2017
Over-the-Counter
Catalog
Your quarterly benefit allowance
for everyday health products.
Y0097_774 Accepted
WELCOME
to your Gateway Health
Over-the-Counter (OTC) benefit!
As a member of Gateway Health, you have access to a host
of OTC wellness products when you use your quarterly allowance—
that can be rolled over each quarter.
Using this benefit is simple. Gateway Health partners with Fieldtex to offer you this service.
Ordering your OTC products from Fieldtex is simple.
ORDER BY MAIL
ORDER ONLINE
Fill out the attached mail
order form and send it in the
postage-paid envelope.
Go to www.Fieldtex-Gateway.com
ORDER BY PHONE
Call 1-855-350-0074/TTY: 711
toll free, 8 a.m. to 5 p.m.,
Monday through Friday.
Benefit Allowance
STATE
KENTUCKY
NORTH CAROLINA
OHIO
PENNSYLVANIA
PLAN NAME
BENEFIT
Medicare Assured DiamondSM
Medicare Assured RubySM
Medicare Assured SelectSM
Medicare Assured PrimeSM
Medicare Assured DiamondSM
Medicare Assured RubySM
Medicare Assured SelectSM
Medicare Assured PrimeSM
Medicare Assured DiamondSM
Medicare Assured RubySM
Medicare Assured SelectSM
Medicare Assured PrimeSM
Medicare Assured DiamondSM
Medicare Assured RubySM
Medicare Assured SelectSM
$100 per quarter
$15 per quarter
$105 per quarter
$25 per quarter
$110 per quarter
$25 per quarter
$105 per quarter
$25 per quarter
$120 per quarter
$50 per quarter
$105 per quarter
$25 per quarter
$120 per quarter
$60 per quarter
N/A
All orders must be placed by 12/31/2017.
Allergy
Airborne Original Orange
10/Tabs
922-90553
$8.75
Banophen Elixir (Unboxed) 4 Oz
(Benadryl)
922-90083
$2.75
Breathe Right Nasal Strips Large
30/Bx
922-10875
$16.00
Breathe Right Strips Sm/Med
30/Ct
922-90895
$16.00
Careall Medicated Chest Rub
3.53 Oz
922-99093
$2.50
Claritin Reditabs 10/Bx
922-11580
$15.50
Complete Allergy Medicine
100/Tabs
922-11569N
$2.75
Goodsense All Day Allergy
30Ct (Cetirizene)
922-90584
$13.00
Goodsense Allergy
10Mg Loratidine 30/Ct
922-90582
$4.50
Goodsense Allergy 24/Caps
922-90581
$3.00
Goodsense Allergy/Sinus
Headache 20/Ct
922-90580
$4.50
Goodsense Nasal Spray Extra
Moisture 1 Oz
922-90898
$3.25
Goodsense Saline Nasal Spray
1.5 Oz
922-90640
$2.75
Mentholatum Ointment 1 Oz Jar
922-90444
$4.50
Nasal Decongestant Spray (Afrin)
1 Oz
922-90897
$3.50
Mail in postage paid order form for fast and easy delivery of your OTC items
Page 1
Cough Drops
Chloraseptic Lozenges - Citrus
18/Bx
922-11562
$5.50
Halls Defense Asst Sugar Free
Citrus 25/Bag
922-90912
$3.00
Halls Defense Citrus 30/Bag
922-90913
$3.00
Luden’s Cough Drop Sugar Free
Wild Cherry 25/Bag
922-99083
$2.75
QC Vitamin C Drops 30/Bag
922-90914
$2.50
Ricola Cough Drop Cherry Honey
24/Bag
922-99114
$3.50
Freshmint Dental Floss Wax Mint
100 Yds
922-90612N
$1.50
Goodsense Floss Waxed
Unflavored 100/Yds
922-90652
$1.75
Goodsense Mint Flosser W/Pick
50/Bag
922-90613
$2.50
Goodsense Tongue Cleaner 1/Ct
922-90954
$3.00
J&J Reach Floss Waxed Mint
55 Yds
922-90077
$2.00
Orajel Dry Mouth Gel
1.5 Oz
922-90079
$6.50
Sucrets Sore Throat Lozenges
Cherry 18/Bx
922-11591
$4.00
Dental Care
Page 2
Visit us online at www.Fieldtex-Gateway.com
Dental Care
Orajel Medicated Mouth Sore
Swabs 12/Ea
922-90080
$6.75
Dental Care - Denture
Denture Bath Sea Bond
(1 Container)
922-90131
$3.00
Denture Brush
922-90909
$1.00
Denture Cleaner Tablets 40/Ct
922-90906
$2.25
Fixodent Original 1.4 Oz
922-90128
$4.50
Freshmint Denture Adhesive
2.4 Oz
922-90908
$3.25
Freshmint Denture Cleaning
90/Tabs
922-90655N
$4.00
Oral B Denture Brush Twin Head
922-90126
$3.25
Polident Overnight 84/Ct
922-90486
$8.50
Poligrip Extra Care 2.2 Oz
922-90490
$7.25
Poligrip SPG Free 2.4 Oz
922-99047
$7.25
Poligrip Super Original 2.4 Oz
922-90491
$7.75
Mail in postage paid order form for fast and easy delivery of your OTC items
Page 3
Dental Care - Toothbrush
Colgate Plus Soft Toothbrush
