LA CentAcnt Catalog ENG Web

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1 List of Qualified Items LouisianaHealthConnect.com 1

2 TABLE OF CONTENTS Baby Care 1 1 Diabetes Care Digestive Health 2 Eye and Ear Care 2 First Aid 2 Groceries 3 Home Health Care 3 Household Products 6 Oral Hygiene 7 Over-the-Counter (OTC) Medicines 7 Personal Care 8 Wellness and Fitness 11

3 Baby Care BABY TOYS, PLAYTHINGS & GIFT SETS B a b y Toy s • BABY FEEDING ACCESSORIES Gyms & Play Stations • Nipples • Walkers, Jumpers & Swings • • Breast Pumps & Nursing Accessories (Includes Nursing Pads & Creams) DIAPERS, WIPES & RELATED ITEMS • Bottles, Bottle Accessories & Kits Diapers • Pacifiers • Wipes & Flushables • Teethers • Baby Diaper Bags, Pins, Pails, Etc. • • Baby Feeding Accessories Training Pants & Swimmers • • Overnight Pants BABY FORMULA, DIETARY SUPPLEMENTS, ELECTROLYTES & FOOD Diabetes Care • Formula • Dietary Supplements BLOOD GLUCOSE TESTING Electrolytes • • Test Strips & Controls Baby Food • • Lancets & Lancet Devices • Blood Glucose Testing Accessories BABY GROOMING Glucose Monitors • • Cotton Swabs Baby Grooming Products • DIABETES CARE ACCESSORIES • Alcohol Swabs BABY HEALTH, BEAUTY & WELLNESS • Baby Oil DIABETES HBW & SUPPLIES • Baby Lotion & Creams • Diabetes Skin Care • Baby Therapeutic Skin Care (Includes Diaper Rash) Diabetes Cough, Cold & Allergy • Baby Powder • Baby Bath & Hair Care • DIABETES DIETARY SUPPLEMENTSS, ETC. Baby Oral & Teething Pain • • Glucose Tablets, Gels, Etc. Diabetes dietary supplements & Foods • BABY LAYETTE Diabetes Candy • Baby Clothing • • Diabetes Supplements • Baby Towels & Washcloths Baby Bedding • INSULIN, SYRINGES & DELIVERY SYSTEMS • Insulin BABY ROOM & TRAINING ACCESSORIES • Syringes Baby Room & Training Accessories (Potty Seats, Etc.) • Auto Injectors, Pens, Kits, Needles, Etc. • • Baby Safety Devices Pumps • • Baby Strollers, Carriers, Car Seats & Accessories 1

4 URINE TESTING • Antacid Effervescent Urine Test Strips • • Multi-Symptom & Nausea Products Urine Test Tablets • Eye and Ear Care Digestive Health CONTACT LENS CARE* ADULT’S DIGESTIVE HEALTH Soft Lens Multi-Purpose Solutions • • Acid Controllers • Soft Lens Disinfecting Anti-Diarrheal Tabs • Soft Lens Saline Solutions • Anti-Diarrheal Liquids • Soft Lens Cleaners • • Anti-Gas Products Soft Lens Rewetting Drops • Gas Permeable & Hard Lens Care • CHILDREN’S DIGESTIVE HEALTH Children’s Stomach Remedies • EAR CARE* • Children’s Laxatives (Includes Fiber) Ear Drops & Syringes • Children’s Anti-Diarrheals • Ear Plugs • • Children’s Anti-Gas Children’s Prebiotics & Probiotics • EYE GLASS* • Lens Accessories HEMORRHOIDAL PREPARATIONS Reading Glasses & Magnifying Glasses • Hemorrhoidal Treatments • • Sunglasses & Accessories Hemorrhoidal Wipes & Washes • EYE PREPARATIONS* LACTOSE INTOLERANCE & DIGESTIVE AIDS • Eye Relief Products • Lactose Intolerance Dry Eye Relief • • Digestive Aids • Eye Wash • Prebiotics & Probiotics *Not accepted at the Vision Centers of stores (Walmart) LAXATIVES • Fiber Products Enemas, Laxative Suppositories, Kits, Etc. • First Aid Laxative Tabs & Powders (Includes • Combination Products) ANTI-ITCH TREATMENTS Laxative Liquids (Includes Combination Products) • • Hydrocortisone Products • Stool Softeners • Anti-Itch Treatments • Jock Itch & Insect Bite Remedies STOMACH REMEDIES Antacid Liquids • ANTIPARASITIC OR LICE TREATMENTS Antacid Tabs & Other Forms • These treatments are covered. 2

