How to use the OTC card: The Medicare Advantage card that does more than you think
Your Medicare Advantage plan may offer money to spend on common drugstore items. Here are step-by-step instructions for spending it at CVS®.
Here’s one great thing about being a senior. About four out of five Medicare Advantage plans will pay for some over-the-counter (OTC) products.1 Think of toothpaste, painkillers, supplements2 and other items that keep you healthy and thriving.
But, surprisingly, about 70% of that money goes unused every year.3 It could especially help the one in three older adults who struggle with health care expenses.4 Part of the reason it’s wasted may be that people don’t know how to use it.
Don’t let that hold you back. This friendly, step-by-step plan shows you how to spend your OTC benefit at CVS.
In this article:
What are OTC benefits?
Over-the-counter benefits — or OTC benefits — are offered to most Medicaid and Medicare Advantage members. They help pay for products that keep their members healthier.
While the list of products covered will vary from plan to plan, they include hundreds of common items. Most plans let you shop for those items at participating retailers, including CVS.
The amount you can spend also varies by plan. The average annual OTC benefit works out to about $100 per quarter. The window for spending the money varies, too. Most plans take a “use-it-or-lose-it” approach, which means you have to spend a certain percentage of your annual benefits every month or every three months.5
OTC benefits not only help you save — they can also keep you healthy. In one study, some people who used their OTC benefits showed better health progress for certain conditions.6
What is an OTC card?
When you have an OTC benefit you often receive a special card. That’s to help you use the benefits more easily. In most cases, this card is different from your main Medicare Advantage card — the one with the account number used at a provider’s office or a hospital.
Both cards are generally sent by mail. They might come with plan information and a booklet that contains OTC benefit instructions. Sometimes it arrives with a catalog of approved products. The OTC card may either come preloaded with a balance or require activation before use.
For some Medicaid and Medicare Advantage plans, the OTC card can be swiped as a form of payment or used on phone and online orders. Just use it like any prepaid card, with no PIN (personal identification number) or signature required. For other plans, you may need to provide your health plan membership ID to verify your OTC eligibility, or your name and date of birth.
How do I check the balance on my OTC card?
Once your card is activated, you should learn how to check your account details. You’ll especially need to check your balance and the amount you’ve used. Most cards have a toll-free number listed on the back of the card, which you can call to find out. The information might also be available on your plan’s website.
Make sure you check your balance often. This is not just to keep you from going over, but to make sure you’re spending all the money you deserve.
How do I check my “use-it-or-lose-it” period?
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. In January, you’ll get $100 to spend, and you’ll need to spend it by March 31. Then on April 1, you’ll get another $100 to spend. And so on.
The details should be in your onboarding materials, available by phone and on your plan’s website.
Once you know this window, it’s easy to set reminders. For instance, you can set an alert on your phone a week before the window ends. When it goes off, you’ve still got a few days to spend any dollars that remain. A sticky note on the refrigerator may work just as well.
How do I see which products are eligible for my OTC card?
Each OTC benefit plan is a little different. But most of them cover thousands of OTC products that help with your health and wellness. To get a sense of exactly what’s covered, it’s a good idea to check with your plan provider.
At CVS stores, the blue tags on the shelves can help. They mark some of the items commonly available in OTC plans.
Some commonly eligible categories include:
- Adult care incontinence items
- Allergy, cold and digestive relief support
- Dental and oral care products
- Eye and ear care
- First aid products
- Foot care
- Health care items like canes and walkers
- Vitamin and mineral supplements
How do I use my OTC card in stores?
You can shop in person at CVS. To start, create a checklist based on the items approved by your Medicare Advantage plan.
Most plans will give you a card to use at checkout. Head to the register with your chosen OTC items. The cashier will ring up your approved purchases. If the amount on the card isn’t enough to cover them, you’ll need to pay the balance out of pocket. Keep the receipt for your records.
What about the OTCHS plan?
Your Medicaid or Medicare Advantage plan may tell you that you belong to OTC Health Solutions. OTCHS members have an even easier time using their benefit with CVS, either in the store, online or by phone.
Available products are easy to spot. Blue tags on the shelves mark these items. In some stores, OTCHS eligible items are shelved together. Often physical catalogs are available, and you can also scan items with the OTCHS app to see if they qualify.
Once you’ve picked up the products you want, head to the register and give your name and date of birth. The cashier can check your balance at the register.
For online shopping, create an account using your member identification number. Your total at checkout will be taken from your benefits balance. If you prefer to order by phone, OTCHS shoppers can call 1-888-628-2770 (TTY: 711). OTCHS orders can be placed with a live agent most weekdays from 9 AM to 8 PM. An automated system is available 24/7.
Here’s a complete guide to the OTCHS program.
The OTC takeaway
Every plan is a little different, so it makes sense to learn about yours. In most, for example, you can’t make a return or exchange unless you receive a damaged item. And there may be quantity limits on single items, ranging from three to nine during a period.
Once you’ve got the “how to” under your belt, you’ll be ready to save. The OTC card can help your budget and help your health — so the sooner you master it, the better.
*This content is for informational purposes only and is not medical advice. Consult your health care provider before taking any vitamins or supplements and prior to beginning or changing any health care practices.