922-90156A
$2.25
Colgate White Adult Soft
Toothbrush
922-99171
$1.25
Freshmint Nylon Toothbrush
922-90910
$0.25
Goodsense Elite Angle Full Head
Medium Toothbrush
922-90654
$2.00
Goodsense Elite Angle Full Head
Soft Toothbrush
922-90653
$2.00
Oral B Adult Medium Toothbrush
922-99126
$3.00
Oral B Ortho Soft Toothbrush
922-90948
$3.25
Oral B Precision Clean Power
Toothbrush
922-99149
$18.00
Oral B Precision Clean Refill
922-99150
$12.00
Dental Care - Toothpaste
Act Dry Mouth Toothpaste
4.6 Oz
922-99153
$9.25
Colgate Total Clean Mint
4.2 Oz
922-90841
$4.25
Crest Prohealth Clean Mint
Toothpaste 3.7 Oz
922-99142
$4.50
Crest Regular Toothpaste 4.6 Oz
922-90615
$3.00
Crest Toothpaste Baking Soda +
Peroxide 6.4 Oz
922-99148
$3.25
Freshmint Anticavity Toothpaste
4.6 Oz
922-90911
$1.50
Page 4
Visit us online at www.Fieldtex-Gateway.com
Dental Care - Toothpaste
Listerine Toothpaste Essential
Care Original Gel 4.2 Oz
922-99147
$6.00
Pepsodent Complete Care 5.5 Oz
922-90617
$2.00
Sensodyne Original Toothpaste
4 Oz
922-90484
$8.00
Digital Temporal Thermometer
Temple Touch Infrared Probe
Hand Held
922-99169
$24.00
Digital Thermometer Waterproof
922-10579
$4.75
Goodsense Ear Wax Removal Kit
0.5 fl Oz
922-90641
$4.00
Murine Ear Wax Removal System
0.5 fl Oz
922-99082
$7.75
Diagnostic Equipment
Advocate Non-Contact Infrared
Thermometer Speaks English/
Spanish
922-99159
$47.00
Infrared Forehead Thermometer
One Second Read
922-99170
$45.00
Ear Care
Debrox Earwax Removal Drops
1/2 Oz
922-11848
$7.00
Swim-Ear Ear Drops 1 Oz
922-11655
$4.75
Mail in postage paid order form for fast and easy delivery of your OTC items
Page 5
Eye Care
Artificial Tears Sterile 1/2 FL Oz
922-90452N
$2.00
Blink Contacts Lubricant Eye
Drop 10 ML
922-90917
$8.25
Clear Eyes Triple Action Relief
.5 Oz
922-91045
$5.00
Eye Drops Original .5 Oz
922-90453N
$2.00
Goodsense Sterile Irritation Relief
Eye Drops .5 Oz
922-90588
$3.75
Lubricating Relief Eye Drops
.5 Oz
922-90587N
$2.00
Stye Eye Ointment 0.125 Oz
922-11668
$8.50
Visine A.C. Seasonal Itching .5 Oz
922-91047
$6.50
Visine Advanced
Lubricant/Redness .28 Oz
922-99063
$2.50
Visine-A Eye Allergy Relief Eye
Drops .5 Oz
922-99064
$7.25
Fiber Supplements
Fiber Choice Sugar Free Chewable
Assorted
922-99080
$16.50
Page 6
Fiber-Con Caplets 36/Ct
922-11839
$10.00
Fiber-Tabs 90/Ct
922-90880
$10.75
Visit us online at www.Fieldtex-Gateway.com
Fiber Supplements
Flaxseed Soft Gel 1000Mg 60/Ct
922-90882
$9.50
Goodsense Best Fiber Powder
Sugar Free 62 Servings
922-90575
$11.75
Metamucil Smooth Orange Singles
30/Ea
922-91041
$17.00
First Aid - Bandages, Dressings & Gauze, Tape, Kits
922-10318
$4.00
J & J Knuckle & Fingertip Bandage
20/Bx
922-90891
$2.75
Cotton Swabs 300/Ct
922-00011
$1.50
Elastic Bandage 2” X 5 Yds
922-10866
$3.00
J&J Plastic Bandages .75”X3” 60/Bx
922-10907
$3.75
J&J Gauze Pads 4 X 4” 10/Bx
922-00006
$1.75
Elastic Bandage 3” X 5 Yds
922-90773
$2.00
922-07104
$2.25
Krimptex Bandage Roll 4.5” X 4.1 Yds QC Cotton Balls 100% Cotton 300/Bag
922-00013
$2.00
Elastic Bandage 4” X 5 Yds
922-10322
$5.00
New Skin Liquid Bandage .3 fl Oz
922-08311
$1.25
Clear Surgical Tape 1” X 10 Yds
922-10317
$3.75
J & J Flex. Fabric Assorted
Bandages 30/Bx
922-11132
$4.75
Nexcare Non-Stick Pads 3 X 4”
12/Bx
922-08312
$2.50
Clear Surgical Tape 2” X 10Yds
922-10319
$3.75
J & J Flexible 3/4” X 3” Bandage
30/Bx
922-11423BX100
$2.50
Sheer Spot 7/8” Bandage 100/Bx
922-00035
$2.00
Covered Tape 1/2” X 5 Yds
922-10320
$3.75
J & J Flexible XL 1 3/4 X 4”
Bandage 10/Bx
922-00010
$2.75
Cohesive Elastic Bandage 3” X 5Yds
922-10992
$1.50
Micropure Surgical Tape
1/2” X 10 Yds
922-90876
$2.25
Antibacterial Sheer Band Aid
Assorted 20/Ct
Goodsense Mini First Aid Kit
922-90457
$3.00
J&J First Aid Kit 125 Piece
(Was 140)
922-90564
$13.00
Personal Soft First Aid Kit
911-93901-10999
