Highmark Wholecare Otc Store (2025)

FAQs

Does Highmark Wholecare cover OTC products? ›

At Highmark Wholecare we feel that medication coverage goes beyond prescriptions. This is why Over-the-Counter (OTC) benefits have been added to your D-SNP. You'll get an OTC allowance every three months, offering you four shopping periods a year to buy plan approved items.

Gateway Health plans will soon be Highmark Wholecare – same access to doctors, same commitment to care and whole-person approach to health. All that's changing is the plan names. You can learn more about the transition to Highmark Wholecare, effective January 1, 2022, by visiting their website.

OTC items are not eligible for reimbursement if they are normally used for general health, are not used to treat a medical condition (e.g. toothpaste, mouthwash, lotion, shampoo) or are cosmetic in nature (e.g. teeth whitening products, wrinkle reducers). See additional examples in the OTC Chart.

The company's average rates are high, but it also has cheap and no-cost plans available. And Medicare.gov gives Highmark an overall quality rating of 4.23 out of 5 stars. The company is particularly well-rated for customer satisfaction, where it earns a Medicare.gov rating of 4.28 out of 5.

What is the Healthy Food Card? Highmark Wholecare's Diamond plan members have access to a monthly amount of money to buy hundreds of healthy food items, including fresh produce.

Highmark's History

The Pennsylvania Medical Society backed the founding of Pennsylvania Blue Shield (now Highmark Blue Shield). In 1996, the two Blue plans were consolidated, forming Highmark Inc. Highmark is now one of the largest health insurers in the United States.

What does the OTC card not cover? A Medicare plan with an OTC allowance typically does not cover prescription medications, alcohol, tobacco products, cosmetics or items for general household use. Additionally, it usually cannot be used to purchase gift cards or pay for services such as doctor visits and lab tests.

You may check check the balance on your OTC benefit card by calling the number on the back of your card or signing in to your OTC plan provider's online member portal.

What are OTC healthcare products? ›

Over-the-counter (OTC) medicines are drugs you can buy without a prescription. Some OTC medicines relieve aches, pains, and itches. Some prevent or cure diseases, like tooth decay and athlete's foot. Others help manage recurring problems, like migraines and allergies.