7 Common Mistakes People Make With Their Medicare OTC Benefit

Don't Leave Money on the Table

Studies show that nearly 40% of Medicare Advantage members don't fully use their OTC benefit each quarter. Here are the 7 most common mistakes — and how to avoid them.

Mistake #1: Not Using Your Benefit at All

Many members don't even know they have an OTC benefit! Check your plan's Evidence of Coverage or call your carrier to find out your quarterly allowance amount.

Mistake #2: Letting the Quarter Expire

OTC benefits reset quarterly (January, April, July, October). Unused amounts do NOT roll over. If you have $75/quarter and don't use it by March 31, that $75 is gone forever.

Mistake #3: Buying Non-Eligible Products

Not everything in the health aisle qualifies. Cosmetics, beauty products, and food items are typically excluded. Always check your catalog or call the OTC line to verify before shopping.

Mistake #4: Only Shopping at One Store

Different retailers have different prices. A blood pressure monitor might be $30 at one store and $22 at another. Compare prices between Walmart, CVS, Walgreens, and Dollar General.

Mistake #5: Ignoring Store Brands

Store-brand OTC products have the same active ingredients as name brands but cost 30-50% less. Your $75 allowance buys $100+ worth of products when you choose store brands.

Mistake #6: Not Tracking Your Balance

Keep track of how much you've spent and how much remains. Call the number on your card or check your carrier's app/website for real-time balance.

Mistake #7: Waiting Until You're Sick

Don't wait until you need cold medicine to use your benefit. Stock up on preventive products — vitamins, first aid supplies, and monitoring devices — while you're healthy.