$6.50
Mail in postage paid order form for fast and easy delivery of your OTC items
Page 7
Foot Care
Foot Care Kit
911-90061
$7.50
Arm & Hammer Easy Spray Foot
Powder 7.5 Oz
922-99151
$9.50
Arm & Hammer Odor Control
Foot Powder 7.0 Oz
922-99158
$7.75
Goodsense Clotrimazole Cream
Usp 1% 1 Oz
922-90610
$4.25
Goodsense Corn & Callus
Remover .3 fl Oz
922-90608
$4.25
Goodsense Corn Cushions
9/Ct
922-90609
$2.25
Goodsense Liquid Wart Remover
.3 fl Oz
922-90605
$4.75
Goodsense Medicated Foot
Powder 4 Oz
922-90607
$4.25
Goodsense Moleskin Plus 4/Ct
(4.125” x 3.375”)
922-90604
$3.50
Goodsense Toe Separator Triple
Layer 6 Pc
922-90611
$4.25
Liquid Callus & Corn Remover
.31 fl Oz
922-11949
$4.50
Lotrimin Spray 4.6 Oz
922-90943
$9.50
Tolnaftate Antifungal Cream .5 Oz
922-90905
$2.00
Page 8
Visit us online at www.Fieldtex-Gateway.com
Hemorrhoid
Goodsense Hemorrhoid Relief
Ointment 2 Oz
922-90139
$5.25
Goodsense Medicated Pads
100/Ct
922-90651
$5.75
Prep Hemorrhoid Suppositories
24/Ct
922-90153
$6.75
Preparation H Cooling Gel
0.9 Oz
922-99157
$9.50
Preparation H Suppositories
24/Ct
922-99145
$19.50
Preparation H Totable Wipes
10/Ct
922-99152
$4.75
Advocate Heating Pad Classic
12” X 15”
922-90890
$20.00
Cold Pack Pocket Wrap
922-11995
$2.00
Cool-It Eye Pack Reusable Cold
2.5 X 5
922-10103
$1.75
Goodsense Cool & Heat Balm
3.5 Oz
922-90448
$5.75
Reusable Ice Bag Medium 9”
922-10089
$7.75
Salonpas Arthritis Pain Patch
5/Ea
922-90888
$9.50
Tucks Medicated Pads 40/Ct
922-90940
$7.00
Hot & Cold Therapy
Mail in postage paid order form for fast and easy delivery of your OTC items
Page 9
Hot & Cold Therapy
Salonpas Deep Relieving Gel
2.75 Oz
922-91030
$9.50
Salonpas Hot-Gel Patch 6/Ea
922-90889
$9.50
Thermacare Knee/Elbow Heat
2/Ea
922-91028
$9.00
Thermacare Lower Back & Hip
2/Ea
922-90885
$9.00
Thermacare Muscle & Joint Heat
1/Ea
922-91031
$3.50
Thermacare Neck To Arm
3/Ea
922-90887
$9.00
Maxi Care 30 X 30 Absorbent Pad
10/Bag
922-90057
$9.00
Prevail Bladder Control Pad
Maximum 48/Bag
922-99161
$17.50
Prevail Bladder Control Pads
Moderate 20/Bag
922-99162
$5.75
Prevail Bladder Control Pads Ultra
Thin 30/Bag
922-99163
$8.00
Prevail Boxers For Men - Large/
XLarge 10/Bag
922-99165
$21.00
Therma-Kool 6X9 Reusable
Cold/Hot Pack
922-00471
$2.50
Incontinence
Page 10
Prevail Boxers For Men - Medium
12/Bag
922-99166
$21.00
Visit us online at www.Fieldtex-Gateway.com
Incontinence
Prevail Breezers Ultimate
Absorbency Unisex Large Blue
18/Bag Waist 45”-58”
922-99174
$26.00
Prevail Breezers Ultimate
Absorbency Unisex Medium
White 16/Bag Waist 32”-44”
922-99172
$26.00
Prevail Breezers Ultimate
Absorbency Unisex Regular Lavender 20/Bag Waist 40”-49”
922-99175
$26.00
Prevail Breezers Ultimate
Absorbency Unisex X-Large Beige
15/Bag Waist 59”-64”
922-99173
$26.00
Prevail Male Guard 14/Bag
922-99164
$6.50
Prevail Per-Fit Protective
Underwear Women XLarge
14/Bag
922-99160
$15.00
Prevail Per-Fit Protective
Underwear Women/Medium
20/Bag
922-99167
$15.00
Prevail Per-Fit Underwear
Women/Large 18/Bag
922-99168
$23.00
Surecare Shield Light-Moderate
25/Pk
922-11090
$8.50
Surecare Underwear Lg 45”-54”
18/Bag
922-90055
$24.00
Surecare Underwear Md 34”-46”
20/Bag
922-90056
$24.00
Surecare Underwear XL 48-66
14/Bag
922-90054
$22.00
Goodsense Dairy Digestive Fast
Acting Caps 60/Ct
922-99052
$14.00
Lactaid Fast Acting Caps 32/Caps
922-90145
$10.75
Lactose
Dairy Aid Original Strength
Caplet 60/Ct
922-11872
$6.25
Mail in postage paid order form for fast and easy delivery of your OTC items
Page 11
Lactose
Schiff Digestive Advantage
Defense 32/Caps
922-99146
$13.00
Medication - Motion Sickness
Acu-Strap Morning & Motion
Sickness Band
922-90198
$4.00
Dramamine Tablets 12/Tabs
922-90201
$5.25
Goodsense Motion Sickness
12/Ct
922-90650
$2.75
Antifungal Cream 1 Oz
922-10752
$4.75
Bacitracin 1 Oz
