Resources / Materials
- 2024 SC H1723 MMP Member Handbook - English (PDF) coming soon
- 2024 SC H1723 MMP Member Handbook - Spanish (PDF) coming soon
- Express Scripts Mail Order Form-English (PDF) - Coming in December 2023
- Express Scripts Mail Order Form-Spanish (PDF) - Coming in December 2023
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 OTC items that you can order and have mailed directly to your home.
There are three ways to order—in store, online, or by phone. You can also download the new OTC Health Solutions App. The app is an easy and quick way to scan items in store, view your benefit information and items offered, process an order, review past orders, and look up account information. 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) - coming sooon
- Over-the-Counter Catalog - Spanish (PDF) - coming soon
You can also connect to CVS® OTC Health Solutions to review products and store information.
Preventive Guidelines
Preventive guidelines are based on the health needs and opportunities for improvement identified as part of the Quality Assurance Program Improvement (QAPI) program. When possible, Wellcare Prime by Absolute Total Care (Medicare-Medicaid Plan) adopts preventive guidelines that are published by nationally recognized organizations or government institutions. These guidelines may also be a statewide collaborative and/or a consensus of healthcare professionals in the applicable field.
- Recommended Adult Immunization Schedule for Adults 19 Years or Older, United States, 2022 (PDF)
- The Adult Well Male Examination
- Prevention and Control of Seasonal Influenza with Vaccines-Recommendations of the Advisory Committee on Immunization Practices - United States, 2021-22 Influenza Season
- Well-Woman Recommendations (PDF)
Links
(Please note: By clicking on the links below you will be leaving the Wellcare Prime by Absolute Total Care's website.)
Procedure Code |
Procedure Description |
C9050 |
EMAPALUMAB-LZSG |
J0129 |
ABATACEPT INJECTION |
J0178 |
AFLIBERCEPT INJECTION |
J0584 |
BUROSUMAB-TWZA 1M |
J0585 |
ONABOTULINUMTOXINA |
J0604 |
CINACALCET, ESRD ON DIALYSIS |
J0717 |
CERTOLIZUMAB PEGOL INJ 1MG |
J0800 |
CORTICOTROPIN INJECTION |
J0897 |
DENOSUMAB INJECTION |
J1300 |
ECULIZUMAB INJECTION |
J1428 |
ETEPLIRSEN, 10 MG |
J1459 |
IVIG PRIVIGEN 500 MG |
J1555 |
CUVITRU, 100 MG |
J1556 |
IMM GLOB BIVIGAM, 500MG |
J1557 |
GAMMAPLEX INJECTION |
J1559 |
HIZENTRA INJECTION |
J1561 |
GAMUNEX-C/GAMMAKED |
J1566 |
IMMUNE GLOBULIN, POWDER |
J1568 |
OCTAGAM INJECTION |
J1569 |
GAMMAGARD LIQUID INJECTION |
J1572 |
FLEBOGAMMA INJECTION |
J1575 |
HYQVIA 100MG IMMUNEGLOBULIN |
J1599 |
IVIG NON-LYOPHILIZED, NOS |
J1602 |
GOLIMUMAB FOR IV USE 1MG |
J1745 |
INFLIXIMAB (REMICADE) |
J1930 |
LANREOTIDE INJECTION |
J2323 |
NATALIZUMAB INJECTION |
J2350 |
OCRELIZUMAB, 1 MG |
J2353 |
OCTREOTIDE INJECTION, DEPOT |
J2357 |
OMALIZUMAB INJECTION |
J2503 |
PEGAPTANIB SODIUM INJECTION |
J2778 |
RANIBIZUMAB INJECTION |
J3262 |
TOCILIZUMAB, 1 MG |
J3304 |
TRIAMCINOLONE ACE XR 1MG |
J3357 |
USTEKINUMAB SUB CU 1 MG |
J3380 |
VEDOLIZUMAB |
J3396 |
VERTEPORFIN INJECTION |
J7189 |
FACTOR VIIA |
J7318 |
DUROLANE 1 MG |
J7320 |
GENVISC 850, 1MG |
J7321 |
HYALGAN SUPARTZ VISCO-3 DOSE |
J7322 |
HYMOVIS INJECTION 1 MG |
J7323 |
EUFLEXXA INJ PER DOSE |
J7324 |
ORTHOVISC INJ PER DOSE |
J7325 |
SYNVISC OR SYNVISC-ONE |
J7326 |
GEL-ONE |
J7327 |
MONOVISC INJ PER DOSE |
J7328 |
GELSYN-3 INJECTION 0.1 MG |
J7329 |
TRIVISC 1 MG |
J9022 |
ATEZOLIZUMAB,10 MG |
J9145 |
INJECTION DARATUMUMAB 10 MG |
J9173 |
DURVALUMAB, 10 MG |
J9176 |
ELOTUZUMAB, 1MG |
J9308 |
RAMUCIRUMAB |
J9311 |
RITUXIMAB, HYALURONIDASE |
J9355 |
TRASTUZUMAB INJECTION |
Q2043 |
SIPULEUCEL-T AUTO CD54+ |
Q5103 |
INFLIXIMAB (INFLECTRA) |
Q5104 |
INFLIXIMAB (RENFLEXIS) |
If you have any questions, call Member Services at 1-855-735-4398 (TTY:711). Hours are from 8 a.m. to 8 p.m., Monday through Friday. After hours, on weekends and on federal holidays, you may be asked to leave a message. Your call will be returned within the next business day.