915 Packaging: 70 ct Strength: -

$11.25

Vitamin C ‡ Item #: 1017 Packaging: 100 ct Strength: 500 mg

$7.25

Vitamin C ‡ Item #: 1706 Packaging: 100 ct Strength: 1000 mg

$11.25

Vitamin C Gummy ‡ Item #: 1916 Packaging: 60 ct Strength: 250 mg

$11.25

Vitamin D ‡ Item #: 1383 Packaging: 100 ct Strength: 400 iu

$7.25

45



Vitamin D ‡ Item #: 1390 Packaging: 100 ct Strength: 1000 iu

$8.25

Vitamin E, Soft Gels ‡ Item #: 1391 Packaging: 100 ct Strength: 100 iu

$7.75

Vitamin E, Soft Gels ‡ Item #: 1384 Packaging: 100 ct Strength: 400 iu

$10.75

Zinc Chelated ‡ Item #: 1419 Packaging: 100 ct Strength: 50 mg

$8.25

WART REMOVER

Dr. Scholl’s Wart Removal System


$17.50

Wart Remover, Liquid Item #: 1075 Packaging: 9 ml Strength: 17%

$10.25

WEIGHT LOSS

Vitafusion Fiber Weight Management ‡


$18.25

46

NOTICE OF NON-DISCRIMINATION In Compliance with Section 1557 of the Affordable Care Act

Steward Health Choice Generations HMO SNP complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. Steward Health Choice Generations does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex.

Steward Health Choice Generations:

Provides free aids and services to people with disabilities to communicate effectively with us, such as: • Qualified sign language interpreters • Written information in other formats (large

print, audio, accessible electronic formats, other formats)

Provides free language services to people whose primary language is not English, such as: • Qualified interpreters • Information written in other languages

If you need these services, contact:

Steward Health Choice Generations Address: 410 N. 44th Street, Ste. 510, Phoenix, AZ 85008 Phone: 1-800-656-8991 Fax: 480-760-4739 TTY: 711 E-mail: [email protected]

If you believe that Steward Health Choice Generations has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you can file a grievance by mail, fax, or email to:

Steward Health Choice Generations Address: 410 N. 44th Street, Ste. 510, Phoenix, AZ 85008 Phone: 1-800-656-8991 Fax: 480-760-4739 TTY: 711 E-mail: [email protected]

You can file a grievance in person or by mail, fax, or email. If you need help filing a grievance, the Grievance Manager/Civil Rights Coordinator is available to help you.

You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, electronically through the Office for Civil Rights Complaint Portal, available at https:// ocrportal.hhs.gov/ocr/portal/lobby.jsf, or by mail or phone at:

U.S. Department of Health and Human Services 200 Independence Avenue, SW Room 509F, HHH Building Washington, D.C. 20201 1-800-368-1019, 800-537-7697 (TDD)

Complaint forms are available at http://www.hhs. gov/ocr/office/file/index.html.

Steward Health Choice Generations HMO SNP is a Health Plan with a Medicare contract and a contract with the state Medicaid program. Enrollment in Steward Health Choice Generations HMO SNP depends on contract renewal.

This information is available in other formats, such as Braille, large print, and audio.

H5587_NoticeofNonDiscrim_M

http://www.hhs

https://ocrportal.hhs.gov/ocr/portal/lobby.jsf

mailto:[email protected]

mailto:[email protected]

AVISO DE NO DISCRIMINACIÓN En cumplimiento con la Sección 1557 de la Ley de Cuidado de Salud de Bajo Costo

Steward Health Choice Generations HMO SNP cumple con las leyes de derechos civiles federales vigentes y no discrimina por motivos de raza, color, nacionalidad, edad, discapacidad o sexo. Steward Health Choice Generations no excluye a las personas ni las trata de manera diferente por su raza, color, nacionalidad, edad, discapacidad o sexo.