922-00065
$3.00
Calamine Lotion Major Brand
177 ML
922-90933
$2.75
Gold Bond Anti-Itch Max Relief
Cream 2 Oz
922-90939
$7.75
Goodsense Burn Gel 4 Oz
922-90471
$4.25
Goodsense Hydrocortisone 1%
Anti-Itch Max Strength 1 Oz
922-90935
$3.50
Goodsense Itch Relief Cream
Extra Soothing 1 Oz
922-90095
$3.50
Hydrocortisone Ointment 1%
1 Oz Tube
922-10057
$2.75
Triple Antibiotic (Neosporin) Plus
1 Oz
922-90932
$9.25
Ointments and Topicals
Page 12
Visit us online at www.Fieldtex-Gateway.com
Ointments and Topicals
Triple Antibiotic Ointment Tube
1 Oz
922-00049
$3.50
Ointments and Topicals - Analgesics
Aspercreme 1.25 Oz
922-10050
$4.50
Ben Gay Greaseless Balm 2 Oz
922-10323
$5.50
Cortizone-10 Ointment 2 Oz
922-99100
$9.50
Icy Hot Cream 1.25 Oz
922-10053
$4.25
Muscle Rub Ultra Strong 3 Oz
922-90900
$3.50
Muscle Rub Vanishing Scent Gel
3 Oz
922-90901
$3.00
Tiger Balm Ultra Strength Sports
Rub 1.7 Oz
922-90560
$16.50
Ointments and Topicals - Cleaners
Alcohol Wipes 200/Bx
922-00050BX200
$3.50
Bactine First Aid Liquid 4 Oz
922-11635
$5.50
J & J Hurt Free Antiseptic Wash
6 Oz
922-10321
$4.25
Mail in postage paid order form for fast and easy delivery of your OTC items
Page 13
Pain Relief
Acetaminophen Extra Strength
500 Mg Apap 100/Ct
922-90599N
$3.00
Advil 100/Ct
922-90658
$15.00
Advil Gel Caplets 24/Ct
922-91067
$5.50
Advil Liqui-Gels 20/Caps
922-91059
$5.75
Advil PM 40/Coated Caplets
922-91065
$10.75
Aleve Arthritis Cap 100/Ct
922-99116
$14.75
Aleve Easy Open Cap 220Mg
40/Gelcaps
922-11704
$9.75
Bayer Chewable Aspirin 81Mg
Cherry 36/Ct
922-90662
$3.50
Goodsense Arthritis Pain Relief
APAP 650Mg 24/Caps
922-90601
$4.75
Goodsense Boxed Aspirin 81Mg
Orange 36/Ct
922-90598
$1.75
Ibuprofen IB Caplets 200Mg
100/Ct
922-90600N
$3.25
Low Dose Aspirin 81 Mg
120/Tabs
922-11876N
$2.75
Motrin IB 100/Ct
922-90659
$12.75
Naproxen (Generic Aleve) 220Mg
100/Ct
922-90602N
$7.25
Norwich Aspirin 100/Ct
922-10880
$3.00
Page 14
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Pain Relief
QC Headache Relief Extra
Strength 50/Tabs
922-99106
$3.75
St. Joseph Aspirin 81Mg
120/Micro Tabs
922-91058
$7.00
St. Joseph Low Dose Aspirin
81Mg 36/Chewable
922-91057
$2.75
Campho-Phenique Cold Sore
Treatment .23 Oz
922-11633
$6.25
Goodsense Aloe Vera 16 Oz
922-90950
$5.00
Goodsense Aloe With Lidocaine
Gel 8 Oz
922-90951
$4.00
Goodsense Scar Gel 1.75 Oz
922-90937
$11.00
Medicated Body Powder 10 Oz
922-90934
$6.25
Tylenol Reg Strength 100/Tabs
922-99062
$10.50
Skin Care
Sleep Aid
Sleep Aid (Generic Unisom)
16/Ct
922-90927
$5.25
Sleep Tabs (Generic Of Sominex)
50/Ct
922-90926
$3.25
Mail in postage paid order form for fast and easy delivery of your OTC items
Page 15
Stomach and Laxatives
Anti-Diarrheal 2 Mg 24/Caps
922-90120
$4.75
Beano Tablets 30/Btl
922-11824
$7.50
Enema Adult 4.5 Oz
922-90918
$2.25
Gas-X Extra Strength 10/Softgels
922-91052
$3.25
Generic Tums 96/Ct
922-90919
$4.25
Glycerin Suppository 25/Ct
922-90922
$4.00
Goodsense Antacid & Pain
Reliever 36/Ct
922-90649
$5.25
Goodsense Anti-Nausea Liquid
Cherry 4 Oz
922-90596
$3.50
Goodsense Famotidine Acid Reducer
10Mg, 30/Ct
922-90648
$7.25
Goodsense Gentle Stool Softener
25/Ct
922-90590
$3.50
Goodsense Laxative Bisocodyl
25/Ct
922-90589
$3.00
Goodsense Senna Laxative 100/Ct
922-90644
$4.25
Miralax OTC 7 Dose 4.1 Oz
922-90883
$8.50
Pepcid AC Original Strength
30/Tabs
922-11686
$13.00
Pepto Bismol 4 Oz
922-90923
$3.75
Page 16
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Stomach and Laxatives
Prevacid 24 Hr 15Mg OTC
14/Tabs
922-90978
$17.00
QC Gas Relief And Prevention
20/Caps
922-91054
$5.75
QC Ultra Strength Antacid Calcium Supplement Flavors Vary
72/Tabs
922-99144
$4.75
Rolaids Advanced Antacid Plus
Anti-Gas 60/Tabs
922-99154
$6.50
Rolaids Softchews Antacid Flavors
Vary 12/Bx
922-99155
$3.00
Rolaids Ultra Antacid Tabs Fruit
