OTC Benefit Changes for 2026: What Medicare Members Need to Know

What Changed for 2026

Medicare Advantage plans update their OTC benefits annually. For 2026, several major insurers increased allowance amounts, expanded product catalogs, and added new ordering options. Here's what you need to know.

Increased Allowances

• Industry trend: Most major insurers increased OTC allowances by 10-25% for 2026 as competition for Medicare Advantage enrollment intensifies
• D-SNP expansion: Dual-eligible Special Needs Plans saw the largest increases, with some plans now offering $300+ per quarter
• Supplemental benefits: Many 2026 plans added grocery/food allowances alongside OTC. Check if your plan includes both

Expanded Product Catalogs

• More health devices: Blood pressure monitors, pulse oximeters, and glucose meters are now covered by more plans
• Healthy food items: Some 2026 plans allow OTC benefits to be used for fruits, vegetables, and other healthy groceries
• Personal care expansion: More plans now cover personal hygiene items like soap, shampoo, and deodorant

New Ordering Options

• More retail partners: Dollar General and Family Dollar joined the OTC retail network for several major insurers in 2026
• Improved apps: Most insurers launched updated mobile apps with easier OTC ordering, real-time balance checking, and delivery tracking
• Same-day delivery: Select plans now offer same-day delivery through partnerships with Instacart and DoorDash in urban areas

How to Check Your Benefits

• Annual Notice of Change (ANOC): Your insurer sent this document in September 2025. It details all changes for 2026
• Evidence of Coverage (EOC): The full benefits document available on your insurer's website or by phone request
• Member portal: Log into your insurer's website to see your current allowance, balance, and eligible products

Action Steps

If you haven't used your Q1 2026 allowance yet, order now — it expires March 31. Then set a reminder for April 1 when your Q2 allowance becomes available. Don't leave free health products on the table.