Steward Health Choice Generations:

Ofrece material de ayuda y servicios sin cargo a las personas que tienen discapacidades que les impiden comunicarse de manera eficaz con nosotros, como los siguientes: • Intérpretes de lenguaje de señas calificados • Información escrita en otros formatos (letra

grande, audio, formatos electrónicos accesibles, otros formatos)

Brinda servicios de idiomas sin cargo a las personas cuya lengua materna no es el inglés, como los siguientes: • Intérpretes calificados • Información escrita en otros idiomas

Si necesita estos servicios, comuníquese con nosotros:

Steward Health Choice Generations Dirección: 410 N. 44th Street, Ste. 510, Phoenix, AZ 85008 Teléfono: 1-800-656-8991 Fax: 480-760-4739 TTY: 711 Correo electrónico: HCH.GrievanceForms@ steward.org

Si considera que Steward Health Choice Generations no ha logrado prestar estos servicios o

ha discriminado de algún otro modo a una persona por su raza, color, nacionalidad, edad, discapacidad o sexo, puede presentar una queja formal por correo, fax o correo electrónico:

Steward Health Choice Generations Dirección: 410 N. 44th Street, Ste. 510, Phoenix, AZ 85008 Teléfono: 1-800-656-8991 Fax: 480-760-4739 TTY: 711 Correo electrónico: HCH.GrievanceForms@ steward.org

Puede presentar una queja formal personalmente o por correo, fax o correo electrónico. Si necesita ayuda para presentar una queja formal, el administrador de quejas formales/coordinador de derechos civiles está a su disposición para ayudarlo.

También puede presentar una queja por violación a los derechos civiles ante la Oficina de Derechos Civiles del Departamento de Salud y Servicios Humanos de los EE. UU. de forma electrónica a través de su Portal de quejas, disponible en https:// ocrportal.hhs.gov/ocr/portal/lobby.jsf, o por correo o teléfono:

U.S. Department of Health and Human Services 200 Independence Avenue, SW Room 509F, HHH Building, Washington, D.C. 20201 1-800-368-1019, 800-537-7697 (TDD)

Los formularios de queja están disponibles en http:// www.hhs.gov/ocr/office/file/index.html.

Steward Health Choice Generations HMO SNP es un plan de salud con contrato con Medicare y contrato con el programa de Medicaid estatal. La inscripción en Steward Health Choice Generations HMO SNP depende de la renovación de los contratos.

Esta información está disponible en otros formatos, como braille, letra grande y audio.

H5587_NoticeofNonDiscrim_M es

www.hhs.gov/ocr/office/file/index.html

https://ocrportal.hhs.gov/ocr/portal/lobby.jsf

https://steward.org

https://steward.org

MULTI-LANGUAGE INTERPRETER SERVICES as required by Section 1557 of the Affordable Care Act

ATTENTION: If you speak a language other than English, language assistance services, free of charge, are available to you. Call 1-800-656-8991 (TTY: 711), 8AM – 8PM, 7 days a week.

ATENCIÓN: Si usted habla español, tiene a su disposición servicios de asistencia lingüística sin cargo. Llame al 1-800-656-8991 (TTY: 711).

請注意：若您使用繁體中文，您可以接受免費的語言協助服務。請致電 1-800-656-8991 (TTY: 711)。

Bilag1ana bizaad doo bee y1n7[ti’ dago d00 saad n11n1 [a’ bee y1n7[ti’go, saad bee ata’ hane’, t’11 n77k’eh, n1 bee ah00t’i’ . Koj8’ hod77lnih 1-800-656-8991 (TTY: 711).

ATENÇÃO: Se você fala português brasileiro, oferecemos serviços gratuitos de assistência para idiomas. Ligue para 1-800-656-8991 (TTY: 711).

CHÚ Ý: Nếu quý vị nói [Tiếng Việt], chúng tôi sẽ cung cấp các dịch vụ hỗ trợ ngôn ngữ miễn phí cho quý vị. Hãy gọi số 1-800-656-8991 (TTY: 711).

.(711

ATTENTION: Si vous parlez français, des services d'aide linguistique vous sont proposés gratuitement. Appelez le 1-800-656-8991 (TTY: 711).

ATANSYON: Si ou pale Kreyòl Ayisyen, sèvis asistans lang, gratis, disponib pou ou. Rele 1-800-656-8991 (TTY: 711).

ACHTUNG: Wenn Sie Deutsch sprechen, steht Ihnen ein kostenloser Fremdsprachenservice zur Verfügung. Rufen Sie 1‑800 -656-8991 (TTY: 711) an.

ΠΡΟΣΟΧΗ: εάν μιλάτε Ελληνικά, μπορείτε να λάβετε δωρεάν υπηρεσίες γλωσσικής βοήθειας. Καλέστε τον αριθμό 1-800-656-8991 (TTY: 711).

ચૂના: જો તમે બોલતા હોવ, તો તમારા માટ મફત ભાષા સહાયતા સેવાઓ ઉપલબ્ધ છે. સપંકર્ 1-800-656-8991 (TTY: 711).

