Resources / Materials
- Annual Notice of Changes - English (PDF) - last updated Oct 1, 2024
- Annual Notice of Changes - Spanish (PDF) - last updated Oct 1, 2024
- Member Handbook - English (PDF) - last updated Mar 25, 2025
- Member Handbook - Spanish (PDF) - last updated Jul 14, 2025
- Summary of Benefits - English (PDF) - last updated Oct 1, 2024
- Summary of Benefits - Spanish (PDF) - last updated Oct 1, 2024
- Prescription Drug Claim Form - English (PDF) - last updated Oct 1, 2024
- Prescription Drug Claim Form - Spanish (PDF) - last updated Oct 1, 2024
Your current health plan offers an over-the-counter (OTC) benefit that lets you buy OTC health and wellness products. The catalog includes a list of approved OTC items that you can order and have mailed directly to your home or pick up at a local CVS community pharmacy.
There are three ways to place an order—in store, online, or by phone. You can also download the OTC Health Solutions App from the App Store (iOS) or Google Play (Android). The app will allow you to process an order, view past orders, view account information, and more!
Ordering is easy. Just follow the steps in your plan's catalog.
Click on the OTC Catalog link below for all of your benefit details:
- Over-the-Counter Catalog - English (PDF) - last updated Nov 6, 2024
- Over-the-Counter Catalog - Spanish (PDF) - last updated Nov 6, 2024
You can also connect to CVS® OTC Health SolutionsExternal Link to review products and store information.
- Covered Diabetes Testing Supplies (PDF) - last updated Aug 1, 2025
Express Scripts® Pharmacy Forms:
- Express Scripts Pharmacy Mail Order Form - English (PDF) - last updated Oct 8, 2024
- Formulario de pedidos por correo de Express Scripts Pharmacy – Español (PDF) - last updated Oct 8, 2024
- PCP Change Request Form - English (PDF) - last updated Feb 24, 2023
- PCP Change Request Form - Spanish (PDF) - last updated Oct 10, 2024
- Part B Step Therapy (PDF) - last updated Jun 3, 2025