72/Tabs
922-99156
$6.25
Tums 96/Ct Flavors Vary
922-90466
$6.50
Zantac 75 Acid Reducer 30 Tabs
922-10914
$13.50
Sunscreen
Coppertone Sunscreen SPF 30
8 Oz
922-90058
$14.00
Nature’s Glo Sunscreen SPF 50
8 Oz
922-90063
$7.50
Ankle Support
Adjustable Ankle Support
922-10007
$11.50
Mueller Ankle Support Elastic
Large
922-10211
$7.00
Mueller Ankle Support Elastic
Medium
922-10210
$7.00
Mail in postage paid order form for fast and easy delivery of your OTC items
Page 17
Support - Ankle
Mueller Ankle Support Elastic
Small
922-10209
$7.00
Procare Elastic Ankle Support
Large
922-90618
$6.50
Procare Elastic Ankle Support
Small
922-90620
$6.50
Procare Elastic Ankle Support XL
922-90621
$6.50
Procare Elastic Ankle Support
Med
922-90619
$6.50
Support - Elbow
Neoprene Elbow Support - One
Size Fits All
922-10790
$19.50
Procare Elbow Support Lg 1011.5”
922-90626
$7.25
Procare Elbow Support XL 11.513”
922-90628
$7.25
Procare Knee Support Sleeve Med
922-90623
$6.50
Procare Knee Support Sleeve
Small
922-90624
$6.50
Procare Elastic Elbow Support
Sm 8-9”
922-90627
$7.25
Support - Knee
Procare Knee Support Sleeve
Large
922-90622
$6.50
Page 18
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Support - Knee
Procare Knee Support Sleeve XL
922-90625
$6.50
Additional Support
Vascura Stocking Open Toe
922-90182 Size Small
922-90179 Size Medium
922-90178 Size Large
922-90183 Size X-Large
Wrist Brace
922-91094
$20.00
$11.50
Vitamins & Minerals
922-90958 $5.50
Certa-Vite Senior 60/Ct (Centrum
Silver)
922-90230 $3.00
Major Calcium 600Mg +D 200 IU
60/Btl
922-90257 $4.75
Major Tab-A-Vite W/Iron 100/Btl
922-90960 $11.25
Goodsense Century Mature Men’s
50+ Multi-Vitamin 100/Ct
922-90312 $2.75
Major Folic Acid 400 Mcg Tablets
100/Btl
922-90292 $8.50
Major Vitamin B-12 1000 Mcg
130/Btl
922-90961 $11.25
Goodsense Century Ultimate Women’s Multi-Vit 100/Ct
922-90253 $7.25
Major High Potency Vitamins &
Minerals 100/Ct
922-90295 $4.50
Major Vitamin B-12 500 Mcg
130/Btl
922-90966 $7.50
Goodsense Chocolate Calcium
Chews 60/Ct
922-90240 $5.00
Major Magnesium 500 Mg Tablets
100/Btl
922-90296 $4.50
Major Vitamin B-6 50Mg
(Pyridoxine) 100/Ct
922-90298 $4.50
Major B-Complex B-12 Caplets
100/Btl
922-90237 $7.00
Major Oyster Shell 500 Mg+D
150/Btl
922-90302 $9.50
Major Vitamin C 1000 Mg Tablets
100/Btl
Mail in postage paid order form for fast and easy delivery of your OTC items
Page 19
Vitamins & Minerals
922-90308 $3.75
Major Vitamin D 1000 IU Tablets 100/Btl
922-90245 $3.00
Major Ferosul 5 Gr Green Tablets 100/Btl
922-90309 $3.25
Major Vitamin D 400 IU Tablets 100/Btl
922-91033 $11.00
Apple Cider Vinegar 60/Tabs
922-90664 $11.50
One A Day Men’s 50+ Advantage 65/Ct
922-91039 $5.75
Chewable Papaya 100/Chews
922-90663 $11.50
One A Day Women’s 50+ Advantage 65/Ct
922-91032 $9.75
Cinnamon Alpha Lipoic Acid 1000M 100/Caps
922-90316 $4.25
Vitamin E 100 IU Dl-Alpha Softgels 100/Ct
922-91040 $10.75
Coconut Oil 1000 Mg 60/Softgels
922-11863 $9.25
Windmill Sustain Release B-Complex 60/Tabs
922-90274 $11.00
Glocosamine Chondroitin 2X Strength 60/Btl
922-11861 $4.75
Windmill Vitamin C-500 100/Tabs
922-90324 $8.50
Major Chromium Picolinate 200Mcg 100/Btl
922-11862 $8.00
Windmill Vitamin E-400 90/Tabs
922-99074 $14.00
Mason Natural Prostate 30/Softgels
922-90964 $8.25
Fish Oil Cholesterol Free 1000/Mg 120/Softgels
922-91035 $9.00
Red Yeast Rice 1200Mg 60/Caps
922-90962 $9.50
Garlic 500 Mg Soft Gel 100/Ct
922-91036 $8.00
Valerian Root Sleep Restfully 60/Caps
922-90838 $21.00
Major Coenzyme Q-10 100Mg 30 Tabs
Page 20
Visit us online at www.Fieldtex-Gateway.com
Ordering Process
3 Easy Ways to Order:
Mail-in Order Form • Call Toll Free • Secure Online Ordering
• You will need to provide your Gateway Health Member ID number (found on the front of
your ID card) and your birthdate to access your account.
