Medicare Advantage OTC Benefits: How to Use Your Over-the-Counter Allowance

Many Medicare Advantage plans include an over-the-counter (OTC) benefit -- a periodic allowance (monthly, quarterly, or annual) that you can use to purchase health-related products without a prescription. OTC benefits can be worth $100-$500 or more per year, yet many beneficiaries never use them. Here is how to find and maximize yours.

The OTC benefit is a supplemental benefit offered by many Medicare Advantage plans -- not Original Medicare. It provides a set dollar amount per period (monthly, quarterly, or annually) that you can spend on approved over-the-counter health products.

Typical OTC allowance amounts:

• $25-$100 per month
• $75-$300 per quarter
• $100-$500 per year

Unused allowances typically do not roll over -- use them or lose them each period.

Eligible products vary by plan but commonly include:

Health and wellness:

• Vitamins and supplements
• Pain relievers (acetaminophen, ibuprofen, aspirin)
• Allergy medications (antihistamines, nasal sprays)
• Cold and flu remedies
• Digestive health products (antacids, fiber supplements)
• Sleep aids

First aid:

• Bandages and wound care supplies
• Antiseptics
• Elastic bandages and braces

Diabetes supplies:

• Blood glucose test strips (some plans)
• Lancets
• Glucose tablets

Personal care:

• Dental care products (toothbrushes, toothpaste, denture care)
• Eye care (reading glasses, eye drops)
• Hearing aid batteries
• Incontinence supplies

Fitness and mobility:

• Some plans include fitness equipment or supplies

OTC card: Most plans provide a dedicated OTC card (similar to a debit card) preloaded with your allowance each period. Use it at participating retailers.

Online ordering: Many plans offer an online OTC catalog -- order products online and have them delivered to your home. This is particularly convenient for beneficiaries with mobility limitations.

Mail-order catalog: Some plans provide a printed catalog with order form.

Participating retailers: Common participating retailers include CVS, Walgreens, Walmart, Dollar General, and other major chains. Not all stores participate -- check your plan's list.

1. Check your plan's Evidence of Coverage (EOC) -- the annual document detailing all your benefits
2. Log in to your plan's member portal -- most plans show your current OTC balance online
3. Call your plan's member services -- the number is on your insurance card
4. Check the plan's mobile app -- many plans have apps that show your OTC balance and eligible products

Use it every period: OTC allowances typically expire at the end of each month or quarter. Set a reminder to use your balance before it expires.

Stock up on staples: Use your allowance for products you use regularly -- vitamins, pain relievers, dental care -- rather than impulse purchases.

Compare plans during AEP: OTC benefit amounts vary significantly between plans. A plan with a $100/month OTC allowance provides $1,200/year in value -- factor this into your total cost comparison.

Combine with other benefits: Some plans also offer food/produce allowances, utility assistance, or other supplemental benefits. Use all available benefits.

We do not offer every plan available in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.