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The Hassle-Free and easy way to get
Over-the-Counter Health related supplies
Receive up to
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your order
3
You receive your
supplies by mail
Select from the items
listed inside and call:
$25
per household
each month
FHM17OTC
OTC Benefits 2017
in over-the-counter
health care related supplies
At No Cost To You!
And Freedom 1st takes
the hassle out of ordering!
1-877-655-2424
TTY/TDD 1-800-955-8771
Monday - Friday, 8 AM to 7 PM
Freedom 1st is a Health Plan contracted with the State of Florida
to provide benefits for Medicaid eligible recipients.
www.freedomhealth.com
Freedom 1st is a Health Plan contracted with the State of Florida
to provide benefits for Medicaid eligible recipients.
Item
MA1
MA2
MA3
MA4
MA5
MB1
MB3
MB4
MB5
MB6
MB7
MB8
MB9
MB10
MB11
MB12
MC1
MC2
MC3
MD1
MD2
ME1
ME2
MF1
MF2
Item Description
(A) Allergies
Generic Comparable of Chlortrimeton
Chlorpheniramine maleate 4mg
Generic Comparable of Benadryl Elixir
Diphenhydramine HCl 12.5mg
Generic Comparable of Benadryl Caps
Diphenhydramine HCl 25mg
Generic Comparable of Ocean Saline Nasal Spray Deep Sea Nasal Spray Saline 0.65%
Generic Comparable of Claritin
Loratadine 10mg Tablet
(B) Analgesics
Generic Comparable of Ben Gay
Muscle Rub
Generic Comparable of Tylenol Ex-500 mg.
Acetaminophen Ex-St 500mg
Generic Comparable of Tylenol Childs Chew Tabs
Apap Tab 80mg Chew
Generic Comparable of Bayer Aspirin Low Dose 81 mg. Aspirin EC (Delayed Release) 81mg.
Generic Comparable of Tylenol Infant Drops
Genapap Pediatric Drop Alcohol Free
Generic Comparable of Advil
Ibuprofen 200mg FC Tab
Generic Comparable of Aleve
Naproxen Sodium 220mg CPL
Generic Comparable of Bayer Aspirin Low Dose Chewable Aspirin 81mg Chewable
Generic Comparable of Icy Hot Patch
Cold and Hot Patch
Generic Comparable of Bayer Asprin
Asprin 325mg
Aspercreme with 4% Lidocaine
Aspercreme
Maximum Strength
(C) Antacids
Generic Comparable of Tums-Ex
Calcium Carbonate 750 mg.
Generic Comparable of Mylicon
Infant Gas Relief Drops
Generic Comparable of Zantac 75
Ranitidine 75 mg.
(D) Anti-Diaharreals
Generic Comparable of Imodium
Loperamide 2mg
Generic Comparable of Pepto Bismol
Pink Bismuth Tablets(chewable)
(E) Anti-Hemorrhoidals
Generic Comparable of Preparation H
Prompt Relief Hem Ointment
Generic Comparable of Preparation H Suppositories Hemorrhoidal Supositories
(F) Cough/Cold
Generic Comparable of Robitussin Sugar-Free DM
Sugar-free cough syrup
Generic Comparable of Vicks
Medicated Chest Rub
Quantity Price
24
118ml
24
44ml
30
$4
$3
$3
$3
$7
35g
100
30
120
30ml
24
50
36
5
100
$3
$4
$4
$4
$7
$3
$7
$4
$8
$3
76g
$6
96
30ml
30
$5
$5
$9
12
30
$4
$5
57g
12
118ml
100g
Item
MF3 Generic Comparable of Afrin Nasal Spray
MF4 Halls Sugar Free Cough Drops
MF6 Generic Comparable of Chloraseptic
MG1
MG2
MG3
MG4
MH1
MH2
MH3
MH4
MH5
MH6
MH7
MH8
MH9
MH10
Item Description
Nasal Spray
Sugar Free Cough Drops
Sore Throat Spray
(G) Eye Care
Generic Comparable of Visine
Redness Reliever Eye Drops
Generic Comparable of Collyrium Eye Wash
Eye Wash
Generic Comparable of Zaditor
Eye-Itch Relief Antihistamine
Eye Glass Wipes
Wipes & Lens Cleaner Pack
(H) First Aid Creams & Ointments & Antiseptics
Generic Comparable of Benadryl Cream
Anti-itch cream
Generic Comparable of Bacitracin
Bacitracin
Generic Comparable of Calamine Lotion
Calamine Lotion
Generic Comparable of Lotrimin
Clotrimazole 1% Cream
Generic Comparable of Desitin Ointment
Diaper Rash Ointment
Generic Comparable of Debrox
Ear Wax Removal
Generic Comparable of Cortizone
Hydrocortisone cream
Generic Comparable of Micatin
Miconazole Nitrate 2% Cream
Generic Comparable of Neosporin
Triple Antibiotic Ointment
Generic Comparable of Zinc Oxide
Zinc Oxide 20% Ointment
( I ) First Aid Supplies
Generic Comparable of Ace Bandage 3”
Elastic Bandage 5 yards
Quantity Price
15ml $3
25
177ml
$4
$5
15ml $4
118ml $4
5ml $15
1 box $4
28g
14g
4 oz
28g
2 oz
.5 oz
28g
28g
28 oz
28g
$3
$6
$3
$7
$5
$4
$5
$4
$6
$8
1
$4
MI2 Butterfly Closures
MI3 Cotton Balls
MI4 Generic Comparable of Q-Tips
10
100
300
$2
$4
$5
$7
$13
MK1
MK2
MK3
100
12
25
$5
$2
$3
$5
$6
ML2
ML3
1
1
$5
$5
MI1
Butterfly Closures
Cotton Balls
Cotton Swabs
(K) Laxatives
Generic Comparable of Colace
Docusate Sodium 100 mg.