5 CHILDREN’S FIRST AID DRESSINGS & TREATMENTS • Puddings, Gels, Gelatin . These treatments are covered Flours, Cornmeals • FIRST AID DRESSINGS NON-PERISHABLE FOOD (CONTINUED) Adhesive & Liquid Bandages • Sugar • • First Aid Tapes Tomato/Spaghetti/Nutritionally Significant Sauce • • Gauze Pads & Dressings • Jams/Jellys/Spreads/Syrups Surgical Bandages & Surgical Dressings • • Peanut Butter (and other nut butters) Cereal • FIRST AID KITS & SUPPLIES • Granola Bars/Fruit Strips First Aid Kits • • Dry Pasta • Rubber Gloves • Dry Beans Masks (Respiratory, Barrier, Etc.) • Rice • Dry Mixes • FIRST AID TREATMENTS Canned Fruits and Vegetables • • Antibiotic Products Prepared Food • • Antiseptics & Medicated Products (Includes Alcohol, • Soup Peroxide, Epsom Salt, Etc.) • Skin Remedies (Includes Burn & Scar Treatments) PERISHABLE FOOD • Skin Protectants (Includes Petroleum Jelly) • Dairy Wound Cleansers (Salines) • Eggs • • Yogur t Produce • • Meats Groceries • Processed meats/Sausage/Jerkey • Seafood BEVERAGES • Fruits & Vegetables Dry Drink Mixes • Cocoa, Coffee & Tea (Bottle and Dry) • Juices • SNACKS & DESSERTS • Bottled Waters Nuts • Enhanced Waters • • Sports Drinks - Gatorade • Bottled Energy Drinks Home Health Care FROZEN FOOD ABDOMINAL SUPPORTS & RIB BELTS Fruits & Vegetables • All Abdominal Supports & Rib Belts are covered. Meats • Seafood • BATHROOM SAFETY • Bathtub Safety & Accessories NON-PERISHABLE FOOD Bathtub & Toilet Rails, Frames • • Baking/Cooking Supplies Elevated Toilet Seats • 3

6 Grab Bars • EMS/NMS Devices (Electronic Muscle Stimulators/ • Sitz Baths Neuromuscular Electronic Stimulators) • Ultrasound Devices • Hand Held Showers • HOT/COLD THERAPY BAT TERIES • Hearing Aid Batteries (Standard & High Performance) Hot/Cold Therapy • • Heating Pads (Electric) BRACES INCONTINENCE SUPPLIES • Ankle & Foot • Hand & Wrist Perineal-Only Cleansers & Washes • • Elbow & Arm • Perineal-Only Wipes & Towelettes • Knee • Perineal-Only Moisturizers, Barriers & Protectants Perineal-Only Antifungals • • Thigh, Calf & Shin Deodorizers • Joint Warmers & Arthritis • • Reusable Garments Reusable Underpads DIAGNOSTIC PRODUCTS • • Stethoscopes, Professional Diagnostics & Accessories INSECT REPELLENTS • Thermometer, Fever Strip & Accessories All insect repellents are covered (including sprays, Blood Pressure Kits & Accessories • bracelets, candles, etc.) DISPOSABLE INCONTINENCE SUPPLIES Disposable Underwear MASTECTOMY PRODUCTS • • • Mastectomy Bras & Clothing Disposable Briefs & Undergarments • • Mastectomy Prosthesis Disposable Underpads Disposable Pads, Shields, Guards & Drip Collectors • MEDICAL DIETARY SUPPLEMENTS & IV THERAPY DECUBITUS/PRESSURE RELIEF • Bags & Tubes • Gravity Flow Sets • Alternating Pressure Pads/Mattresses & Pumps Decubitus Bed Pads & Wedges • • IV Equipment, Stands & Accessories Decubitus Treatment Supplies Medical Dietary Supplements • • • Heel/Elbow/Foot Protectors • Pumps • Solutions ELASTIC BANDAGES & ATHLETIC TREATMENTS • IV Catheters, Syringes, Needles & Supplies Athletic Supports & Cups • Athletic Tape/Wraps • MEDICAL/SURGICAL SUPPLIES • Elastic Bandages • Caps & Gowns, Etc. Protective Guards • • Instruments & Cleansers • Labware & Accessories • ELECTROTHERAPY Sutures & Accessories • TENS Units (Transcutaneous Electrical Nerve • Examination Room Supplies Hand Cleaners & Sanitizers Stimulation) • Electrotherapy Supplies (Electrodes, Wires, Gels, Etc.) • 4

