Medicare Advantage Over-the-Counter (OTC) Cards

An OTC benefit card is a prepaid card loaded by your Medicare Advantage plan with a set dollar amount each month or quarter. You can use it to purchase approved over-the-counter health products at participating retailers, either in-store or through an online catalog. Original Medicare (Parts A and B) does not include this benefit, so it is only available to people enrolled in a Medicare Advantage plan.

In 2026, the OTC benefit landscape has shifted. Fewer plans are offering OTC allowances compared to 2025, and CMS policy changes have separated OTC credits from healthy food and utility credits for the first time. Below, we break down how much plans are offering, what you can buy, what changed, and how to make the most of your benefit.

How Much Is the OTC Benefit in 2026?

OTC card allowances vary significantly depending on your carrier, plan type, and whether you are enrolled in a standard Medicare Advantage plan or a Dual Special Needs Plan (D-SNP). The average Medicare Advantage plan provides approximately $400 per year in OTC benefits, but individual plans range from $25 per quarter to over $250 per month.

What Changed with OTC Benefits in 2026? (VBID Ending)

One of the biggest changes for 2026 involves the end of the CMS Value-Based Insurance Design (VBID) model. Through 2025, this program allowed Medicare Advantage plans to bundle OTC credits, healthy food allowances, and utility bill assistance into a single benefit card. Starting in 2026, CMS ended the VBID model and plans now use the Special Supplemental Benefits for the Chronically Ill (SSBCI) program instead.

Here is what this means for you:

• OTC-only credits are still available without any condition verification. If your plan offers an OTC allowance, you can spend it on approved health products just like before.

• Healthy food and utility bill credits now require chronic condition verification. To use your card for groceries or utility payments, you must have a qualifying chronic condition confirmed by your plan.

• Qualifying conditions include diabetes, chronic high blood pressure, cardiovascular disease, chronic high cholesterol, and chronic heart failure (among others).

• Your plan may verify your condition automatically using claims data, or they may ask you to complete a verification form and provide your physician's contact information.

What Can You Buy with an OTC Card?

Eligible items vary by plan, but most OTC benefit cards cover a broad range of health and wellness products. The following categories are commonly approved across carriers:

• Pain relievers (acetaminophen, ibuprofen, aspirin)

• Cold, flu, and allergy medications

• Vitamins, minerals, and dietary supplements

• First aid supplies (bandages, antiseptic wipes, gauze, medical tape)

• Blood pressure monitors and glucose testing supplies

• Dental care products (toothbrushes, toothpaste, mouthwash, denture adhesive)

• Eye drops, reading glasses, and vision care products

• Hearing aid batteries

• Skin care products (sunscreen, moisturizers, anti-itch creams)

• Digestive health products (antacids, fiber supplements, probiotics)

• Incontinence supplies (pads, protective underwear)

• Thermometers and pulse oximeters

Items that are typically not covered include cosmetics, food or beverages (unless your plan has a separate food benefit), cleaning supplies, and prescription medications. Always check your plan's OTC catalog for the complete list of approved products.

Where Can You Use Your OTC Card?

Most OTC benefit cards are accepted at major national retailers. The specific stores depend on your carrier and plan, but common options include:

• CVS Pharmacy

• Walgreens

• Walmart

• Rite Aid

• Dollar General (select plans)

• Online OTC catalogs (NationsBenefits, OTC Health Solutions, or your plan's member portal)

Many plans now offer online ordering with home delivery, which is especially convenient if you have mobility limitations or live in a rural area. Check your plan's Summary of Benefits or call the member services number on your ID card for the full list of participating locations.

Tips to Maximize Your OTC Benefit

Research shows that only about 30% of Medicare Advantage members actually use their OTC allowances. That means roughly 70% of eligible members are leaving money on the table. Here are some tips to make sure you get the full value of your benefit:

1. Set a calendar reminder at the start of each month or quarter so you do not forget to spend your allowance before it resets.

2. Stock up on essentials you use regularly, such as vitamins, dental supplies, and first aid items.

3. Check whether your plan allows online ordering, which often has a wider selection than in-store purchases.

4. Review your plan's OTC catalog each year because eligible items can change.

5. If your allowance was reduced for 2026, compare plans during the Annual Enrollment Period (October 15 to December 7) to find a plan with a better OTC benefit.

How to Check Your OTC Balance

You can check your remaining OTC balance in several ways depending on your carrier:

• Log in to your plan's member portal or mobile app (UnitedHealthcare members use the UHC app, Aetna members use the Aetna Health app, etc.)

• Call the member services number on the back of your OTC card or insurance ID card

• Visit the NationsBenefits or OTC Health Solutions website if your plan uses one of these platforms

• Check the receipt from your last OTC purchase, which often shows the remaining balance

Frequently Asked Questions