Who qualifies for an OTC card?
Asked by: Kristina Bergstrom III | Last update: June 6, 2025Score: 4.2/5 (34 votes)
How do I know if I qualify for an OTC card?
You'll need to be enrolled in a Medicare Advantage plan that offers the OTC benefit. Once you're enrolled, your plan should provide you with the card automatically. If you're not sure if your plan includes this benefit, it's a good idea to check with your plan provider or review your plan's summary of benefits.
Who can get the OTC benefit?
*FOR OVER-THE-COUNTER BENEFITS AT NO ADDITIONAL COST: Over-the-counter (OTC) allowance benefits are included in select Medicare Advantage and Medicaid plans. The allowance may only be applied to select OTC products. Allowance amount may vary by plan.
Can you get an OTC card on Medicaid?
In some states, Medicaid beneficiaries may need a prescription or need to meet other requirements for an OTC product to be covered. In both MA and Medicaid, OTC benefits are typically provided through an OTC card that has a set dollar limit.
How do I get money on my OTC card?
Depending on the health plan, funds are loaded or reloaded to the card on a monthly, quarterly or annual basis. OTC funds not used during the allotment period are lost and do not roll over to the next period, unless the health plan specifically allows for a rollover period.
Medicare Advantage OTC Card
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 groceries can you buy with an OTC card?
Examples of approved food items are fruits, vegetables, meats, poultry, seafood, eggs, dairy, rice, pasta, beans, and much more.
Can I get 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 OTC drugs are covered by Medicaid?
These OTCs include select medications in the following categories: analgesic and antipyretic, antacid, anti-diarrheal, antihistamine, anti-vertigo, artificial tears and ocular/oral lubricants, chronic renal disease, cough and cold, dermatological, family planning, fecal softener and laxative, hematinic, insulin, ...
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.
Can I buy laundry detergent with my OTC card?
Use your $25 a month to get items like baby wipes, allergy products, pain relief medicine and more. You can also get everyday items like laundry detergent, soap and toothbrushes.
Will Medicare pay for OTC?
Most Medicare Advantage plan members receive a quarterly OTC benefit allowance to cover health and wellness products, non-prescription medications, vitamins, and more.
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.
How much is the 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.
What qualifies as OTC?
Refers to a medicine that can be bought without a prescription (doctor's order). Examples include analgesics (pain relievers), such as aspirin and acetaminophen. Also called nonprescription and OTC.
How does OTC allowance work?
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.
Who qualifies for OTC card Medicaid?
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.
What does an OTC card not cover?
OTC items are not eligible for reimbursement if they are normally used for general health, are not used to treat a medical condition (e.g. toothpaste, mouthwash, lotion, shampoo) or are cosmetic in nature (e.g. teeth whitening products, wrinkle reducers). See additional examples in the OTC Chart.
Does Medicaid pay for Tylenol?
Medicaid does cover over-the-counter (OTC) drugs if the patient has been given a doctor's prescription for the drug verbally, in writing, or via an electronic message. In order to be covered, over-the-counter drugs have to be manufactured by a pharmaceutical company that participates in the Federal Drug Rebate Program.
What groceries can you buy with OTC card?
- • Fresh fruits and vegetables. • Canned fruits and vegetables. • Frozen produce and meals.
- • Fresh salad kits. • Dairy products. • Meat and seafood.
- • Beans and legumes. • Pantry staples – flour, sugar, spices, etc. ...
- • Nutritional shakes and bars. • Soups.
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 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.
Does an OTC card cover bread?
You can use your food credits to buy thousands of approved foods. Use the handy list below to help you shop for foods that qualify. Pantry staples - flour, sugar, spices, etc. Healthy grains - bread, cereals, pastas, etc.
What can I buy with my UCard at Walmart?
- Braces and supports.
- Dental and oral care.
- Diabetes care.
- Eye and ear care.
- First aid.
- Foot care.
- Incontinence products.
- Pain relief.
Does Amazon accept an OTC card?
No, members cannot shop directly on amazon.com or use the Amazon mobile app to purchase products using their OTC credit or UCard. Do members need an Amazon Prime account to purchase products? No, members do not need an Amazon Prime account to purchase products.