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OvertheCounter (OTC) Benefit Catalog As a member of Keystone First VIP Choice, you have a quarterly overthecounter (OTC) benefit which allows you to order OTC products such as bandages, cold and allergy medicines,.

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How to fill out the Keystone Otc Store online

This guide provides step-by-step instructions on how to complete the Keystone Otc Store Order Form online, ensuring a smooth and efficient experience for users. With your OTC benefit, you can easily access a variety of health-related products at no cost to you.

Follow the steps to successfully complete your order form.

  1. Press the ‘Get Form’ button to access the Keystone Otc Store Order Form and open it in your preferred editor.
  2. Fill in your personal information, including your date of birth, member ID number (located on your health ID card), last name, first name, middle initial, street name, street number, apartment or suite number, city, state, ZIP code, email, and daytime phone number. If this is a new address, check the box provided.
  3. Select the OTC products you wish to order by entering the item number, product name, quantity, and price for each item. Ensure that your total order amount does not exceed your quarterly benefit allowance.
  4. Review your completed order form carefully to confirm that all information is accurate and that you have included only the products you need.
  5. Once satisfied with your order, you can save the changes to your document, download it for your records, or choose to print it out.
  6. Mail your completed order form to the OTC Servicing Center at the specified address or, if you prefer, place your order via phone.

Start filling out your order form online today for quick and easy access to your OTC benefits.

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Visit a participating pharmacy or retailer to buy eligible OTC items with your available funds. Participating retailers and OTC categories can be found under the Over-the-Counter Benefit Section of the online portal at KeystoneFlexCard.com. Your benefit amount of $315 is offered at the beginning of each quarter.

Medicaid, Medical Assistance in Pennsylvania and referred to here as MA, covers OTC medications. A list of 15 medication categories can be found at 55 PA Code § 1121.53 (d), but the list is not exhaustive or comprehensive. (3) it falls into a covered category on the list.

Keystone First is a Medical Assistance (Medicaid) managed care health plan that was founded by the Sisters of Mercy in 1982 to help people get care, stay well, and build healthy communities. Today, we remain committed to that mission.

Over-the-counter medicines Keystone First covers over-the-counter (OTC) medicine for all members who are eligible for pharmacy benefits. Members must have a prescription from a health care provider. Some examples of OTC medicines covered by Keystone First are: Cough syrup.

Get started at our online prior authorization request form Opens a new window or learn more in our tutorial Opens a new window. Call the Pharmacy Services department at 1-800-588-6767. Outside of normal business hours, call Member Services at 1-800-521-6860. Please see available prior authorization request forms below.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Help Portal
Legal Resources
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate WorkFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232