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2023 Over-the-Counter (OTC) Benefit Catalog - Keystone First VIP-2026

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The 2023 Over-the-Counter (OTC) Benefit Catalog for Keystone First VIP Choice (HMO-SNP) members outlines the quarterly OTC benefit of $315, allowing members to order eligible health-related products online, by mail, or by phone. The catalog includes ordering guidelines, product categories, and specific items available for purchase. Members are encouraged to utilize their benefits before the end of each quarter, with restrictions on payment methods and item returns. The document also provides information on how to access and manage orders through the KeystoneFlexCard website.

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Click ‘Get Form’ to open the 2023 Over-the-Counter (OTC) Benefit Catalog in our editor.
Begin by entering your personal information at the top of the form, including your name, address, and member ID number.
Next, navigate to the product selection section. Here, you can browse through the available OTC items listed in the catalog.
For each item you wish to order, enter the item number, quantity desired, and unit price in the designated fields.
Once you have completed your selections, calculate the total order amount and ensure it does not exceed your benefit limit.
Finally, save your completed form and either print it for mailing or submit it directly online if using our platform's features.

Start utilizing your OTC benefits today by accessing our platform for free!

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Versions	Form popularity	Fillable & printable
2023	4.5 Satisfied (49 Votes)
2017	4.1 Satisfied (22 Votes)

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