Who Qualifies for a Medicare OTC Card?
Medicare Advantage plans often include over-the-counter card benefits that help cover the cost of health and wellness products. These Medicare Advantage ancillary benefits provide a set amount of money to purchase eligible health and wellness items like vitamins, pain relievers, first aid supplies, and personal care products, so you don’t have to pay out of pocket.
Not everyone with Medicare qualifies for an over-the-counter card since they’re only offered as an extra benefit by Medicare Advantage plans. OTC card qualifications depend on your Medicare Advantage plan enrollment and the specific benefits your plan offers.
Key Takeaways
OTC benefits are available only through certain Medicare Advantage plans and are not available through Original Medicare.
The average annual Medicare OTC benefits are around $400 per year per enrollee.
Eligible products include over-the-counter medications, health supplies, and personal care items from approved retailers.
What is a Medicare OTC card?
A Medicare OTC card is a prepaid benefit card that Medicare Advantage plans provide to help members purchase over-the-counter health and wellness products. The card works like a debit card with a set dollar amount that reloads on a monthly or quarterly schedule.
Medicare Advantage plans offer OTC cards as an ancillary benefit beyond what Original Medicare covers. These benefits help reduce out-of-pocket costs for everyday health and wellness items.
How Medicare Advantage OTC cards work
Medicare Advantage plans provide OTC benefits that plan holders can use. When your plan issues an over-the-counter benefit, you receive a physical card or access to an online account with your allocated benefit amount. Kaiser is one insurance carrier that does not provide a physical card.
Your allowance resets each benefit period, which is likely either every month or quarter, and is determined by your plan. Most plans don't allow unused balances to roll over to the next period, though some plans may offer annual allowances with more flexibility.
Who qualifies for OTC cards?
Not all Medicare Advantage plans offer OTC cards, and benefit amounts vary significantly between plans. You are not necessarily eligible or ineligible for an OTC card—you will receive one if you’re on a Medicare Advantage plan that provides one as a benefit.
Medicare Advantage plan enrollment requirement
You must be enrolled in a Medicare Advantage plan that specifically includes OTC benefits. Original Medicare, Medicare Supplement Plans, and standalone Part D plans don't provide OTC cards.
To qualify for a Medicare Advantage plan, you need to maintain enrollment in both Medicare Part A and Part B. Learn more about Medicare Advantage enrollment.
Age and disability eligibility (65+ or qualifying disability)
Medicare Advantage eligibility follows the same age and disability requirements as Original Medicare. You qualify at age 65 or older, or under 65 if you receive Social Security Disability Insurance benefits for at least 24 months.
People with certain qualifying disabilities, including Lou Gehrig's disease (ALS), become eligible for Medicare immediately without the 24-month waiting period.
Geographic availability by plan and region
Medicare Advantage plans operate in specific service areas, and plans in one county may offer different benefits than plans in neighboring areas. As such, not everyone has access to plans that provide OTC benefits.
Urban areas typically have more Medicare Advantage plans available compared to rural regions. The Medicare OTC allowance amounts and eligible products also differ by plan, and plan availability depends on where you live.
Dual eligible beneficiary advantages
Beneficiaries enrolled in both Medicare and Medicaid (dual eligible individuals) often qualify for Medicare Advantage plans with enhanced OTC benefits. Many Dual Eligible Special Needs Plans (D-SNPs) include higher Medicare OTC allowance amounts as part of their benefit package.
Medicare Advantage plans that offer OTC benefits
Major Medicare Advantage carriers, including UnitedHealthcare, Humana, Aetna, and Wellcare offer plans with OTC benefits in many regions. However, benefit availability and amounts vary by plan.
Special Needs Plans (SNPs) designed for people with chronic conditions, dual eligibility, or institutional needs often include more generous allowances. These plans recognize that members may need additional support.
When comparing Medicare Advantage plans, review the Summary of Benefits document to find specific information about OTC card amounts, eligible products, and ordering processes. Plans can update their benefits annually, so OTC offerings may change during each Medicare Annual Enrollment Period.
OTC card benefit amounts and limits
The average Medicare Advantage OTC limit is around $400 per year, but each plan is unique. Most plans typically offer either monthly or quarterly limits.
Plans designed for dual eligible members or those with chronic conditions may provide higher quarterly allowances. The benefit amount appears in your plan's Summary of Benefits and Evidence of Coverage documents.
Many plans don't allow unused balances to carry over to the next benefit period. If you don't use your full quarterly allowance, the remaining balance typically expires when the new period begins. However, some plans offer annual allowances that provide more flexibility in timing your purchases throughout the year.
What you can buy with OTC cards
Medicare Advantage OTC benefits can be used to purchase a wide range of health and wellness products. Each plan has its own catalog of eligible items, and covered products may vary between plans.
Eligible over-the-counter medications
OTC cards typically cover common over-the-counter medications, including pain relievers like acetaminophen and ibuprofen, allergy medications, cold and flu medicines, digestive aids, and topical treatments.
Many plans also cover vitamins and supplements, particularly those commonly recommended for seniors such as vitamin D, calcium, and multivitamins.
