OTC Medicare Drug Coverage

According to the Consumer Healthcare Products Association, the average American makes 26 trips per year to buy over-the-counter (OTC) products. As you age, this number may increase. This means you may be spending more on these products each year.

Every penny counts and understanding the products, drugs, and the role of a Medicare Advantage OTC pre-paid card can help you save in the long run.

Contact Us | Medicare Plan Finder
Contact Us | Medicare Plan Finder

What Are Over-the-Counter Medications?

These medications don’t require a doctor’s prescription to be purchased. They can help ease pains such as backaches, help prevent or treat illnesses such as athlete’s foot and allergic reactions, and help manage recurring issues such as migraines.

The most common over the counter medications are fever reducers, anti-inflammatories, allergy pills, and cold medicine.

OTC Medicare | Medicare Plan Finder
OTC Medicare | Medicare Plan Finder

Does Medicare Cover Over-the-Counter Drugs?

Original Medicare (Part A and Part B) does not cover over-the-counter products and medications. Some stand-alone Part D plans may cover the costs, but generally, a Medicare Advantage plan is your best option if this type of drug coverage is important to you.

Your Medicare Advantage plan provider should give clear instructions on how to utilize your allowance towards medications and products.

Oftentimes, your insurance carrier will provide a website or downloadable document that lists the eligible products/medications, instructions to purchase, and the details of the benefit. If you have any issues, feel free to contact a licensed agent here.

Medicare Advantage | Medicare Plan Finder
Medicare Advantage | Medicare Plan Finder

What Is Medicare Advantage OTC Card Coverage?

Certain Medicare Advantage plans offer beneficiaries a unique way to buy over the counter products: a pre-paid card! These cards can be used to purchase most OTC products and medications.

Once you exceed your allowance (average of $50-$100/month for most providers), the card is no longer valid until it is reloaded by your insurance provider. Most plans reload the cards to the set amount on a monthly basis and any previous balance will be lost.

What Can I Buy With My OTC Card?

Before you ask yourself, “What can I buy with my OTC card,” you should first look at your plan’s OTC catalog. Eligible products and medications may vary through your plan provider, but common eligible items include:

  • Acne aids
  • Cough, cold, and flu medications
  • Antibiotic creams
  • Bandages
  • Denture products
  • Digestive aids
  • Ear care
  • First-aid kits
  • Orthopedic support
  • Pain relievers
  • Sleep aids
  • Wart removal

Generally, these items are not covered:

  • Chapstick
  • Deodorant
  • Dietary supplements
  • Mouthwash
  • Perfume
  • Soaps
  • Teeth whitening products
OTC Medicare | Medicare Plan Finder
OTC Medicare | Medicare Plan Finder

Where Can I Use My Medicare Advantage OTC Card?

Stores and locations that accept your card will vary by provider. However, the following stores are included in most plans:

Medicare OTC Card Online Stores

Along with an extensive inventory of over-the-counter products in the stores, many of the major pharmacies listed above also have a mail-order feature so you can have many of your favorite OTC and even prescription items shipped straight to your door! You may be able to use your OTC card at the following online pharmacies*:

*This is not an exhaustive list of online pharmacies.

Medicare OTC Card Activation

Your card should come with information about how to activate it. If you’re unsure how to activate your card, contact your plan’s customer service center and ask about OTC card activation.

How to Check Your OTC Card Balance

For information about how to check your OTC card balance, go to the website your plan gave you. If you’re not sure how to access it, call your plan’s customer service center for help.

How Do I Save on My Prescriptions?

While a Medicare Advantage OTC benefit can certainly be a great perk to have, you’re probably still wondering how you can cut down on your prescription costs.

You may want to start by finding out if you’re eligible for “Extra Help,” a Medicare savings program for prescription drugs. Then, look at your current coverage and make sure you have the right plans for your needs. A licensed agent can help you.

Then, download our free prescription drug savings card. It works in many major pharmacies and is sort of like a coupon. Just show the card when you pick up your prescriptions, and your pharmacist can tell you whether or not your prescriptions can be cheaper with the card. It’s worth a try!

Medicare Plan Finder Tool

How Do I Get Medicare Advantage OTC Coverage and Prescription Drug Coverage?

Are you interested in getting OTC Medicare coverage? Our licensed agents are contracted with most major carriers in your state. There are countless plans that can fit your personal needs and budget all while having the additional benefit of over-the-counter drug coverage.

Already enrolled in a Medicare Advantage plan? You may unknowingly have this benefit already, and we want to help you use it. Call us today at 844-431-1832 or fill out this form to get started.

Find Medicare Plans | Medicare Plan Finder
Find Medicare Plans | Medicare Plan Finder

This post was originally published on January 17, 2019, by Kelsey Davis and updated on July 15, 2019, by Troy Frink, and November 12, 2020, by Anastasia Iliou.

Drug Price Transparency: Everything You Need to Know

Drug Price Transparency: Everything You Need to Know

The Henry J Kaiser Family Foundation estimates that $1 out of every $6 in Medicare spending is for prescription drugs. These medications play an important role in the health of 59 million seniors and Medicare eligibles. Drug price transparency is crucial in informing consumers and developing new strategies that address the issue of rising drug costs.

How is CMS involved?

Earlier this month, CMS proposed a new drug price transparency rule that was targeted at direct-to-consumer television advertising. This rule would require drug manufacturers to publish wholesale prices during commercials. This will allow beneficiaries to make informed drug purchasing decisions, especially beneficiaries with high deductibles and drug costs.

Direct-to-consumer television advertising can dramatically impact a beneficiary’s purchasing decisions. These commercials can spark informational discussions between beneficiaries and their health care providers, but understanding the costs is crucial when making a final decision.

State vs Federal Legislation

Several states across the US are implementing new bills and laws that require drug companies to not only report but also justify any dramatic increases in their drug prices. Since early August, there have been over 100 bills introduced into legislation addressing the different issues of drug price increases. 30 states have drafted a total of 60 drug price transparency bills.

States are feeling the pressure to improve the sustainability of their budget and promote coverage access to all of their residents. As the push for drug price transparency rises, more states may begin to explore new laws and federal legislation could be impacted. Many of these proposed changes are in the works and may be finalized in the near future.

How should you choose a pharmacy, doctor, or Part D plan?

Do you already have a primary pharmacy? Are you concerned about enrolling in a plan where your doctor is out of network?  Our agents at Medicare Plan Finder work with nearly every carrier in your state. Agents can help you enroll in the plan that best fits your needs, budget, and network requirements. Ready to learn more? Call us at 844-431-1832 or fill out this form to arrange a no-cost, no-obligation appointment with a top agent.

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