If you’re enrolled in a Medicare Advantage plan, you may have access to an over-the-counter (OTC) benefit. In fact, nearly four out of five plans offer one. When used correctly, this benefit can cover the full cost of select OTC products — meaning no additional out-of-pocket expense for eligible items.
Even if you only use the benefit occasionally, a little planning can help you get more value from it. OTC benefits typically cover everyday essentials like cold medicine, toothpaste and pain relief products. They can also support broader wellness goals, such as keeping your first aid kit stocked or maintaining a steady supply of vitamins.
Below, you’ll find simple strategies to help you take full advantage of your OTC benefit.
OTC Benefit Basics
The OTC benefit is a common feature of many Medicare Advantage plans. It provides an allowance you can spend on eligible over-the-counter products at participating retailers or pharmacies. Some plans issue an OTC card that works like a prepaid card in approved stores.
Depending on your plan, you may receive a set dollar amount monthly, quarterly or annually. The amount and frequency vary by plan. Eligible items often include products in categories such as:
- Cough, cold and allergy relief
- Digestive health
- Eye and ear care
- First aid supplies
- Foot care
- Oral and dental care
- Pain relief support
- Skin care
- Vitamins and supplements
Why Don’t More People Use Their OTC Benefits?
Although many Medicare Advantage members have access to an OTC benefit, about 70% don’t use it. In some cases, people simply don’t realize they have the benefit, or may be unsure how it works and when to use it.
If you’re not certain whether your plan includes OTC coverage, call the customer service number on the back of your Medicare Advantage card and ask the following questions to avoid leaving unused dollars behind:
- Do I have an OTC benefit?
- How much is my allowance?
- How often does the benefit reset?
5 Tips for Using Your Medicare Advantage OTC Benefit Before They Expire
1. Review your plan materials and read the fine print – While OTC categories are often similar across plans, the specific items that qualify can vary. Some plans also limit how often you can place orders. Review your plan materials carefully and if anything is unclear, call your plan and ask questions. A quick conversation can prevent confusion later.
2. Plan ahead – Not all plans allow unused OTC dollars to roll over, and even when they do, it’s usually for a limited time. If you don’t use your allowance before it expires — monthly, quarterly or yearly — you lose it. Consider using your OTC benefit to restock regular item before your allowance resets. Pay attention to items running low and replenish them in time. Also, think seasonally (cold & flu supplies, allergy relief, year-round oral care and daily essentials).
3. Ask your PCP for recommendations – Your doctor understands your medical history and current needs. Let them know you have an OTC benefit and ask whether there are products that could support your care plan. OTC items can help manage chronic conditions and support overall wellness. Getting personalized suggestions ensures you’re choosing products that truly benefit your health.
4. Set reminders before your OTC benefits expire – Mark your calendar with your benefit reset date at the start of each year. Setting a reminder two weeks before expiration gives you time to shop without rushing.
5. Choose items that fit your routine – Many plans offer multiple ways to redeem your OTC benefit, including in-store and sometimes online options at participating retailers. If your redemption method doesn’t fit your lifestyle, you’re less likely to use it. Think about how often you shop and where it’s most convenient for you. It may take a few cycles to find your rhythm, but once it becomes a habit, using your OTC benefit will feel automatic.
The Bottom Line
Your Medicare Advantage OTC benefit is designed to support your everyday health needs. By understanding your plan, planning ahead and setting simple reminders, you can make sure you’re getting the full value available to you — and keeping essential health products within easy reach. If you are ever confused, ask your local pharmacist for help.