Generic Comparable of Glycerin Supp. Chlidren
Glycerin Chlidren Supposisitories
Generic Comparable of Dulcolax Tablet
Reliable Gentle Lax Tablet 5mg
(L) Miscellaneous Items
Digital Thermometer
Digital Thermometer
Pill Splitter
Pill Splitter
Item
ML4 Pill Organizer
ML5 Generic Comparable of Band Aid
MM1
MM2
MN1
MN2
MN3
MN4
MO1
MO2
MO3
MO4
MO5
MO7
MO8
MP3
MP4
MP5
MP6
MP7
MP8
MP9
MP10
MP11
Item Description
One Day At a Time Medicine
Organizer -Weekly
Adhesive Bandages
(M) Pediculicides
Lice Treatment Max Strength
Generic Comparable of RID Extra Strength Shampoo
Shampoo
Generic Comparable of NIX
Permethrin 1% Lotion Alph 60ml
(N) Topical Oral
Oragel Baby
Tooth & Gum Cleanser
Oragel
Oragel Analgesic 20% Paste
Toothpaste
Toothpaste
Toothbrush
Toothbrush
(O) Vaginal & Women’s Health
Generic Comparable of Gyne-Lotrimin
Clotrimazole 1% Vaginal Cream
Generic Comparable of Monistat
Miconazole 3 Combo Pack
Monistat
Miconazole 7 Cream
Generic Comparable of Vagistat-1
Tioconazole 6.5 % Ointment
Generic Comparable of Citracal Calcium Citrate
Calcium Citrate & Vitamin D *
Generic Comparable of Bayer One A Day Women’s One A Day Women’s Multivitamin*
Generic Comparable of Os-Cal*
Oyster Calcium + Vitamin D*
(P) Vitamins & Minerals *
Generic Comparable of Vitamin B
B Complex
Ferrous Sulfate
Ferrous Sulfate 325mg
Folic Acid Tabs
Folic Acid 800mcg tablet
Generic Comparable of Flintstones
Fruity Chew Tablets (NF)
Generic Comparable of Stuart Prenatal Tabs
Prenavite PC Tab 100
Vitamin D
Vitamin D 1000 IU
Antioxidant tablets
Antioxidant tablets
Glucosamine Chondrotin
Glucosamine Chondrotin
Generic Comparable of Centrum
Multivitamin & Mineral
Quantity Price
1
$7
50
$3
118ml
$11
59ml
$12
.07 oz
0.33 oz
76g
1
$6
$8
$4
$3
1.5 oz
.32 oz
1.59 oz
0.16 oz
60
60
60
$7
$15
$10
$20
$7
$10
$4
100
100
100
100
100
100
50
60
60
$8
$3
$5
$5
$9
$5
$7
$15
$6
Our team is here to help you,
Monday – Friday, 8 am – 7 pm.
*These items are considered dual purpose items. Prior to ordering these items, the enrollee must have an appropriate conversation with the enrollee’s personal provider who orally recommends the OTC item for a specific diagnosable condition.
Disclaimers: 1. OTC items may only be purchased for the enrollee; it is prohibited to purchase supplies for family members, and friends. 2. The following supplies are not covered as they are non-eligible supplies: Alternative Medicines (Includes botanicals,
herbals, probiotics, homeopathic, and neutraceuticals), baby supplies, contraceptives, convenience & comfort supplies (insoles, gloves, etc.), cosmetics, food products or supplements, replacement & attachments such as contact lens containers or batteries.
3. To minimize mailing costs the plan may impose a limited ordering quantity per purchase. 4. This list is subject to change. 5. This benefit is only available if your plan offers the OTC service as a benefit. Orders will be shipped via UPS or USPS. Please allow
7-10 business days to receive your order from the time the order is placed. 6. Please consult with your doctor before using any OTC products. 7. All OTC supplies are generic comparable of Brand item. Any branded item may be substituted for its Generic
Comparable based on availability. 8. All items are shipped based on manufacturer availability. 9. All items may not be available all the time. 10. If Generic Item is not acceptable, plan will not ship Brand Name Item.