7 NICOTINE PATCHES, GUM, ETC. Medical Alert ID’S • All nicotine items are covered Medicine Droppers, Spoons, Pillboxes, Etc. • Reachers, Grippers & Lifts • ORTHOPEDIC AIDS* • Reading, Writing & Telephone Aids • Padded Mattress & Pillow Covers • Backrests, Cervical Pillows, Lumbar Supports & PATIENT ROOM SUPPLIES* Posture Aids • Beds-Manual & Electric • Orthopedic Footwear Mattresses • Joint Warmers • Commodes & Commode Parts • • Cast Boots, Bandage Covers & Post-Op Shoes Urinals, Bedpans • • Splints & Accessories (Includes Cushioning Materials) • Patient Lifting Aids (Includes Lift Chairs, Traction Equipment (Belts, Halters, • Trapeze Bars, Etc.) Overbed, Overdoor) Hospital Bed Accessories • • Bedding (Waterproof & Regular) Restraints, ORTHOPEDIC & SURGICAL SUPPORT* Gowns, Etc. Hernia Supports & Suspensories • • Sacro & Back Braces PHYSICAL & COGNITIVE THERAPY Arm Slings & Cervical Collars • Hydrotherapy (Whirlpools, Foot Baths, Etc.) • • Shoulder & Clavicle Braces • Steam Packs, Hydrocollators • Continuous Passive Motion Machines OSTOMY PRODUCTS* • Cognitive Therapy (Activities, Games, Books, Etc.) • Adhesive & Adhesive Removers • Light Therapy (Infrared, S.A.D., Etc.) Irrigation Products • Massagers & Treatment Tables • Deodorants • Drains • RESPIRATORY THERAPY • Karaya Products, Rings • Air Purifiers & Filters • Wafers, Barriers Aspirators & Suction Machines • Night Drainage Sets • • Apnea Monitors Ostomy Skin Care Products • • IPPB, CPAP & BiPAP Machines Closed End Pouches • • Nebulizers (Includes Ultrasonics), Atomizers • Mini Pouches Air Compressors, Oxygen Concentrators, Emergency, • Drainable Pouches-One Piece • Portable, Liquid Systems & Tanks • Drainable Pouches-Two Piece • Tracheostomy Supplies • Pediatric Pouches Urostomy Pouches-One Piece • SPECIALIZED ORTHOPEDIC BRACES/SUPPORTS* Urostomy Pouches-Two Piece • • Specialized Ankle & Foot (Includes Metatarsals) Specialized Elbow & Arm Supports • PATIENT AIDS FOR DAILY LIVING • Specialized Knee Braces/Hinged Bathing & Oral Hygiene Aids • • Specialized Knee Immobilizers Eating & Drinking Aids • Specialized Wrist & Hand Supports • Grooming & Dressing Aids • • Specialized Shoulder & Clavicle Supports • Specialized Thigh & Calf Supports *If you have a medical need for these items, they may be covered by your health plan. Call us at 1-866-595-8133 (Hearing 5 Loss: 711) for more information. Monday-Friday, 7 a.m. to 7 p.m.

