Edit, Download, and Sign the 2024 Over-the-Counter Product Catalog
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How do I fill this out?
To fill out this catalog, first, keep it accessible for easy reference. Next, use your benefit allowance to choose items from the listed categories. Finally, follow the provided order form instructions to place your order conveniently.
How to fill out the 2024 Over-the-Counter Product Catalog?
1
Keep the catalog easily accessible.
2
Choose items using your benefit allowance.
3
Fill out the order form.
4
Use the postage-paid envelope for mailing.
5
Submit your order for processing.
Who needs the 2024 Over-the-Counter Product Catalog?
1
Molina Healthcare members who wish to utilize their OTC benefit.
2
Individuals looking to purchase health-related products at no cost.
3
Families that need access to wellness products through their insurance.
4
Patients with chronic conditions requiring regular health supplies.
5
Seniors seeking easier access to health and wellness items.
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Editing your PDF on PrintFriendly is seamless and user-friendly. You can directly highlight the items you wish to select and modify the order form as needed. Once you are finished editing, simply save or download your updated PDF.
1
Open the PDF on PrintFriendly.
2
Click on the edit option to make changes.
3
Highlight desired selections and remove unnecessary items.
4
Finalize your document with any additional information.
5
Download or save your edited PDF for submissions.
What are the instructions for submitting this form?
To submit your form, mail it using the postage-paid envelope provided in the catalog. You may also submit it online via your Benefits Pro Portal once logged in. For assistance, you can contact member support at 877-208-9243.
What are the important dates for this form in 2024 and 2025?
Important dates for using your OTC benefit include the start and end of your benefit period, which is determined by your health plan. Make sure to utilize your allowance before it resets. Always stay updated on any announcements regarding changes in dates.
What is the purpose of this form?
The purpose of this form is to facilitate access to over-the-counter health products for Molina Healthcare members. It serves as a convenient way to utilize your benefit allowance effectively. By utilizing this form, members can easily select and order necessary health items for improved well-being.
Tell me about this form and its components and fields line-by-line.
- 1. Member ID: A unique identifier for each member.
- 2. Product Selection: Options to choose desired OTC products.
- 3. Quantity: How many of each product you wish to order.
- 4. Shipping Address: Address where products should be delivered.
- 5. Signature: Member's signature for order confirmation.
What happens if I fail to submit this form?
If you fail to submit this form, you will not be able to utilize your OTC benefits effectively. This may lead to missing out on essential health products that you may need. Ensuring timely submission is crucial for maintaining access to your benefits.
- Delay in Product Access: Failure to submit may delay your access to necessary products.
- Loss of Benefits: You risk losing out on the benefits if the form is not submitted.
- Inability to Order: Without submission, you cannot place an order for your health items.
How do I know when to use this form?
- 1. To Utilize OTC Benefits: When you want to use your OTC allowance to order products.
- 2. For Regular Orders: If you have routine health items to order, this is the form for you.
- 3. Before Benefit Expiration: To ensure you make the most of your benefits before they reset.
Frequently Asked Questions
What products can I order using this catalog?
You can order a variety of OTC health and wellness products.
How do I access my benefit allowance?
Log into your personalized Benefits Pro Portal to check your allowance.
Can I return items from my order?
Due to the nature of the products, returns are not required.
How can I track my order?
You can track your order status in real-time through the Benefits Pro Portal.
What should I do if an item is out of stock?
We will ship a similar product of equal or higher value.
Who can use the OTC benefit?
The benefit is exclusively for you and cannot be shared.
What happens if I disenroll?
Your OTC benefit will automatically end.
Is there customer support available?
Yes, you can call Member Experience Advisors for assistance.
How long does delivery take?
Please allow two business days for delivery.
Where do I find the order form?
The order form is included in this catalog for your convenience.
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