Over-The-Counter Health & Wellness Products - Catalog And Order Form - 2015 Page 2

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2015 Over-the-Counter (OTC)
Health and Wellness Product Order Form
Your current plan may have an over-the-counter benefit that would allow
you to purchase over-the-counter (OTC) health and wellness products
from the Humana-owned RightSource
mail-order pharmacy.
®
Call RightSource at 1-855-211-8370 (TTY: 711) if you have questions
about how to use this benefit at RightSource. Customer Care
representatives are available Monday – Friday, 8 a.m. – 11 p.m. and
Saturday, 8 a.m. – 6:30 p.m., Eastern time.
Keep this catalog somewhere important. You’ll need this to look up the
health and wellness products you want to order each month.
How to order:
Place your order no later than the 20th of each month to ensure that
RightSource is able to process your order within the applicable benefit
month. If your total order exceeds your benefit amount limit, please be
sure to include a check, money order, or credit card information to pay
the remaining amount due. Failure to submit payment in full will lead to
a delay in shipment.
You can place your order:
• Online: Go to
• Mail: Fill out the OTC Health and Wellness Product Order Form and mail
only the order form pages to:
RightSource
PO Box 1197
Cincinnati, OH 45201-1197
• Fax: Fill out the OTC Health and Wellness Product Order Form and fax
only the order form pages to: 1-800-379-7617
* This order form is for the 2015 benefit year. Please do not submit your first order until after January 1, 2015.
Other pharmacies available in our network.
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