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Member Information - The information entered below must match the information listed on your Health Plan Benefit card.
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Please enter the digits as they show on your Member ID card
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Date Of Birth
Location
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By providing your email address to us, you expressly consent that we may send communication to you via email. If you do not wish to provide an email address, you can place your OTC order by calling the OTC Order Fulfillment Center1-866-575-3744 for Medicaid.
Login Information - Complete the following information to create your user name and password to securely access your OTC benefit.
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Your user name should contain a minimum of 6 characters and a maximum of 25 characters.
(Only Alphanumeric and Special Characters -._@+)
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Password must contain 1 upper case letter, 1 lower case letter, 1 number and be at least 8 characters long.
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By clicking on Register below, you agree to the Terms and Conditions and Privacy Policy
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