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- Click ‘Get Form’ to open the Humana OTC order form in the editor.
- Begin by completing your personal information in Step 1. Fill in your Member ID, Date of Birth, First Name, Last Name, and contact details including daytime and evening phone numbers.
- In Step 2, select the month for your order and list the products you wish to purchase. Enter the Product Code and Product Name for each item along with the desired quantity.
- If your total order exceeds your monthly allowance, proceed to Step 3 to provide payment information. Include credit card details or indicate if you are sending a check.
- Review all entered information for accuracy before submitting your order through our platform. Ensure that you meet the submission deadline of the 20th of each month.
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