Does everyone on Medicare get OTC benefits?
Asked by: Dr. Orville Kovacek MD | Last update: November 12, 2025Score: 4.4/5 (6 votes)
Who qualifies for an OTC card for Medicare?
Who Qualifies for an OTC Card? To get a Medicare Advantage OTC card, you must meet the requirements for Medicare coverage, which usually means being 65 or older and having worked for 10 years (or 40 quarters) while paying the Medicare tax.
How do I know if I have OTC benefits?
To find out if you have coverage, call the customer service number on the back of your Medicare Advantage card. Ask if you have the OTC benefit, how much you can spend and how often the benefit resets.
How much is the medicare OTC benefit?
Most CDPHP Individual Medicare Advantage members get a prepaid benefits card with up to $100 per quarter to spend on over-the-counter (OTC) supplies online through their Benefits Pro Portal, over the phone, or at thousands of retail locations.
How do you get money on an OTC card?
A physical OTC benefit card is provided annually to eligible members, along with a predetermined amount put onto the card that is only to be used for eligible OTC items. Depending on the health plan, funds are loaded or reloaded to the card on a monthly, quarterly or annual basis.
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How often do you get money on your OTC card?
It's important to know when your OTC card reloads. Money might be added on a monthly, quarterly or annual basis, depending on your plan. And remember, if benefits don't roll over to the following period, you'll need to use them — otherwise you'll lose them. For example, some plans have a quarterly structure.
What is the OTC allowance?
The OTC allowance benefit can be used to buy eligible non-prescription items, plus health and wellness items. There are 2 types of OTC allowance benefits: OTC Mail Order or OTC Allowance.
Can I buy toilet paper with my OTC card?
OTC items are not eligible if they are normally used for general health, are not used to treat a medical condition (e.g. lotion, shampoo (except for products used to treat dandruff), toilet paper, lip balm) or are cosmetic in nature (e.g. teeth whitening products, wrinkle reducers).
What part of Medicare covers OTC?
Part D sponsors choosing to do so must account for the OTC costs under their administrative cost structure and provide them at no cost to their beneficiaries. Part D sponsors electing to offer OTCs must do so for the full contract year and cannot limit their use to certain phases of the benefit.
Is OTC cheaper than prescription?
Q: Is it cheaper to buy a medication over-the-counter? A: Not always. OTC medications are generally not covered by health insurance plans and can be expensive. It may be easier to buy OTC medication if you do not have insurance that covers prescriptions.
What household items can I buy with my OTC card?
- Nicotine replacement therapy items.
- Band aids and first aid supplies.
- Food scales.
- Oral hygiene care products.
- OTC antibiotic creams/ointments.
- OTC antihistamines and allergy sprays.
- OTC cold/cough/flu drugs.
- OTC pain relievers.
How do I get my OTC balance?
Use the My Benefit portal to view your OTC balance, search eligible items or find participating retailers near you or available online. If the scanned/entered item is discounted, the savings will be displayed. View available discount offers, at www.myotcoffers.com.
Do OTC benefits roll over?
A quarterly OTC spending allowance is pre-loaded to your Benefits Prepaid Card on the first day of each quarter. Unused amounts rollover to the next quarter but must be used by the end of the calendar year.
Can people on Medicaid get an OTC card?
' Both MA's and Medicaid plans' coverage of OTC products is typically provided via an OTC card with a pre-determined dollar limit. MA and Medicaid beneficiaries can then redeem the OTC card for certain products either through an MA OTC benefit catalog or at specified retailers.
What products are considered OTC?
- Pain relievers and fever control medicine (e.g., acetaminophen, ibuprofen)
- Decongestants (e.g., Sudafed*)
- Expectorant (e.g., Mucinex, Robitussin)
- Antihistamines (e.g., Benadryl)
- Saline nasal spray.
- Cough drops.
Is deodorant OTC approved?
Anti-perspirants/Deodorants
The anti-perspirant component still requires an approved aluminum compound as the active ingredient. Because of this, all anti-perspirant/deodorant products are considered OTC drugs and are regulated by the FDA.
How do I get an OTC card from Medicare?
To receive an OTC card, you need to enroll in a Medicare Advantage plan that includes this benefit. The card is usually provided automatically once you're enrolled in the Medicare Advantage plan, with details on how to use it.
What are the 6 things Medicare doesn't cover?
- Eye exams (for prescription eyeglasses)
- Long-term care.
- Cosmetic surgery.
- Massage therapy.
- Routine physical exams.
- Hearing aids and exams for fitting them.
How much is Medicare OTC benefit?
OTC benefits are typically structured on an allowance basis where an enrollee is provided an allotted annual, quarterly, or monthly allowance with quarterly allowances being the most common. On an annualized basis, the average allowance per enrollee in 2021 was $400.
Can I use my OTC card at Walmart for food?
OTC Food Benefit Card
You can use this card at the following participating retailers: CVS, Walgreens, Family Dollar, Dollar General, and Walmart. You will a receive gray colored OTC card, similar to the example shown, with a maximum $20 monthly limit for purchasing the approved food items items.
Is shampoo an OTC item?
Examples of OTC drug products include, sunscreen, antidandruff shampoo, acne care, and hand sanitizer. These designations are not mutually exclusive as a product can be both cosmetic and OTC when it has two or more intended uses. For example, an anti-dandruff shampoo will claim to both cleanse hair and treat dandruff.
Can I buy coffee with my OTC card?
Items that do not qualify include non-food and pet items, alcohol, baby formula, candy, chips, coffee shop items, desserts, fresh baked goods, soda, and tobacco. To check if an item is approved, members can download the Healthy Benefits Plus app, scan the product and it will advise if item is allowable.
What is Walmart OTC benefit?
With this benefit, you'll receive $50–$155* each calendar quarter to spend on approved over-the- counter (OTC) health-related items. Choose from thousands of items in-store, online, or through our catalog. or use the Walmart app. Mail an order form directly to Walmart.
What is OTC cash withdrawal?
“Cash over counter,” also known as “over-the-counter (OTC) cash withdrawal,” is a financial service that allows individuals to withdraw cash directly from a bank or financial institution's counter, as opposed to using an ATM or other automated methods.
How do I know what I can buy with my OTC card?
- Allergy relief support.
- Cough and cold relief support.
- Dental care.
- Digestive care, including antacids and laxatives.
- Ear care.
- Eye care.
- First aid and medical supplies.
- Pain relief support.