ध्यान द: य द आप हन्द बोलते ह, तो आपके लए भाषा सहायता सेवाएं नःशल्क उपलब्ध ह। 1-800-656-8991 ु (TTY: 711) पर कॉल कर।

ATTENZIONE: Se parla italiano, sono disponibili per lei servizi gratuiti di assistenza linguistica. Chiami il numero 1-800-656-8991 (TTY: 711).

H5587_MultiLanguageDisclaimer2019093_C 09/06/18

صي: ن فتا(ھ 1-800- 656-8991ى لعلصتاا. ًانجم،ةویلغ لاةدعاسلماتادمخكدیلرفوتتف وسف،ةربی لع اثدحتتت كنا ذإ:ھ بیتن

MULTI-LANGUAGE INTERPRETER SERVICES as required by Section 1557 of the Affordable Care Act

注意：日本語を話される場合、無料で言語支援サービスをご利用いただけます。次の番号までお電話

してください：1-800-656-8991 (TTY: 711)

주의: 한국어를 사용하는 경우, 언어 지원 서비스가 무료로 제공됩니다. 1-800-656-8991 (TTY: 711) 번으로 전화하십시오.

ស ូ ្របសិនេបើេលាកអកនិយ‌យភាសា ែខរ េយមយកចិតទុកដ‌ក់៖

:्

មានេសវ‌កមជំនួយភាសាដល

नेपाली – बोल्न न्छ भने तपा का ला ग न:शल्क रूपमा भाषा सहायता सेवाहरू उपलब्ध छन ्। ध्यान दनहोस तपा 1-800-656-8991 (TTY: 711) मा कल गनर्हु ोस ्।

ु ु ुहु

ើ ំងខ េលាកអកេដ‌យមិនគិតៃថ ន‌ះេទ។ សមេ ទូ សពមកេលខ 1-800-656-8991 (TTY៖ 711)។់ េ ូ រ

ساتم ).TTY: 711(1-800-656-8991ا بد.وش ی مھائرااشمھبناگایریانزبتادمخ،دنیکمیتبحصسیرافنابزھبرگاھ:جوت. د ریگیب

UWAGA: Jeżeli mówi Pan/Pani po polsku, oferujemy bezpłatne usługi pomocy językowej. Prosimy o kontakt pod numerem 1-800-656-8991 (telefon tekstowy (TTY: 711).

ВНИМАНИЕ! Если вы говорите на Русский, вам бесплатно доступны услуги языковой поддержки. Звоните 1-800-656-8991 (телетайп: 711).

PAŽNJA: Ako govorite srpsko-hrvatski, usluge jezičke pomoći dostupne su Vam besplatno. Pozovite 1-800-656-8991 (TTY: 711).

@8991M656M800M1@@@@@NaÚ„âÜ«Î@aÚí9ÒÖ@bíÓ‰i@aäua@b€Ö@Âv∂Î@HbÓÌâÏça@b‰í€I@ÚÿÇflÖ@⁄ÏÙ€b»i@ÂÌa@ZaÒÏ„äÓ»fl@Nb‰Ó‰fl@ÂÙi@aÚ‹jÙÓ‹‘ë@ÖÏj«@HTTY:711I

ATENSIYON: Kung nagsasalita ka ng Tagalog, ang mga serbisyong tulong sa wika, na walang singil, ay magagamit mo. Tumawag sa 1-800-656-8991 (TTY: 711).

โปรดทราบ: หากคุณพดูภาษา ไทย คุณจะสามารถใชบ้ริการความช่วยเหลือดา้นภาษาไดโ้ดยไม่มีค่าใชจ่้าย โทร 1-800-656-8991 (TTY: 711)

FAKATOKANGA’I: Kapau ‘oku ke Lea-Fakatonga, ko e kau tokoni fakatonu lea ‘oku nau fai atu ha tokoni ta’etotongi, pea teke lava ‘o ma’u ia. Telefoni mai 1-800-656-8991 (TTY: 711).

H5587_MultiLanguageDisclaimer2019093_C 09/06/18

MEMBER SERVICES: 1-844-457-8938 | TTY: 711 8:00 a.m. to 11:00 p.m., EST, Monday - Friday

VISIT OUR WEBSITE AT: www.stewardhcgenerationsotc.com

http://www.stewardhcgenerationsotc.com

STEWARD HEALTH CHOICE GENERATIONS (HMO SNP) 2019 …...Steward Health Choice Generations HMO SNP is a Health Plan with a Medicare contract and a contract with the state Medicaid program.

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