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Over The Counter Benefits Underutilized 


The over the counter, (OTC) allowance is a great additional benefit with Medicare Advantage plans that allows beneficiaries to purchase certain items they use every day at no additional cost to them.  Unfortunately, it is an often-underutilized additional benefit.  Nearly 70% of the OTC benefits go unused every year.  It goes without saying that there is a lot of money that is being left on the table.  So, how do we change that and make sure that beneficiaries are utilizing the benefits that are available to them.   

How to receive OTC Benefits 

Original Medicare and Medicare Supplement plans do not cover the cost of OTC health products.  If this, along with other additional benefits, is something that is important when deciding which type of health coverage is best for you, then a Medicare Advantage plan is the way to go.  While not every Medicare Advantage plan offers OTC benefits, many do.   

Again, not every Medicare Advantage plan includes an OTC benefit, but if you choose to enroll in a plan that does, it is usually in the form of a prepaid card that is loaded with a certain dollar amount on a quarterly or monthly basis.  If the plan that you have includes a rollover allowance, any unused balance will carry over to the next month or quarter depending on your plan but will not carry over to the next plan year.  If the plan does not allow rollover, then the balance will need to be used each month or quarter depending on the plan.   

What is covered 

The OTC benefit covers a variety of products including: 

  • Vitamins & supplements 
  • Pain relievers, cough drops, and other OTC medications 
  • Toothbrushes, toothpaste, denture cream and tablets 
  • Bandages and first aid supplies 
  • Orthopedic support 

This is by no means a complete list and it is always a good idea to check with your plan provider for a complete list of what is covered.   

Where can you use your OTC benefits 

Each carrier’s preloaded card will have different approved locations but typically you will have the ability to use it at several major retailers nationwide.  In some cases, plans will also have their own online store where you can use your OTC allowance to order items and have them delivered to your home.   

This is a brief rundown on what OTC benefits are, how to receive and use these benefits, and what items are covered.  But the key take away is making sure that you understand the benefits that are available to you, to ensure that you are getting the most out of your plan.  If you have questions regarding the benefits of your current plan or if you are in the process of choosing your health coverage, our Medicare specialists are available year-round to assist you. 

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