The Medicare OTC Card Explained: What It Is and Who Can Get One

What is a Medicare OTC card and how does it work?

An OTC (over-the-counter) benefit is a supplemental benefit that some Medicare Advantage plans offer. It usually works as a dollar allowance the plan sets, loaded onto a plan-issued debit-style card and tracked by the plan. CMS uses the example of an enrollee with a $100 monthly OTC benefit spending $90 of it.

Despite the common name, it is not a card issued by Original Medicare or the federal government. Original Medicare (Part A and Part B) does not provide an OTC card or allowance. The 'Medicare' in the name simply means the benefit comes through a private Medicare Advantage plan that contracts with Medicare.

Because each plan designs its own benefit, the allowance amount, how often it refills, the approved item list, and where you can shop all vary. Always confirm the details in the plan's Evidence of Coverage.

• Type of benefit: an optional extra (supplemental) benefit, not core Medicare coverage
• How it's delivered: a plan-set dollar allowance, often on a plan-issued card
• Who sets the rules: the individual Medicare Advantage plan, not the government
• Bottom line: a benefit of some Part C plans, not a card you get just for having Medicare

Which Medicare plans offer an OTC card (and which don't)

Only Medicare Advantage (Part C) plans can offer an OTC benefit, and not all of them do. Most Medicare Advantage plans include extra benefits Original Medicare doesn't cover, such as vision, hearing, dental, and over-the-counter items, but the specifics differ by plan.

Original Medicare and Part D do not cover OTC items. Over-the-counter drugs are excluded from Part D drug coverage. Part B generally covers only drugs that are not usually self-administered, and because OTC medicines are self-administered, Part B does not cover them either.

• Medicare Advantage (Part C): may offer an OTC allowance — varies by plan
• Original Medicare (Part A and Part B): no OTC card or allowance
• Part D drug plans: OTC drugs are not covered Part D drugs
• Special Needs Plans (SNPs): a type of Medicare Advantage plan for people with specific conditions or characteristics; benefits including OTC are tailored to that group
• Dual Eligible SNPs (D-SNPs): for people with both Medicare and Medicaid; many pair OTC allowances with Medicaid benefits — confirm amounts in your plan documents

How much you get, what you can buy, and whether it rolls over

The allowance amount is set by each plan. CMS's own illustration uses a $100 monthly OTC benefit as an example, but real plans range widely — confirm your plan's exact amount in its Evidence of Coverage. Approved items are typically everyday health products such as pain relievers, cold and allergy medicine, vitamins, first-aid supplies, and similar over-the-counter goods, with the specific list set by the plan.

Whether unused money rolls over or expires depends entirely on the plan. Many OTC allowances reset on a schedule (for example, monthly or quarterly) and unused amounts may be lost. CMS had finalized a rule requiring Medicare Advantage plans to send a personalized mid-year notice of unused supplemental benefits (which could include the OTC allowance), but CMS rescinded that requirement before it took effect, so you should not count on receiving such a notice. The safest approach is to track your own balance through your plan's card portal, app, or member services.

Where you can use the card also varies: some plans allow purchases at participating retail stores, some offer online or mail-order catalogs, and some combine methods. Check your plan for the approved retailers and ordering options.

• Amount: plan-set; CMS example is $100/month, but real amounts vary — check your plan
• Items: typically OTC health products; the approved list is defined by the plan
• Rollover: depends on the plan; many allowances reset and may not carry over
• Where to shop: participating stores, online, and/or mail order — varies by plan
• Tracking: plans are not required to send a mid-year unused-benefits notice, so check your balance via the plan portal or member services

OTC cards vs. flex cards, food allowances, and chronic-illness benefits

An OTC card is not automatically the same thing as a 'flex card' or a grocery/food allowance, though they can overlap. Plans are allowed to combine multiple supplemental benefits onto a single card — for example, one card carrying both an OTC allowance and a food or produce allowance. The term 'flex card' is marketing language used by some plans, not an official Medicare benefit.

Some expanded OTC and food allowances are offered only to enrollees with qualifying chronic conditions, under Special Supplemental Benefits for the Chronically Ill (SSBCI). These benefits must have a reasonable expectation of improving or maintaining the enrollee's health or function, and CMS limits what they can cover (for example, excluding non-healthy food, alcohol, tobacco, and life insurance). If you don't have a qualifying chronic condition, you may not be eligible for those expanded amounts.

Be cautious with advertising that promises a large 'flex' or 'OTC' amount — what you actually get depends on the specific plan, your eligibility, and the plan's rules. Verify everything in the plan's Evidence of Coverage before enrolling.

How to qualify, enroll, and find a plan with an OTC card

To get an OTC benefit through Medicare, you must enroll in a Medicare Advantage plan, and to do that you must have both Medicare Part A and Part B. In 2026, the standard Part B premium is $202.90 per month and the Part B deductible is $283 per year; Part A is premium-free if you (or a spouse) have 40 or more quarters of Medicare-covered work. Many Medicare Advantage plans charge a $0 monthly plan premium on top of your Part B premium, but plan premiums vary, so the OTC benefit is generally not 'free' in the sense of being separate from your overall Medicare costs.

To find plans in your area that offer an OTC benefit and to see the allowance amount, use the official Medicare Plan Finder at Medicare.gov and review each plan's Evidence of Coverage. You can typically enroll in or switch Medicare Advantage plans during the Annual Enrollment Period (October 15 to December 7) and during the Medicare Advantage Open Enrollment Period (January 1 to March 31), or when you first become eligible for Medicare. Some people qualify for Special Enrollment Periods.

If you have both Medicare and Medicaid, look specifically at Dual Eligible Special Needs Plans (D-SNPs), which often include OTC allowances tailored to dual-eligible members; amounts and eligibility still vary by plan and area.

• Requirement: enroll in a Medicare Advantage plan that offers OTC — and you need both Part A and Part B
• 2026 costs: Part B $202.90/mo premium, $283/yr deductible; Part A premium-free at 40+ quarters
• Find a plan: use the Medicare Plan Finder at Medicare.gov and read the Evidence of Coverage
• When to enroll: Oct 15–Dec 7, the Jan 1–Mar 31 MA open enrollment window, or your initial eligibility/SEP
• Dual eligible: ask about D-SNPs, which often pair OTC with Medicaid benefits