8 SUPPORT HOSE-LOW COMPRESSION (8-15 MMHG) WHEELCHAIRS* Wheelchair-Hemi • • Men’s Support Hose • Wheelchair-Lightweight & Heavyweight • Women’s Support Hose-Knee High Wheelchair-Narrow Women’s Support Hose-Thigh High • • • Women’s Support Hose-Full & Maternity • Wheelchair-Recliner • Wheelchair-Standard • Athletic Support Socks • Wheelchair-Transport Wheelchair-Extra Wide • SUPPORT HOSE-HIGH COMPRESSION (OVER 8-15 MMHG) • Knee High Medical Support Wheelchair-Youth • Thigh High Medical Support • Waist High Medical Support • WHEELCHAIR ACCESSORIES* Lymphedema Treatments (Sleeves, Socks, • Wheelchair Ramps & Lifts • Wheelchair Cushions/Seats • P ump s , Etc.) Wheelchair Belts • Women’s High Compression Support Hose - Wheelchair Footrests Full & Maternity • • Wheelchair Legrests UROLOGICAL PRODUCTS* WOUND CARE-SPECIALIZED* Catheters-External • • Catheters-Foley Latex Calcium Alginate • Collagen Dressings • Catheters-Foley Red Rubber • • Catheters-Foley Silicone • Foam Dressings • Hydrocolloid/Hydropholic/Gel Dressings • Catheters-Foley Teflon Catheters-Self Granules/Powders • • • Normal Saline Dressings Catheter Lubricants • • • Irrigation Trays, Supplies & Solutions Petrolatum Dressings • Catheter Care Trays • Transparent Dressings • Collection Bags, Drain Bags & Leg Bags Tubing & Connectors • Vacuum Devices • Household Products AIR & FABRIC FRESHENERS WALKING AIDS* • Canes Disinfectants ONLY • • Crutches Forearm Crutches CLEANERS & WAXES • • • Quad Canes Abrasive Cleaners Walkers & Rollators • • Bathroom Cleaners Multi-Purpose Cleaners/Disinfectants • • Walking Aid Accessories Accessories • • Oven Cleaners *If you have a medical need for these items, they may be covered by your health plan. Call us at 1-866-595-8133 (Hearing 6 Loss: 711) for more information. Monday-Friday, 7 a.m. to 7 p.m.

9 • Drain Cleaners Oral Pain Relief & Mouth Sores • • • Floor, Furniture Waxes/Polishes & Rug Cleaners Dry Mouth Products Temporary Dental Repair • • Window Cleaners CLEANING TOOLS & ACCESSORIES TOOTHBRUSHES • Cleaning Tools & Accessories (Includes Mops, Vacuum Manual Toothbrushes • Bags, Household Gloves, Etc.) Battery Toothbrushes & Refills • • Rechargeable Toothbrushes & Refills • Tr i a l / Tr ave l S i ze s DISH & LAUNDRY • Dishwashing Powders/Liquids • Laundry - Washer Products TOOTHPASTE & TREATMENTS Laundry - Dryer Products • • Regular Toothpaste & Toothpowder After Laundry Products • Sensitive Toothpaste & Treatments • • Whitening Strips & Treatments INSECTICIDES, RODENTICIDES & PESTICIDES • Whitening Toothpaste All insecticides, rodenticides & pesticides are covered. PLASTICS, FOIL & PAPER PRODUCTS Over-the-Counter • Plastic & Foil Medicine (OTC) Food Storage Bags • Facial Tissue • ADULT COUGH, COLD & FLU • Bath Tissue • Cough, Cold & Flu Liquids • Paper Toweling Cough, Cold & Flu Tabs • • Premoistened Towels • Cold & Flu Preventatives/Symptom Reducers • Disposable Napkins, Plates & Cups Garbage Bags • ALLERGY, SINUS & COMBINATIONS • Allergy, Sinus & Combination Liquids • Allergy, Sinus & Combination Tabs Oral Hygiene CHILDREN’S COLD & ALLERGY INTERDENTAL, GUM CARE, ETC. Children’s Cough, Cold & Flu • • Floss & Flossers • Children’s Throat & Cough Relief Interdental • • Children’s Allergy & Sinus • Gum Care • Children’s Nasal Products Dental Gum • COUGH DROPS, SORE THROAT RELIEF MOUTHWASH • Sore Throat Pain Relief • All mouthwashes are covered • Throat & Cough Drops HERBALS & BOTANICALS ORAL REMEDIES Echinacea • 7

