Need to contact or place a phone call to Kalos Health Gold Plus: 1-800-399-1954 (TTY users should call 711)

Contact Line for Current Members: Please first call the number found on the back of your member ID card for accurate and faster service. 

Kalos Health was founded in 2014 as a regional nonprofit Health Insurance Company that preserves its reputation in the constantly changing landscape of health care across Western New York.  They stay informed and sees these changes as opportunities to create new partnerships, collaborate, drive change and affect the future for the improvement of their members’ lives.  

Kalos is a Greek word meaning honorable, morally good, or worthy.  These definitions are how they see themselves in building themselves as a health management organization.  They commit to empower their members to accomplish and preserve a healthy lifestyle that sustains their personal goals.

Kalos Health Gold Plus (HMO SNP) has a Medicare contract and a coordination of benefits agreement with the New York State Department of Health.  Kalos Health Gold Plus is a Medicare Advantage Plan created specifically for members with Medicare Parts A and B and also enjoys benefits provided by the New York State Medicaid.  The Kalos Health Gold Plus Care Team will closely work with their members in order to provide a personalized care while achieving the goal of helping their members live healthier and stay more active, be more independent, and reducing any unnecessary hospitalizations.

The following are the requirements to be able to enroll in the Kalos health Gold Plus:

• Age 21 or older
• Have Medicare Parts A and B
• Have full New York State Medicaid benefits
• Continuously pays for their Part B premiums (and Part A, if applicable)
• Currently residing in any of the following counties:
  • Orleans
  • Cattaraugus
  • Niagara
  • Erie

Kalos Health Gold Plus members will receive an OTC card with a maximum of $75 monthly limit to purchase approved non-prescription, over-the-counter medications as well as health-related items at participating retail locations.

It is a benefit that provides members a FREE allowance that they may enjoy to purchase OTC drugs at no extra cost.  A predetermined dollar amount or allowance is provided to you within this plan.  This benefit will also assist you with the cost of essential health care products that are not within the medical or pharmacy expense under your plan.  To add to this, it can aid you in saving money on a vast array of generic branded health essential products like cold medicines, pain relievers, dental care, first aid supplies, and so much more.  

Advantages of using OTC benefit:

If you will use the credit or pre-determined allowance that is provided within this benefit, all products you wish to get will be given to you at no extra cost.  Your orders will also be delivered to your home without worrying about shipping fee as these will all be covered by the benefit.

Kalos Health Gold Plus (HMO SNP) currently works with OTC Network to enable their members to purchase common everyday medical and personal health care essentials.  Their team of clinicians, researchers, engineers, financial experts, and a great number of direct sales representatives have outstanding expertise and know everything about healthcare business.  

The following are the common medical and personal care items that they offer for their partners:

• Skin and sun care products
• First aid supplies
• Allergy sprays and gels
• Cold and flu products
• Dental and Denture Care
• Eye and Ear Care
• Antacids and Acid Reducers
• Vitamins and Minerals
• And so many more!

These OTC products are all given to members at no extra cost.  A credit or pre-determined allowance is given within the benefit.  Shipping fee will not be charged to the member especially if this is inclusive in your plan.  Find below the easy methods where active members of this program can submit their orders to:

• They may scroll down below and go through on how to set up an account online.  This is considered to be the fastest, most convenient, and easiest way to order 24/7.
• They may visit participating local retailers and use their activated OTC card.

Members must make sure to review the Summary of Benefits of their existing personal plan to verify if their plan has this benefit included in it.  If it does, members must also be aware of the plan’s specified OTC allowance frequency, whether it is provided monthly or quarterly.  The allowance amount may vary depending on the plan.  The number to contact is given at the start of this article if you need further information about your plan benefits.

There are a few plans that are inclusive of an allowance that is provided on a quarterly basis.  These credits may be consumed to purchase some over-the-counter medications and supplies, comprising of digestive health treatments, allergy medication, pain relievers, first aid supplies, and so many more.  Members must review the Evidence of Coverage of their plan to check if it is included in their benefit and to find out the exact amount of the quarterly allowance provided.

IMPORTANT: Go directly to the site to confirm and acquire more information.

• https://www.kaloshealth.org/mltc/mltc-member-resources/
• https://www.kaloshealth.org/over-the-counter-benefits/

NOTE:  The information provided here is not a comprehensive explanation of the benefits available to you.  It is always best to communicate directly with the company to know more information about their available plans.

Easy-to-follow steps are provided below should you feel the need to access the login or registration page.  A brief guide is available for you so you can discover how you can login or activate a new online account and gain access.  Just make sure your personal information is close by.

• Stable internet access
• Email address
• Member information
• Personal information

1. Visit this link in your preferred search engine on your device.
2. Type in your 16- or 19-digit card number in the space provided.
3. Select the blue “Go” button to move forward.
4. Continue to move forward and provide all the necessary information to complete the activation.

OR you may also choose to contact 1-888-682-2400 to activate your card over the phone.  All you need to do is follow the instructions.  

NOTE:

If you wish to download the catalog, please visit the link below:

• 2020 Kalos Health Gold Plus (HMO SNP) OTC Summary of Benefits