How to Use Your Medicare Advantage OTC Benefits

Are you taking full advantage of your Medicare Advantage plan? One of the many benefits that some Medicare Advantage plans offer is an OTC (over-the-counter) allowance. It's all too common to see individuals select their Medicare without utilizing these additional perks. Who doesn't appreciate extra benefits and allowances, especially if it's included! By the end of this post, you'll understand exactly what an OTC benefit is, how to use it effectively, and make sure not a single dollar is wasted.

What are Medicare Advantage OTC Benefits?

OTC benefits refers to an allowance to be used at participating stores for certain over-the-counter items, like vitamins and supplements. This can be in the form of a preloaded card, or you may be able to use the allowance to purchase items online and have them shipped to your home. This benefit is offered through private insurance companies on many Medicare Advantage plans at no additional cost.

What Can You Buy With Your OTC Allowance?

Common eligible items:

• Pain relievers and cold medicine

• Bandages and first aid supplies

• Vitamins and supplements

• Dental care items - (e.g., toothbrushes, toothpaste, etc.)

• Vision and hearing-related supplies

• Blood pressure cuffs, diabetes supplies

• Health related clothing items (e.g. compression socks)

*Products depend on brand, location availability, and what stores are included with your insurance carrier

How to Use Your OTC Benefits

Step 1 – Check Your Allowance

• You may be able to check your allowance on your member portal by logging into your account or using the mobile app.

• Call the phone number on the back of your OTC card to check allowance and find participating retailers near you.

• Check whether you have a monthly or quarterly allowance.

• See if your allowance rolls over or expires at the end of the month or quarter.

Step 2 – Shop Approved Retailers

• Online portals

• Participating stores (e.g., CVS, Walmart, Walgreens, etc.)

• Catalog orders - Your insurance carrier usually mails you a catalog to order OTC items by mail, online, or by phone call.

Step 3 – Place Your Order

• Use your OTC card at approved store locations

• Ordering online or by phone

Common Mistakes to Avoid

1. Not knowing you have an OTC allowance on your Medicare Advantage plan - This is the most common mistake and can easily be avoided by reviewing your plan's summary of benefits to see all available benefits included in your plan and ensure you're taking advantage of them.

2. Letting it expire - It's important to determine how much allowance you have and whether its a quarterly or monthly allowance, because it may expire and reset periodically. Some plans allow it to roll over, and knowing this ahead of time ensures you don't leave benefits on the table!

3. Not reviewing your plan every year - Plans update every year, and you may be eligible for a higher allowance than the previous year.

How Can I Qualify For an OTC Allowance?

OTC benefits are offered exclusively through Medicare Advantage (Part C) plans. You must have Medicare Parts A and B to qualify for an Advantage plan, and not all plans include an OTC allowance—availability depends on the plans offered in your zip code.

While this is a useful benefit, choose a plan that fits your overall healthcare needs first; extras like OTC allowances are just a bonus. Ask your agent or broker if this benefit is available in your area and to help you find plans that include it.

Why Did My OTC Benefit Decrease?

If you noticed a recent decrease in your OTC allowance, it's likely because your plan was renewed and benefits are subject to change with every new year. It could also happen if you switched coverage recently. Every Medicare Advantage plan is different, and benefits vary by carrier and plan type. Even switching to another plan from the same carrier might mean some benefits improved while others, like OTC, got reduced.

That's why checking your plan every year matters—to stay current on new benefits and make sure they still fit your healthcare needs. A licensed broker can walk you through a full needs analysis to find the best benefits and savings tailored just for you.

Next Steps

1. Talk to a local Medicare broker to see if you qualify for an OTC allowance.

2. If you have a Medicare Advantage plan, review your current benefits to ensure you're not missing out on anything important.

3. Download your plan’s app or check the member portal today to see your current OTC balance and eligible items.

4. Save the customer service number on your OTC card for quick questions about retailers or orders.

5. Mark your calendar for the next Medicare Annual Enrollment Period (Oct 15–Dec 7) to shop plans with the best OTC perks for next year.