• Choose the items you would like and write the number on your order form. Have the form
available when you call or go online for fast and easy ordering.
• Total all the items, be sure to stay within your available quarterly allowance.
Please Note – we no longer accept credit cards to cover amounts over your benefit allowance.
Call for details.
Call us toll-free at 1-855-350-0074 (TTY 711)
Monday-Friday 8:00 AM to 5:00 PM
Or Visit Us Online at
www.Fieldtex-Gateway.com
Important Things to Remember
•
Your OTC benefit covers only the items included in this catalog.
• Please note that certain items in this catalog may be covered under Medicare Part B or Part D. When
the item is covered under Part B or Part D, you may not be able to use this OTC benefit. In those instances,
you must use your Gateway Health medical or outpatient drug benefit to obtain the item if medically
appropriate.
• The website is available 24/7, unless down for maintenance, the call center is available to take orders
Monday – Friday from 8:00 a.m. to 5:00 p.m., and if you want to place your order by mail please give at
least 7 days for the mail order form to reach us.
• Please allow 7 - 10 days for delivery of in-stock items. You will be notified if an item is out of stock and
may take longer for delivery. If mailing your order, please allow 1 week for mail delivery to Fieldtex. Mail
orders will be processed the month in which they are received.
• If you receive a damaged item, call Fieldtex Products immediately at 1-800-353-7763
(TTY Hearing Impaired: 711) Monday - Friday 8:00 am to 5:00 pm. The item will be exchanged
for an identical item at no cost to you. Please note that only damaged products can be exchanged within
30 days of purchase, no other returns are allowed.
•
We will not substitute brand name products with generic products.
• Gateway Health and Fieldtex Products are not responsible for lost or stolen packages. For delivery
issues, please contact your local post office.
• Fieldtex Products is the supplier of all the products in this catalog and can only answer questions
pertaining to your order. Medical information regarding the use of these products is not available. Please
consult your physician.
•
The health information provided in this catalog is general in nature and is not medical advice or a
substitute for professional health care. It is provided for your information and convenience only. Fieldtex
Products does not guarantee the accuracy or completeness of the information, and does not recommend
or endorse the products which are referenced in the catalog.
• The OTC benefit only guarantees members a credit to use while ordering items listed in this catalog.
Please note, however, that the items themselves are not offered or guaranteed by Gateway Health.
•
Products in this catalog should only be ordered for the enrolled member.
• All items listed on pages 18-20 are Dual Purpose items. 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.
**Keep this catalog for use throughout the 2017 calendar year**
Contact Us:
Toll-Free: 1-855-350-0074
TTY Hearing Impaired: 711
Hours: Monday to Friday, 8AM to 5PM
Or Visit Us Online:
www.Fieldtex-Gateway.com
Gateway HealthSM complies with applicable Federal civil rights laws and does not discriminate on the basis of
race, color, national origin, age, disability, or sex. Gateway HealthSM does not exclude people or treat them
differently because of race, color, national origin, age, disability, or sex.
Gateway HealthSM:
Provides free aids and services to people with disabilities to communicate effectively with us, such as:
o 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:
o Qualified interpreters
o Information written in other languages
If you need these services, contact Member Services at PA: 1-800-685-5209, OH: 1-888-447-4505, NC: 1-855847-6430, KY: 1-855-847-6380, 8 AM to 8 PM, 7 days a week. TTY users should call 711.
If you believe that Gateway HealthSM 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 with:
Gateway HealthSM Appeals and Grievances
PO Box 22278
Pittsburgh, PA 15222
Phone: 1-844-207-0336
Fax: 1-412-255-4503
You can file a grievance by mail, or by fax. If you need help filing a grievance, Gateway HealthSM Appeals and
Grievances 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, DC 20201, 1-800868-1019, 800-537-7697 (TDD).
Complaint forms are available at http://www.hhs.gov/ocr/office/file/index.html.
ENGLISH
ATTENTION: If you speak English, language assistance services, free of charge, are available to you. Call PA: 1800-685-5209, OH: 1-888-447-4505, NC: 1-855-847-6430, KY: 1-855-847-6380 (TTY: 711).
SPANISH
ATENCIÓN: Si usted habla español, tenemos servicios de asistencia lingüística disponibles para usted sin costo
alguno. Llame al PA: 1-800-685-5209, OH: 1-888-447-4505, NC: 1-855-847-6430, KY: 1-855-847-6380 (TTY:
711).
CHINESE
小贴士：如果您说普通话，欢迎使用免费语言协助服务。请拨 PA: 1-800-685-5209, OH: 1-888-447-4505,
NC: 1-855-847-6430, KY: 1-855-847-6380 (TTY: 711)。
VIETNAMESE
CHÚ Ý: Nếu quý vị nói tiếng Việt, thì có sẵn các dịch vụ trợ giúp ngôn ngữ miễn phí dành cho quý vị. Hãy gọi số
PA: 1-800-685-5209, OH: 1-888-447-4505, NC: 1-855-847-6430, KY: 1-855-847-6380 (TTY: 711).