Other eligible health and wellness products
Health monitoring supplies are popular items purchased by OTC benefit holders. Covered items often include blood pressure monitors, thermometers, glucose monitoring supplies, and pulse oximeters.
First aid supplies like bandages, antiseptic wipes, gauze, and medical tape are usually covered. Many plans also cover heating pads, cold packs, and compression wraps.
Personal care items and medical supplies
Personal care products eligible for OTC benefits usually include denture care supplies, oral health items like toothbrushes and toothpaste, incontinence supplies, and adult diapers.
Many plans cover basic medical supplies such as diabetic testing supplies, hearing aid batteries, and mobility aids, like canes or walkers. Bath safety items including shower chairs and grab bars may also qualify under some plans.
Items not covered by OTC benefits
OTC cards don't cover prescription medications, which require separate Part D coverage. Food items, beauty products, and cosmetics typically aren't eligible, even if sold at approved retailers.
Dietary supplements marketed for weight loss or athletic performance generally aren't covered. Each plan defines specific exclusions in their OTC catalog.
Maximizing your OTC card benefits
Review your plan's OTC catalog to understand which products qualify and identify items you use frequently. Planning your purchases around your benefit period helps ensure you use your full allowance before it resets.
Plans allow online ordering with home delivery, which provides convenience and helps you easily shop from the complete catalog of eligible items. You can also use the Chapter OTC app to order eligible items with ease.
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Stock up on regularly used items like vitamins, pain relievers, and personal care supplies during each benefit period, especially if you have no specific needs. For plans with quarterly allowances, create a shopping list at the start of each quarter to maximize your benefits.
Finally, if you have unused balance near the end of your benefit period, consider purchasing items with longer shelf lives or supplies you'll need in coming months. The Chapter OTC app can send you reminders so you never let OTC dollars go unused again!
Bottom line
OTC card benefits provide valuable savings on health and wellness products for eligible Medicare Advantage plan members. Meeting OTC card qualifications requires enrollment in a Medicare Advantage plan that includes this supplemental benefit, with availability and amounts varying by plan and location.
Compare Medicare Advantage plans during the Annual Enrollment Period to find coverage that fits your needs and preferences, including an OTC benefit if that’s important to you.
Not sure which Medicare Advantage plan is right for you? Give us a call at (855) 900-2427 or schedule a free consultation to discuss when to enroll in Medicare, which coverage is best for you, and how to get the most value from your Medicare insurance.
FAQs
Do all Medicare Advantage plans offer OTC cards?
No, not all Medicare Advantage plans offer OTC cards. It’s important to check your plan closely to understand each plan’s OTC benefit, including the dollar amounts provided.
How much money do you get on an OTC card?
The average Medicare Advantage plan has a $400 annual OTC benefit. OTC card amounts typically range from $25 to $200 per quarter, depending on your specific Medicare Advantage plan. Some plans provide monthly allowances instead, generally between $15 and $50. Special Needs Plans may offer higher amounts.
Can I use my OTC card at any pharmacy?
Plans generally contract with major pharmacy chains and some grocery stores. You will need to look up which retailers accept your plan’s OTC benefit.
What happens to unused OTC card money?
Most Medicare Advantage plans don't allow unused OTC balances to carry over to the next benefit period. If you don't use your full quarterly or monthly allowance, the remaining balance typically expires when the new period begins. Some plans offer annual allowances with more flexibility.
Do I automatically get an OTC card with Medicare?
No, OTC cards are not automatic with Medicare enrollment. You must enroll in a Medicare Advantage plan that specifically includes an OTC benefit. Original Medicare and Medicare Supplement plans don't provide OTC cards.
Can I buy prescription medications with my OTC card?
No, OTC cards only cover over-the-counter products that don't require a prescription. Prescription medications require coverage through Medicare Part D.
Sources
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Centers for Medicare & Medicaid Services. (2025). Medicare and You 2026. Retrieved from https://www.medicare.gov/publications/10050-medicare-and-you.pdf
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Centers for Medicare & Medicaid Services. (n.d.). Special Needs Plans (SNP). Retrieved from https://www.medicare.gov/health-drug-plans/health-plans/your-health-plan-options/SNP
Kaiser Family Foundation. (2025, Apr 10). Most people in rural areas get Medicare coverage from traditional Medicare. Retrieved from https://www.kff.org/medicare/most-people-in-rural-areas-get-medicare-coverage-from-traditional-medicare/
Medicare Interactive. (2025, March 31). How to enroll in Medicare if you have ALS. Retrieved from https://www.medicareinteractive.org/understanding-medicare/health-coverage-options/original-medicare-enrollment/how-to-enroll-in-medicare-if-you-have-als
Medicare Interactive. (2025, April 3). Medicare Advantage eligibility for people with ESRD. Retrieved from https://www.medicareinteractive.org/understanding-medicare/health-coverage-options/medicare-and-end-stage-renal-disease-esrd/medicare-advantage-eligibility-for-people-with-esrd
UnitedHealthcare. (n.d.). Dual Special Needs Plans. Retrieved from https://www.uhc.com/medicare/shop/dual-special-needs-plans.html