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How do I fill this out?

To fill out this form, start by reviewing the product categories and selecting the items you need. Then, choose your preferred method to place the order: by mail using the order form, online via the website or mobile app, or by telephone. Follow the detailed instructions provided in the next section to complete your order.

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How to fill out the Peoples Health 2022 Over-the-Counter Benefit Catalog?

  1. 1

    Review the product categories and select items.

  2. 2

    Choose your preferred method to place the order.

  3. 3

    Fill out the order form if using mail.

  4. 4

    Visit the website or app if ordering online.

  5. 5

    Call the provided number to place an order by phone.

Who needs the Peoples Health 2022 Over-the-Counter Benefit Catalog?

  1. 1

    Medicare Advantage members who have an over-the-counter benefit.

  2. 2

    Elderly individuals needing easy access to health products.

  3. 3

    Caregivers assisting Medicare Advantage members with their orders.

  4. 4

    Individuals looking to purchase health products at no cost using their credits.

  5. 5

    People who prefer shopping for health products via mail, online, or phone.

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What are the instructions for submitting this form?

To submit this form, fill out the required sections, including your personal information and product selection. Choose your preferred method of ordering: mail, online, or phone. For mail orders, send the completed form to the provided address. For online orders, visit the website or use the mobile app. For phone orders, use the provided phone number to complete your order. Ensure all information is accurate to avoid delays.

What are the important dates for this form in 2024 and 2025?

Important dates for 2024 and 2025 will vary based on your specific plan. Typically, credits are added quarterly: January 1, April 1, July 1, and October 1. Check with your plan provider for exact dates.

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What is the purpose of this form?

The purpose of this form is to help Peoples Health Medicare Advantage members utilize their over-the-counter (OTC) benefits. Members can use this benefit to purchase a variety of essential health products, from pain relievers to first aid items. By providing an easy-to-use catalog and multiple purchasing options, the form ensures members can access necessary products conveniently and at no additional cost.

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Tell me about this form and its components and fields line-by-line.

This form includes various sections and fields for collecting necessary information to place an OTC order.
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  • 1. Personal Information: Collects member's personal details and plan information.
  • 2. Product Selection: Allows members to list the products they wish to order from the catalog.
  • 3. Ordering Method: Indicates the preferred method of ordering: mail, online, or phone.
  • 4. Payment Details: Optional section if any additional payments are required.
  • 5. Signature: Requires member's signature to confirm the order.

What happens if I fail to submit this form?

Failing to submit this form may result in the inability to utilize your OTC benefits for the period.

  • Missed Benefits: You might miss out on receiving necessary health products covered by your plan.
  • Expired Credits: Unused credits may expire and cannot be carried over.
  • Delay in Receiving Products: Delays in submission can lead to delays in receiving the essential products you need.

How do I know when to use this form?

Use this form whenever you need to order over-the-counter products using your Medicare Advantage plan benefits.
fields
  • 1. Quarterly Orders: Submit the form at the beginning of each quarter to utilize your new credits.
  • 2. Need for Health Products: Whenever you run out of essential health items covered by the benefit.
  • 3. Plan Changes: After any changes in your plan that might affect your OTC benefits.

Frequently Asked Question

How do I fill out the OTC benefit form?

Review product categories, select items, and place your order via mail, online, or phone.

Can I edit this form on PrintFriendly?

Yes, you can use PrintFriendly's PDF editor to add or modify information on the form.

Are digital signatures supported?

Yes, PrintFriendly allows you to add digital signatures to your PDF documents.

How can I share the completed form?

You can share the PDF via email or a link using PrintFriendly's sharing options.

What types of products are covered?

Products include allergy relief, bathroom safety, braces & supports, cold & flu medicines, first aid items, and more.

When do my OTC credits expire?

Credits expire at the end of each quarter or year, depending on your plan.

Is there any cost for members?

No, members get these benefits at no cost.

Can I see all available products?

The catalog provided is a sample. More items are available online or via the mobile app.

How frequently are credits added to my account?

Credits are added to your account every quarter.

What do I do if I need help?

Contact customer service via the provided phone number for assistance.

Peoples Health 2022 Over-the-Counter Benefit Catalog

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