Benefits Nov 8, 2024

Why an OTC Benefit Is a Top Medicare Advantage Perk

Whether it’s a BOGO at the grocery store or free appetizer at a restaurant, everyone loves a bonus. Wouldn’t it be nice to get perks from your health insurance plan too?
Senior man visits with a pharmacist.

If you’re 65 or older, you’ll find that most Medicare Advantage Part C plans offer a variety of extra benefits; some even include an allowance for over-the-counter (OTC) products. This benefit pays for items you need to maintain your health and independence, leaving you more money for other expenses.

What Do Over-the-Counter Benefits Cover?

Items you can purchase using your OTC benefit run the gamut of health and wellness products. Some examples include:

  • Antacids
  • Bath chairs and other medical equipment
  • Cold and allergy medicines
  • First-aid supplies
  • Incontinence supplies
  • Pain relievers
  • Toothbrushes
  • Vitamins and supplements

Your plan may have a wide selection of brands and sizes or limit what you can purchase. If you use specific products regularly, it’s a good idea to find out ahead of time if they’re on your plan’s “approved” list.

You may also find Medicare Advantage plans that offer a more flexible benefit for things like groceries and other expenses. These plans are typically for people who meet certain requirements related to health condition or income.

How Much Is a Typical OTC Benefit?

OTC benefits vary widely depending on the specific plan. You may receive allowances on a monthly, quarterly or yearly basis. Some plans allow any unused allowance to “roll over” and add up from month to month or quarter to quarter, while others do not. Be sure to find out so that you’re not leaving any money on the table.

How Do You Use Your OTC Benefit?

You may be able to purchase items in certain stores, online or over the phone. Many plans offer all three options.

The most important thing with an OTC benefit is to remember it’s there. You’d be surprised how many members forget to use their allowance. If the unused funds don’t roll over, you lose them.

To be sure you’re getting the most out of this benefit, think about the products you need on a routine basis and plan your spending. Not sure what to purchase? Ask your doctor if there are certain items they recommend to help you stay healthy. A home blood pressure monitor, for example, or a certain supplement.

How Do You Know If Your Medicare Advantage Plan Offers an OTC benefit?

Many members aren’t aware of their OTC benefits. To find that information:

  • Check your evidence of coverage documents
  • Look at your benefits online, if your plan offers that ability
  • Call your health plan and ask

Knowing your benefits is also important because they can change from year to year. Any plan changes for the upcoming year will be listed in your Annual Notice of Changes, which comes out every September.

Pro tip: Mark your calendar each fall to review your plan coverage. Not only will you be in a better position to make the most of your current benefits—you’ll also have time to decide if you want to stay where you are or switch to a new Medicare Advantage plan.

OTC Benefits With SCAN Medicare Advantage Plans

SCAN offers many Medicare Advantage plans. Across them, you’ll find a wide range of supplemental benefits, including dental, vision and hearing coverage. More than 90% of our plans also include an OTC benefit, with allowance amounts varying by plan and location.

Using your SCAN OTC benefit is easy. You’ll receive an OTC card preloaded with your allowance in the mail. Use your card as you would any credit card at CVS Pharmacy stores across the U.S. Your balance will refill automatically either monthly or quarterly, depending on your plan.

Want all your OTC benefits at your fingertips? Download our OTC Health Solutions mobile app, which lets you:

  • Check your balance
  • Look at available items
  • Place an order
  • Review past orders

You can also check your balance and manage your benefits online at cvs.com/benefits or by calling Health Solutions at 1-844-428-8135 (TTY: 711).

SCAN Flexible Spending Benefits

Certain SCAN plans provide an enhanced benefit for OTC products and other expenses. Depending on your plan, this flexible spending benefit may include:

  • Groceries
  • Dental, vision and hearing expenses
  • Fitness activities
  • Utility bills

You can use your OTC card for any eligible expenses. In addition to CVS Pharmacy stores, you can spend your allowance at many retail stores, such as Walmart, Family Dollar and many grocery chains.

Learn More About SCAN

SCAN’s OTC and flexible spending benefits reflect our commitment to supporting our members’ health and wellbeing. To find out which plans offer these benefits, use our online search tool.

You can see all the plans available in your area and compare options.

You can also contact us for more information at:

  • 1-800-559-3500 (TTY: 711) for current SCAN members
  • (877) 452-5898 TTY: (888) SCAN-TTY for non-members
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