Medicare OTC Benefit Changes for 2026: What's New

What's New for OTC Benefits in 2026

Medicare Advantage plans continue to expand their OTC benefits. Here are the key changes for 2026 that could affect your coverage.

Higher Allowances

Many plans increased their quarterly OTC allowances for 2026:

• Average increase: 10-15% higher than 2025
• Top-tier plans: Some now offer $200+ per quarter
• Competition effect: Plans are using OTC benefits as a key differentiator to attract enrollees

Expanded Product Lists

Several categories were expanded in 2026:

• OTC hearing aids — more plans now include them
• Home health devices — blood pressure monitors, pulse oximeters
• Healthy food items — some plans now include healthy groceries in OTC benefit
• Mental health supplements — stress relief, sleep aids expanded

More Online Ordering Options

Plans are making it easier to order online:

• Improved mobile apps for browsing and ordering
• Same-day delivery through partnerships with Amazon and Instacart
• Better product descriptions and eligibility checking tools

Dual-Eligible Member Extras

Members who qualify for both Medicare and Medicaid (dual-eligible) may receive even higher OTC allowances in 2026, with some plans offering up to $300 per quarter.

How to Switch Plans

If your current plan's OTC benefit isn't competitive, you can switch during the Annual Election Period (October 15 - December 7) or, if you qualify, during special enrollment periods throughout the year.