Over-the-Counter Pharmacy Program

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Over-the-Counter Pharmacy Program
Sunshine State Health Plan
Mail-Order Over-the Counter Program
S
unshine State Health Plan (Sunshine Health) pharmacy benefit allows you to get a select group of
Over-the-Counter (OTC) items to help you stay in good health. Your family can get up to $25 of
these items each month by choosing from the list below. Use these items only as directed and
contact your physician if you have any questions on the safe use of these products. To place your order
call 1-866-535-2296. The order line is open from Monday through Friday from 9:00 in the morning until
5:00 in the evening. When you call to place your order you will need your Sunshine Health ID card. Use
the item numbers when placing your order.
ITEM
NUMBER
COMPARABLE
PRODUCT
DESCRIPTION
PRICE
Analgesics
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
IBUPROFEN 200MG TAB
NAPROXEN SOD 220MG TAB
ASPIRIN 325MG TAB
ASPIRIN EC 325 MG TAB
ASPIRIN EC 81 MG
ACETAMINOPHEN 500MG TAB
MENTHOLATED OINTMENT
Antacids
SIMETHICONE 80MG TAB
CALCIUM CARBONATE 500MG CHEWABLE
RANITIDINE 75MG TAB
Anit-Diahrrheals
LOPERAMIDE 2MG CAP
BISMUTH MIXTURE
Anti-Fungals
CLOTRIMAZOLE 1% VAGINAL CREAM
TOLNAFTATE 1%
Anti-Hemorrhoidals
HEMORRHOIDAL OINTMENT
Childrens Products
Orajel Baby
Diaper rash ointment
SIMETHICONE DROPS
MULTIVITAMIN DROPS
IBUPROFEN 100MG/5ML SUSP
ACETAMINOPHEN LIQUID
ACETAMINOPHEN CHEWABLE TABS
ACETAMINOPHEN DROPS
Cough/Cold
DIPHENHYDRAMINE 25MG CAPS
DIPHENHYDRAMINE 12.5MG/5ML ELIXIR
SORE THROAT LOZENGE
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Motrin IB
Aleve
Bayer Aspirin
Ecotrin
Halfprin
Tylenol Extra Strength
Ben Gay
$6.00
$9.00
$5.00
$6.00
$5.00
$6.00
$6.00
Mylanta Anti-Gas
TUMS
Zantac 75
$6.00
$6.00
$9.00
Imodium
Pepto-Bismol
$5.00
$5.00
Gyne-Lotrimin
Tinactin
$9.00
$5.00
Preparation-H
$8.00
Orajel Baby
Balmex
Mylanta Drops
Poly-Vi-Sol
Childrens Motrin
Tylenol Liquid
Tylenol Chewables
Tylenol Drops
$9.00
$9.00
$7.00
$8.00
$9.00
$6.00
$5.00
$6.00
Benadryl caps
Benadryl Elixir
Chloraseptic Lozenge
$5.00
$5.00
$4.00
Mail-Order Over-the-Counter Program
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
MEDICATED CHEST RUB
GUIAFENESIN SYRUP
OXYMETAZOLINE 0.05%
LORATADINE 10MG TAB
Vicks Vapo-Rub
Robitussin
AFRIN
Claritin
Eye Care
NAPHAZOLINE EYE DROPS
Visine
First Aid Creams, Ointments & Antiseptics
CALAMINE LOTION
Calamine Lotion
HYDROCORTISONE 1% CREAM
Cort-Aid
TRIPLE ANTIBIOTIC OINTMENT
Neosporin
First Aid Supplies
ATHLETIC BANDAGE
Ace Bandage
ADHESIVE TAPE
First-Aid Tape
BAND-AIDS
Band-Aids
CARBAMIDE PEROXIDE
Debrox Drops
GAUZE PADS
J&J Gauze Pads
COTTON SWAB
Q-Tips
ORAL THERMOMETER
Oral Thermometer
ALCOHOL SWABS
Alcohol Swabs
ICE BAG 9 INCH
Faultless Ice Bag
Laxatives
DSS 100MG
Colace
BISACODYL SUPPOSITORY
Dulcolax Suppository
BISACODYL TAB
Dulcolax tabs
GLYCERIN SUPPOSITORY- CHILD
Glycerine Suppository
Pediculicides
RID LICE TREATMENT
RID
Vitamins & Minerals
CALCIUM CARBONATE 600MG TAB
Caltrate 600
MULTIVITAMINS W/MINERALS
Theragran-M
CHILDRENS CHEWABLE VITAMINS
Flintstones
VITAMIN A 10,000U CAPS
Vitamin A
VITAMIN C 500MG TABS
Vitamin C
VITAMIN E 400IU GELS
Vitamin E
Condoms
CONDOMS
Trojan Enz
Miscellaneous Items
PILL BOX - 7 DAYS
Pill Box
$6.00
$5.00
$5.00
$10.00
$4.00
$4.00
$4.00
$5.00
$5.00
$3.00
$4.00
$4.00
$3.00
$4.00
$5.00
$4.00
$9.00
$6.00
$4.00
$4.00
$3.00
$8.00
$6.00
$10.00
$7.00
$5.00
$5.00
$6.00
$2.00
$2.00
For the most current program description you may call Member Services at 1-866-796-0530 (TTY/TTD 1-866-796-0524)
visit the Sunshine Health website at www.SunshineStateHealth.com.
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