New to Medicare OTC Benefits? Your Complete Starter Guide

Welcome to Your OTC Benefit

If you just enrolled in a Medicare Advantage plan with OTC benefits, congratulations — you have access to free health products every quarter. This guide walks you through everything you need to know to start using your benefit right away.

Step 1: Understand Your Benefit

• Check your plan documents: Your Evidence of Coverage (EOC) lists your exact OTC allowance amount and what's covered
• Know your amount: Most plans offer $25-$200 per quarter. Some D-SNP plans offer $300+
• Quarterly reset: Your allowance resets every quarter (Jan 1, Apr 1, Jul 1, Oct 1). Unused amounts do NOT roll over

Step 2: Activate Your Card

• Your OTC card: Most plans mail you a benefits card. It may arrive separately from your member ID card
• Activation: Some cards need activation by phone or online before first use. Check the instructions that came with your card
• PIN setup: You may need to set a PIN for in-store purchases. Your plan's customer service can help

Step 3: Browse and Order

• Online catalog: Visit your plan's OTC website (listed on your card or in your welcome materials) to browse eligible products
• In-store: Many plans let you shop at CVS, Walmart, Walgreens, or Dollar General using your OTC card
• By phone: Call the OTC hotline number on your card to place orders with an agent

Common New Member Mistakes

• Waiting too long: Don't wait until the end of the quarter — shipping takes 5-10 business days
• Not checking the catalog: Not everything in the store is eligible. Only items in your plan's OTC catalog are covered
• Forgetting quarterly deadlines: Set calendar reminders for the first of each quarter
• Not using the full amount: Many members leave money on the table. Use it all — it's part of your plan's value