May 1st 2024
By Ari Parker
Learn how to make the most of your Medicare OTC card with this comprehensive guide for seniors. Find out how to access and use your benefits effectively.
By Ari Parker
Some Medicare Advantage plans offer over-the-counter (OTC) cards as an additional benefit to pay for items like cold medicine, sunscreen, and over-the-counter painkillers. OTC benefits vary and can be difficult to use. As a result, we get a lot of questions about OTC card benefits and how to use them. We’ve also helped several of our members save on healthcare expenses by using their OTC credits.
In this guide, we answer common questions about OTC cards to help you get more value from your plan and use this money-saving perk effectively.
Some Medicare Advantage plans offer OTC cards loaded with cash funds to buy over-the-counter items.
OTC cards are like prepaid debit cards that can be used at participating retailers for eligible purchases.
Insurance companies provide online accounts where you can check your balance, find participating retailers, and look through eligible items.
Many Medicare Advantage plans offer benefits beyond what Original Medicare offers. One common benefit is an OTC card. You can use these cards to buy over-the-counter items including first aid kits, medications, and more.
Like many Medicare Advantage benefits, OTC benefits work differently, and your specific benefit depends on your policy. Most of the time, you’ll receive a preloaded card that functions like a debit card to purchase products at supermarkets, pharmacies, and convenience stores.
Your card may be loaded on a quarterly or monthly basis, depending on your plan. Credits don’t typically roll over into the next month or quarter, so it’s best to use them before they expire!
Depending on your Medicare Advantage plan, there may be multiple allowances, each you can use for different products and services. OTC cards and flex cards are easy to confuse, but you use them to pay for different things. If your plan includes a flex card, you can sometimes use them to pay for food, household goods, rent/utilities, or routine vision, hearing, and dental care. Most of the time, you must be eligible to receive this type of allowance. For example, Dual Eligible Special Needs Plans (D-SNPs), which are available in many states for people on both Medicare and Medicaid, may provide flex cards for people who need help paying for rent, utilities, and groceries.
Keep in mind that insurance providers name flex cards and other spending cards differently. For example, the Wellcare flex card program is called “WellCare Spendables.”
There are no eligibility requirements for an OTC card. If your Medicare Advantage plan includes OTC credits, you can use them as the plan allows.
A few things to note about OTC cards:
Original Medicare doesn’t provide any coverage for OTC items
Medicare Advantage plans aren’t obligated to add OTC cards as a benefit
The main benefit of a Medicare Advantage OTC card is that you can save some money on health-related items that you can typically find at a pharmacy.
Here’s a list of what you can usually get with a Medicare Advantage OTC card:
Over-the-counter medications like Tylenol and cold/flu remedies
Health and wellness products like cough drops, first aid supplies, thermometers, blood pressure monitors, vitamins/supplements, healing ointments, and heating/cooling pads
Personal care items like incontinence products, rubbing alcohol, and cotton swabs
Health aids like pill organizers, non-slip bath mats, grab bars, earplugs, and sleep masks
Not all items are eligible for purchase with an OTC card. You may not be able to buy the following products:
Cosmetic items like certain lotions and deodorant
Durable medical equipment like canes, walkers, and wheelchairs (usually)
Medical services like doctor visits and screenings
Non-eligible health items, items that aren’t listed on your plan’s catalog
Prescription medications
Check your plan materials to see a full list of what you can get with your OTC card because each OTC benefit is different. You can typically find your summary of benefits online along with the OTC catalog of approved items.
You can’t typically buy food with an OTC card. A few Medicare Advantage plans may allow you to buy health-related food and drink items like nutritional shakes, protein bars, and meal replacement products. However, OTC benefits are different from one plan to another and don’t usually let you buy food products.
Most major supermarkets, convenience stores, and pharmacies accept OTC cards, including:
CVS Pharmacy
Walgreens
Rite Aid
Walmart
Kroger
Safeway
Publix
Albertsons
Target
Online retailers
However, your plan may have a list of preferred retailers. Your summary of benefits is the best place to check where you can use your OTC credits.
You can buy over-the-counter products using the card at a participating retailer just as you would with a normal debit or credit card. Here’s a couple important tips to keep in mind:
Check your balance before purchasing items. If you buy more than the credits you have, you’ll have to pay the remaining balance out of pocket.
Make sure you go to a retailer that accepts the OTC card.
Ask for a receipt so you can keep track of your purchases.
Using your OTC card should be relatively straightforward, but it can be difficult to manage your allowance.
While you can’t apply specifically for an OTC card, you can enroll in a Medicare Advantage plan that includes OTC benefits. But OTC benefits are only one benefit that could be included as part of your Medicare plan. You’ll want to find a plan that’s best for your health and financial priorities. It’s important to compare your healthcare options so you can get the coverage you need.
The right Medicare plan for you should reduce your expenses for healthcare and health-related expenses. If you’re interested in enrolling in a plan with OTC card benefits, reach out to one of our licensed Medicare Advisors. We’ll compare every plan from every insurance carrier to get you the best value. Get in contact with us at 855-900-2427 or schedule a time to chat.
