Medicare OTC Benefit Changes for 2026: What's New This Year
2026 OTC Benefit Updates
Medicare Advantage plans adjust their OTC benefits annually. Here are the most important changes for the 2026 plan year that affect your allowance and shopping options.
Higher Allowances
Competition among MA plans has driven OTC allowances higher in 2026. The average quarterly allowance increased from $65 to $85 across major carriers. Some premium plans now offer $200+ per quarter.
Expanded Product Categories
- OTC hearing aids: More plans now cover OTC hearing devices (since FDA's 2022 rule)
- Continuous glucose monitors: Select plans cover OTC CGM devices
- Home health testing: COVID, flu, and strep tests remain covered
- Digital thermometers: Smart thermometers with app connectivity now eligible
Retail Network Changes
- Amazon partnership: Some UHC plans now allow OTC orders through Amazon Pharmacy
- Dollar Tree added: Several carriers added Dollar Tree to their retail network
- Instacart delivery: Select plans offer Instacart integration for OTC delivery
What Hasn't Changed
- Unused balances still do NOT roll over between quarters
- Products must be from the approved catalog — not all store items qualify
- You still cannot use your OTC benefit for prescription medications
Action Item: Review your 2026 Evidence of Coverage document to see your specific plan's changes. Many members have higher allowances than they realize!