10 SPECIALTY SUPPLEMENTS • Garlic • Joint Health Ginkgo Biloba • • Soy • Ginseng • Enzymes, Amino Acids & Hormones • St. John’s Wort Essential Fatty Acids (Fish Oil, Flax, GLA, Etc.) • Colon Cleanse & Detox (non-weight loss) • VITAMINS/DIETARY SUPPLEMENTS LIP CARE Adult Multivitamins & Multivitamins w/Minerals • • Medicated Lip Treatments Eye Health Vitamins • • Lip Moisturizers Children’s Vitamins, Multivitamins, Multivitamins • w/Minerals & Minerals NASAL • Children’s Herbals Nasal Sprays, Drops & Inhalers • Children’s Dietary Supplements • • Nasal Moisturizing Products & Washes • Dietary Supplements Nasal Strips & Snore Relief • • Calcium Iron • PAIN RELIEF • Mineral Supplements • Adult Acetaminophen Multi-Mineral • • Feminine Pain Relief • Prenatal Vitamins • Adult Aspirin & Combinations Vitamin B & Vitamin B Complex • • Adult Ibuprofen & Other Anti-inflammatories Vitamin C • • Adult Nighttime Pain Relief Vitamin E • • Adult Specialty (Includes Topical Headache & Single Entity Vitamins • Fever Relief ) • Vitamin D • Children’s Acetaminophen Children’s Ibuprofen • • External Muscle/Joint Pain Relief Patches & Pads Personal Care External Muscle/Joint Pain Relief Rubs & Liquids • External Muscle/Joint Pain Relief Liquids, • ACNE MEDICATIONS (FACE & BODY) Roll-ons and Sprays Acne Creams, Gels, Lotions & Patches • Acne Soaps & Cleansers • RESPIRATORY TREATMENTS • Acne Astringents & Pads • Asthma Preparations • Vapor Products (Includes Waterless Vaporizers) AFTER SUN & SUN ACCESSORIES Vaporizers, Humidifiers & Accessories • All after sun and sun accessories are covered. SLEEP AIDS, STIMULANTS & MOTION SICKNESS ANTIFUNGAL TREATMENTS Sleep Aids & Sedatives • Antifungal Powders • Stimulants • • Antifungal Creams & Liquids Motion Sickness • Antifungal Sprays • Restless Leg Treatments • Nail Fungus Treatments • 8

11 Make Up Removers • BREATH REMEDIES FACIAL MOISTURIZERS & TREATMENTS • Breath Fresheners (Includes Strips) • Therapeutic Breath Treatments Facial Moisturizers • • Eye Treatments Therapeutic Facial • CHILDREN’S ORAL CARE • Lip Treatments • Children’s Toothpaste • Children’s Toothbrushes Children’s Oral Rinses FAMILY PLANNING • Condoms • COSMETIC ACCESSORIES & IMPLEMENTS Female Contraceptives • Pregnancy Tests All cosmetic accessories and implements are covered. • • Ovulation/Fertility Tests COSMETIC PUFFS & PADS FEMININE ANTIFUNGAL PRODUCTS All cosmetic puffs & pads are covered. All feminine antifungal products are covered. DENTURE PRODUCTS Denture Adhesives FEMININE PERSONAL CARE • • • Denture Cleaners & Accessories Deodorants & Powders Denture Repair & Pain Relief • • Wipes & Washes • Anti-Itch Products • DEODORANTS - MEN’S Feminine Moisturizing Products • Men’s Solids & Gels Men’s Sprays FEMININE PROTECTION • Feminine Pads • Men’s Roll-Ons • Tampons • Panty Liners DEODORANTS - UNISEX • Unisex Solids & Gels • FOOT GROOMING & PAIN RELIEF Unisex Sprays • • Implements Unisex Roll-ons • Foot Moisturizers & Exfoliators • DEODORANTS - WOMEN’S • Corn, Callus & Bunion Pads Women’s Solids & Gels • • Corn & Callus Removers • Women’s Sprays • Foot Pain Relief Women’s Roll-Ons • HAIR - CHILDREN’S FACIAL CLEANSERS Children’s Shampoo • • Facial Cleansers & Scrubs Children’s Conditioners • • Astringents, Toners, Pads & Towelettes Children’s Styling Aids • Pore Strips & Masks • Facial Sponges • 9

