Helping a Family Member Use Their OTC Benefit: Caregiver's Guide

Many Members Need Help

Nearly 40% of Medicare Advantage members rely on a family member or caregiver to help manage their benefits. If you're helping a loved one use their OTC benefit, here's how to do it effectively.

Becoming an Authorized Representative

1. Call the plan: Use the number on the back of the member's insurance card
2. Request authorization: Ask to be added as an authorized representative
3. Verify identity: The member will need to confirm verbally (or in writing if they can't speak by phone)
4. Get it in writing: Request written confirmation of your authorization

Ordering on Their Behalf

• Online: Log into their plan portal with their credentials (with permission)
• Phone: Call the OTC line, identify yourself as the authorized representative, and place the order
• In-store: Use their OTC card at approved retailers — you don't need to be the member to swipe the card

Tips for Caregivers

• Set quarterly reminders so the allowance doesn't expire unused
• Keep a running list of their regular health product needs
• Order in bulk at the start of each quarter when the balance resets
• Check with their doctor about which OTC products are most important for their conditions