KOREAN
알림: 한국어를 하시는 경우 무료 통역 서비스가 준비되어 있습니다. PA: 1-800-685-5209, OH: 1-888-4474505, NC: 1-855-847-6430, KY: 1-855-847-6380 (TTY: 711)로 연락주시기 바랍니다.
TAGALOG
Pansinin: Kung nagsasalita ka ng Tagalog, mga serbisyo ng tulong sa wika, nang walang bayad, ay magagamit sa
iyo. Tawagan ang PA: 1-800-685-5209, OH: 1-888-447-4505, NC: 1-855-847-6430, KY: 1-855-847-6380 (TTY:
711).
RUSSIAN
ВНИМАНИЕ: Если вы говорите на русском языке, вам будут бесплатно предоставлены услуги
переводчика. Звоните по телефону: PA: 1-800-685-5209, OH: 1-888-447-4505, NC: 1-855-847-6430, KY: 1855-847-6380 (телетайп: 711).
ARABIC
PA: 1-800-685-5209, OH: ‫ اﺗﺼﻞ ﺑﺎﻟﺮﻗﻢ‬.‫ ﺗﺘﻮﻓﺮ ﺧﺪﻣﺎت اﻟﻤﺴﺎﻋﺪة اﻟﻠﻐﻮﻳﺔ ﻣﺠﺎﻧًﺎ ﻣﻦ أﺟﻠﻚ‬،‫ إذا ﻛﻨﺖ ﺗﺘﺤﺪث اﻟﻌﺮﺑﻴﺔ‬:‫ﻣﻼﺣﻈﺔ‬
.(711 :‫ )اﻟﻬﺎﺗﻒ اﻟﻨﺼﻲ‬1-888-447-4505, NC: 1-855-847-6430, KY: 1-855-847-6380
FRENCH CREOLE
ATANSYON: Si w pale Kreyòl Ayisyen, gen sèvis èd pou lang ki disponib gratis pou ou. Rele
PA: 1-800-685-5209, OH: 1-888-447-4505, NC: 1-855-847-6430, KY: 1-855-847-6380 (TTY: 711).
FRENCH
ATTENTION : Si vous parlez français, des services gratuits d’interprétation sont à votre disposition. Veuillez
appeler le PA: 1-800-685-5209, OH: 1-888-447-4505, NC: 1-855-847-6430, KY: 1-855-847-6380 (TTY: 711).
POLISH
UWAGA: Dla osób mówiących po polsku dostępna jest bezpłatna pomoc językowa. Zadzwoń pod numer PA: 1800-685-5209, OH: 1-888-447-4505, NC: 1-855-847-6430, KY: 1-855-847-6380 (TTY: 711).
PORTUGUESE
ATENÇÃO: Se fala português, estão disponíveis serviços gratuitos de assistência linguística na sua língua.
Telefone para PA: 1-800-685-5209, OH: 1-888-447-4505, NC: 1-855-847-6430, KY: 1-855-847-6380 (TTY: 711).
ITALIAN
ATTENZIONE: Se lei parla italiano, sono disponibili servizi gratuiti di assistenza linguistica nella sua lingua.
Chiami PA: 1-800-685-5209, OH: 1-888-447-4505, NC: 1-855-847-6430, KY: 1-855-847-6380 (TTY: 711).
JAPANESE
お知らせ: 日本語での対応を望まれる方には、無料で通訳サービスをご利用になれま
す。電話番号 PA: 1-800-685-5209, OH: 1-888-447-4505, NC: 1-855-847-6430, KY: 1-855-847-6380 (TTY:
711)までお問い合わせ下さい。
GERMAN
BITTE BEACHTEN: Wenn Sie Deutsch sprechen, stehen Ihnen unsere Dolmetscher unter der Nummer PA: 1800-685-5209, OH: 1-888-447-4505, NC: 1-855-847-6430, KY: 1-855-847-6380 (TTY: 711) kostenlos zur
Verfügung.
FARSI
.‫ در اﺧﺘﯿﺎر ﺷﻤﺎ ﻗﺮار ﺧﻮاﻫﺪ ﮔﺮﻓﺖ‬،‫ ﺑﻪ ﺻﻮرت راﯾﮕﺎن‬،‫ ﺧﺪﻣﺎت ﮐﻤﮏ زﺑﺎﻧﯽ‬،‫ ﭼﻨﺎﻧﭽﻪ ﺑﻪ زﺑﺎن ﻓﺎرﺳﯽ ﺻﺤﺒﺖ ﻣﯽﮐﻨﯿﺪ‬:‫ﺗﻮﺟﻪ‬
PA: 1-800-685-5209, OH: 1-888-447-4505, NC: 1-855-847-6430, KY: 1-855-847-6380 (TTY: 711) ‫ﺑﺎ ﺷﻤﺎره‬
.‫ﺗﻤﺎس ﺑﮕﯿﺮﯾﺪ‬
SERBO-CROATIAN
OBAVJEŠTENJE: Ako govorite srpsko-hrvatski, usluge jezičke pomoći dostupne su vam besplatno. Nazovite
PA: 1-800-685-5209, OH: 1-888-447-4505, NC: 1-855-847-6430, KY: 1-855-847-6380 (TTY- Telefon za osobe sa
oštećenim govorom ili sluhom: 711).
PENNSYLVANIA DUTCH
Wann du Deitsch schwetzscht, kannscht du mitaus Koschte ebber gricke, ass dihr helft mit die englisch Schprooch.
Ruf selli Nummer uff: Call PA: 1-800-685-5209, OH: 1-888-447-4505, NC: 1-855-847-6430, KY: 1-855-8476380 (TTY: 711).
