Keystone First VIP Choice (HMO-SNP) 2022 Over-the-Counter Benefits

Preventative Health Products at No Cost to You

Satisfied OTC Benefits Recipients Welcome to your 2022 Over-the-Counter Benefit, administered by Fieldtex. We hope that you enjoy the selection of products and the convenience of the service. The OTC Benefit is designed to give you access through your health plan to preventative health products that you are already using at no additional cost to you. For ordering assistance, please call 1-844-981-1614 (TTY: 711) Monday - Friday 8 am - 5 pm, Saturday from 9 am - 5 pm and Sunday from 10 am - to 5 pm.

For any other questions, please contact Keystone First VIP Choice Member Services at: 1-800-450-1166 (TTY: 711) 8 am - 8 pm, 7 days a week.

Due to increased demand during the COVID-19 outbreak, we have placed quantity limits on certain items.  Once the national emergency has passed and inventory levels return to normal, these restrictions will be lifted.

If you exceed your available benefit allowance when placing an order, that order will not be processed. Be sure to stay within your available balance when ordering.

Keystone First VIP Choice is an HMO-SNP plan with a Medicare contract and a contract with the Pennsylvania Medicaid program. Enrollment in Keystone First VIP Choice depends on contract renewal.

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922-10476

Complete clean soft toothbrush

922-10476 - Complete clean soft toothbrush
$2.00
922-90910

OUT OF STOCK
Freshmint nylon toothbrush

922-90910- Freshmint nylon toothbrush
$0.50
922-91045

Clear eyes triple action relief 0.5 fl. oz.

922-91045 - Clear eyes triple action relief 0.5 fl. oz.
$5.50
922-00010

Cohesive elastic bandage 3 in. x 5 yds.

922-00010 - Cohesive elastic bandage 3 in. x 5 yds.
$2.50
922-90773

OUT OF STOCK
Cotton balls 100% cotton 300 ct.

922-90773 - Cotton balls 100% cotton 300 ct.
$2.00
922-00050F

Alcohol wipes 1 in. x 2 in. 200 ct.

922-00050F - Alcohol wipes 1 in. x 2 in. 200 ct.
$3.50
922-90600N

Ibuprofen IB caplets 200mg 100 ct.

922-90600N - Ibuprofen IB caplets 200mg 100 ct.
$3.25
922-25000

DISCONTINUED
Adult Sized Reusable Cotton Mask w/Ear Loop

922-25000 - Adult Sized Reusable Cotton Mask w/Ear Loop
$8.00
922-10673

Mint flosser with pick 90 ct.

922-10673 - Mint flosser with pick 90 ct.
$2.50
922-10692

DISCONTINUED
Germ X Hand Sanitizer with Pump 8 oz.

922-10692 - Germ X Hand Sanitizer with Pump 8 oz.
$6.00
922-12001

Hand sanitizer 4 oz.

922-12001 - Hand sanitizer 4 oz.
$4.00
922-90643

Black cherry sugar free cough drops 25 ct.

922-90643 - Black cherry sugar free cough drops 25 ct.
$2.00
922-99044

Aquafresh cavity protection toothpaste 5.6 oz.

922-99044 - Aquafresh cavity protection toothpaste 5.6 oz.
$4.00
922-11633

Campho-phenique cold sore treatment gel .23 oz.

922-11633 - Campho-phenique cold sore treatment gel .23 oz.
$6.25