As healthcare costs rise, Medicare Advantage plans have introduced benefits aimed at helping seniors manage expenses more effectively. One such benefit is the over-the-counter (OTC) allowance, which provides enrollees with funds they can use to purchase health-related items that don’t require a prescription.
Let’s dive into what OTC allowances are, how much they can offer, some essential items that can get covered and tips for finding a plan with OTC benefits.
An OTC allowance is a benefit included in many Medicare Advantage plans that allows members to purchase certain healthcare products without out-of-pocket costs. This benefit is designed to cover non-prescription health items that can promote overall well-being, support preventive care, and assist in managing chronic conditions.
How this allowance is issued depends on the Medicare Advantage plan. However, most plans provide a prepaid benefits card to qualified beneficiaries, which can be used like a debit card to purchase approved items.
These allowances can be provided yearly, quarterly, or monthly, depending on the plan. Members can use the funds to buy products directly from a list of approved items. These items may range from vitamins and pain relievers to first aid supplies and dental care products.
How Much is the OTC Allowance?
The amount of an OTC allowance varies greatly depending on the Medicare Advantage plan, but most plans seem to offer a range between $200 and $250 per quarter. That means, on average, consumers receive about $150 to $1,000 annually.
Some plans may offer higher allowances based on factors such as location, plan tier, or extra benefits for specific health needs. Note that, for most plans, these amounts are “use it or lose it.” So, if you don’t spend the full allowance during the time period, the remaining balance does not roll over to the next period.
Tips for Finding Plans with OTC Allowances
If you’re interested in enrolling in a Medicare Advantage plan that offers an OTC allowance, there are a few strategies you can use to find a plan that meets your needs:
- Use Medicare’s Plan Finder: The Medicare Plan Finder tool (available at Medicare.gov) is a great resource for comparing Medicare Advantage plans in your area. You can filter plans to see which ones offer OTC allowances and compare them based on allowance amounts, premiums, and other benefits.
- Consult with an Insurance Broker: A licensed Medicare insurance broker can often help you navigate plan options and find one that includes OTC benefits. They are well-versed in the different benefits provided by various insurance carriers and can recommend plans tailored to your needs.
- Contact Medicare Advantage Providers Directly: Many insurance companies offering Medicare Advantage plans provide detailed information on their websites about the benefits they offer, including OTC allowances. It’s worth contacting these providers directly to confirm the specifics of their OTC program, such as allowance amounts, covered products, and how you can use the benefit.
- Look at Local Plans: Some OTC benefits may be specific to certain regions or plan tiers, so look at local plans available in your area to see what’s included. In some cases, smaller regional plans may offer more generous OTC allowances compared to larger, national carriers.
By Admin –