NEPALI
ध्यान िदनहु ोस्: तपाइ�ले नेपाली बोल्नहु �न्छ भने तपाइ�को िनिम्त भाषा सहायता सेवाह� िनःशल्ु क �पमा उपलब्ध छ । फोन गनर्हु ोस् PA: 1-800-685-5209, OH: 1888-447-4505, NC: 1-855-847-6430, KY: 1-855-847-6380 (�ट�टवाइ: 711) ।
OROMO
XIYYEEFFANNAA: Afaan dubbattu Oroomiffa, tajaajila gargaarsa afaanii, kanfaltiidhaan ala, ni argama.
Bilbilaa PA: 1-800-685-5209, OH: 1-888-447-4505, NC: 1-855-847-6430, KY: 1-855-847-6380 (TTY: 711).
BANTU
ICITONDERWA: Nimba uvuga Ikirundi, uzohabwa serivisi zo gufasha mu ndimi, ku buntu. Woterefona PA: 1800-685-5209, OH: 1-888-447-4505, NC: 1-855-847-6430, KY: 1-855-847-6380 (TTY: 711).
CAMBODIAN
្របយ័ត�៖ េបើសិន�អ� កនិ�យ ��ែខ� រ, េស�ជំនួយែផ� ក�� េ�យមិនគិតឈ� �ល គឺ�ច�នសំ�ប់បំេ រ �អ� ក។
ចូ រ ទូ រស័ព� PA: 1-800-685-5209, OH: 1-888-447-4505, NC: 1-855-847-6430, KY: 1-855-847-6380 (TTY: 711)។
HMONG
LUS CEEV: Yog tias koj hais lus Hmoob, cov kev pab txog lus, muaj kev pab dawb rau koj.
685-5209, OH: 1-888-447-4505, NC: 1-855-847-6430, KY: 1-855-847-6380 (TTY: 711).
Hu rau PA: 1-800-
HINDI
ध्यान द�: य�द आप िहं दी बोलते ह� तो आपके िलए मुफ्त म� भाषा सहायता सेवाएं उपलब्ध ह�। PA: 1-800-685-5209, OH: 1-888447-4505, NC: 1-855-847-6430, KY: 1-855-847-6380 (TTY: 711) पर कॉल कर� ।
LAO
ໂປດຊາບ: ຖ້າວ່າ ທ່ານເວົ້າພາສາ ລາວ, ການບໍລິການຊ່ວຍເຫຼືອດ້ານພາສາ, ໂດຍບໍ່ເສັຽ
ຄ່າ, ແມ່ນມີພ້ອມໃຫ້ທ່ານ. ໂທຣ PA: 1-800-685-5209, OH: 1-888-447-4505, NC: 1-855-847-6430,
KY: 1-855-847-6380 (TTY: 711).
GUJARATI
સુચના: જો તમે ગુજરાતી બોલતા હો, તો નિ:શુલ્ક ભાષા સહાય સેવાઓ તમારા માટે ઉપલબ્ધ છે. ફોન કરો PA: 1-800-685-5209, OH:
1-888-447-4505, NC: 1-855-847-6430, KY: 1-855-847-6380
(TTY: 711).
DUTCH
AANDACHT: Als u nederlands spreekt, kunt u gratis gebruikmaken van de taalkundige diensten. Bel PA: 1-800685-5209, OH: 1-888-447-4505, NC: 1-855-847-6430, KY: 1-855-847-6380 (TTY: 711).
UKRAINIAN
УВАГА! Якщо ви розмовляєте українською мовою, ви можете звернутися до безкоштовної служби мовної
підтримки. Телефонуйте за номером PA: 1-800-685-5209, OH: 1-888-447-4505, NC: 1-855-847-6430, KY: 1855-847-6380 (телетайп: 711).
ROMANIAN
ATENȚIE: Dacă vorbiți limba română, vă stau la dispoziție servicii de asistență lingvistică, gratuit. Sunați la PA:
1-800-685-5209, OH: 1-888-447-4505, NC: 1-855-847-6430, KY: 1-855-847-6380 (TTY: 711).
Toll-free: 1-855-350-0074
TTY Hearing impaired: 711
Hours: 8 a.m. to 5 p.m., Monday through Friday
Online: www.Fieldtex-Gateway.com
Gateway HealthSM offers HMO plans with a Medicare contract. Some Gateway Health plans
have a contract with Medicaid in the states where they are offered. Enrollment in these plans
depends on contract renewal.
Attachment 2: MEDICARE Nondiscrimination Statement & Taglines
Gateway HealthSM complies with applicable Federal civil rights laws and does not discriminate on the basis of
race, color, national origin, age, disability, or sex. Gateway HealthSM does not exclude people or treat them
differently because of race, color, national origin, age, disability, or sex.
ENGLISH
ATTENTION: If you speak English, language assistance services, free of charge, are available to you. Call PA:
1-800-685-5209, OH: 1-888-447-4505, NC: 1-855-847-6430, KY: 1-855-847-6380 (TTY: 711).
SPANISH
ATENCIÓN: Si usted habla español, tenemos servicios de asistencia lingüística disponibles para usted sin costo
alguno. Llame al PA: 1-800-685-5209, OH: 1-888-447-4505, NC: 1-855-847-6430, KY: 1-855-847-6380 (TTY:
711).
CHINESE
小贴士：如果您说普通话，欢迎使用免费语言协助服务。请拨 PA: 1-800-685-5209, OH: 1-888-447-4505,
NC: 1-855-847-6430, KY: 1-855-847-6380 (TTY: 711).