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Click ‘Get Form’ to open the Keystone First VIP Choice OTC Catalog in the editor.
Begin by entering your personal information in the designated fields, including your date of birth, member ID number, last name, first name, and address details. Ensure accuracy to avoid any issues with your order.
In the 'Product Selection' section, refer to the catalog for available OTC products. Note the item numbers and product names as you select your desired quantities.
Calculate your total order amount based on selected items. Remember that your quarterly order total must not exceed your benefit amount.
Once completed, review all entries for accuracy before submitting. You can either print and mail the form or save it for electronic submission if applicable.
Start using our platform today to easily fill out and manage your OTC orders!
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Keystone First Community Health Choice; Keystone First VIP Choice; PA Health Wellness. Apply. Location: 610 Old York Road, Suite 400, Jenkintown, PA 19046.Read more
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