12 HAIR - CONDITIONERS & HAIR TREATMENTS MULTI-CULTURAL ETHNIC SKIN CARE Creams, Lotions & Soaps • • Conditioners Hair Treatments Shaving Needs • • • Therapeutic Conditioners ODOR & WETNESS TREATMENTS Odor & Wetness Powders • HAIR - MEN’S HAIR CARE • Men’s Hair Preparations • Odor & Wetness Creams & Liquids Men’s Hair Color Odor & Wetness Sprays • • • Men’s Grooming Implements (Manual Only) PATIENT CLEANSING & BATHING HAIR - MULTI-CULTURAL HAIR CARE • Cleansers & Washes • Towelettes & Wipes • Relaxers & Curl Kits, Perms Shampoos & Conditioners • • PATIENT SKIN SUPPORT Sheens, Activators & Moisturizers • Moisturizers, Barriers & Protectants • Pomades, Hair Dressings & Styling Aids • Antifungals • Multi-Cultural Hair Color HAIR - PERMANENTS & CHEMICAL RELAXERS RAZORS & REFILLS • Men’s Razor Refills All hair products are covered, excluding hair styling Men’s Reusable System Razors • tools - such as hair straightener, curling iron. Men’s Disposable Razors • Women’s Razor Refills HAIR - SHAMPOO & THERAPEUTIC HAIR & SCALP • • TREATMENTS Women’s Reusable System Razors • All hair products are covered, excluding hair styling Women’s Disposable Razors tools - such as hair straightener, curling iron. SHAVING & SKIN CARE HAIR - STYLING AIDS • Men’s Shaving & Hair Removal Mousses & Gels • • Women’s Shaving Men’s Aftershave & Skin Care • • Hair Sprays • Preshave and Shaving Accessories • Pomades & Waxes • SHOE INSOLES, INSERTS & CUSHIONING HAND & BODY CLEANSING • Hand & Body Cleansing Bars & Soaps All shoe insoles, inserts & cushioning are covered. • Hand Cleansing Liquids • Body Cleansing Liquids (Body Washes & Gels) SUN PROTECTION Children’s Sun Protection • Instant Hand Sanitizers • HAND & BODY MOISTURIZERS & TREATMENTS • Sun Protection (SPF 15-50+) Hand & Body Moisturizers Lip Protection (Sun Care Lines Only) • • Therapeutic Hand & Body Sport Sun Protection • • Skin Novelties & Gift Sets • • Sun Tanning (SPF 0-14) 10

13 WART REMOVERS • Sport/Energy Bars All wart removers are covered. Sport/Energy Tablets, Caps, Etc. • WET & DRYS SUGAR & SALT SUBSTITUTES • Drys (Epsom Salt & Borid Acid in First Aid) • Liquids (Alcohol & Peroxide in First Aid) WEIGHT CONTROL Weight Control Foods, Liquids & Powders • WOMEN’S HAIR REMOVAL & BLEACHES • Weight Control Bars • Women’s Hair Removal Products & Skin Treatments • Weight Control Tablets, Caps, Etc. • Women’s Body & Facial Waxes • Weight Scales Women’s Body & Facial Bleaches • Wellness and Fitness DIURETICS & WEIGHT LOSS CLEANSING & DETOX EXERCISE EQUIPMENT • Treadmills Steppers & Ellipticals • • Stationary Bikes DIETARY SUPPLEMENT FOODS • Dietary Supplement Liquids • Dietary Supplement Powders Dietary Supplement Bars • Thickeners & Pre-thickened Foods • PHYSICAL FITNESS Strength/Range of Motion (Bands, • Hand Exercisers, Etc.) Balls/Stability Devices (Balls, Boards, Etc.) • • Foam Rollers/Massage Devices Weights • • Cardio (Aerobic Steps, Jump Ropes, Pedometers, Etc.) Scales (Includes Body Fat Analyzers) • • Yoga and Exercise Mats SPORT/ENERGY Sport/Energy Liquids • Sport/Energy Powders • 11

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