March 2025

If you are a caregiver to someone who is 65 or older, you may worry about out-of-pocket health care costs. In addition to co-pays and prescription drug costs, another money drain is over-the-counter (OTC) medicine and products, such as vitamins and cold medicine.

Before you dip into your own wallet to help your loved one pay for OTC medicines, take a look at their Medicare plan. If your loved one has a Medicare Advantage plan, it may come with OTC benefits coverage.

About 80% of Medicare Advantage plans include an OTC benefit, according to the Consumer Healthcare Products Association. Members often get a set dollar amount to use for OTC products over a certain time period, such as every month or quarter.

The average OTC benefit allowance is about $400 each year, or $100 every three months, according to the Consumer Health Products Association. Depending on what plan your loved one chooses, they may get more or less.

How to check if a Medicare Advantage plan has OTC benefits?

First, ask your loved one whether they have a Medicare Advantage plan or an OTC benefits card. Health insurance companies mail out plan cards and documents outlining what the plan covers. They also send instructions on how to create an online portal.

Some also send a separate OTC benefits card pre-loaded with their OTC allowance. It works somewhat like a debit card. Common cards include Nations Benefits, OTC Network, or S3.

Every Medicare Advantage card looks different or goes by a different name, depending on the health insurance company. Most cards will have the plan’s name and logo and identifying information, such as the member’s name, plan number, and contact information.

Even if they have a Medicare Advantage card, you may not know if it covers OTC benefits. To check, do the following:

• Call the customer service number on the back of the card to find out about OTC benefits.
• Review the plan summary that was sent in the mail.
• Log onto the plan’s online portal to see what’s covered.

Making the most of OTC benefits

Medicare Advantage plans send out a catalog (sometimes called a formulary) of the OTC medicine and products they cover. The plan’s online portal may also list what items it will and won’t cover.

Common products OTC benefits cards may cover include:

• First aid supplies, such as bandages and gauze pads.
• Vitamins and supplements.
• Incontinence supplies, such as adult briefs.
• Dental care products, such as toothpaste, mouthwash, and floss.
• OTC medication for pain and fever, cough, cold and allergy, upset stomach, or other health issues. (If you’re taking any prescription medications, ask your pharmacist about potential interactions with OTC products.)
• Medication management supplies, such as pill boxes or splitters.
• Leg and foot care products, including orthotic braces and orthopedic support.
• Skin health products, such as hand lotion or sunscreen.
• Eye and ear care products, such as eye or ear drops.
• Home medical and safety supplies, such as thermometers, nebulizers, bath seats, bath grab bars, raised toilets, canes, and walkers. Traditional Medicare may also cover some durable medical equipment.

How can you help someone use their Medicare OTC benefits?

To use the card, shop online or in person at a participating retailer that accepts OTC benefit cards, including your local independent pharmacy. Caregivers can shop for a loved one with OTC benefits but may be asked to provide the member’s health plan card or their name and date of birth to checkout.

How can you get Medicare Advantage OTC benefits?

Your loved one can sign up for Medicare coverage, including a Medicare Advantage plan, three months before or after turning 65. Otherwise, they will have to wait until Medicare Open Enrollment, which runs from October 15 to December 7 each year.

OTC benefits are just one of many variables to consider when choosing Medicare coverage. Whatever plan you choose, understanding exactly what it does — and doesn’t — cover is the key to selecting the plan that’s right for you.