An Over-the-Counter, or OTC, card is a prepaid financial tool loaded with a set allowance to cover approved health and wellness products. This benefit is a common inclusion within many private Medicare Advantage plans, which offer coverage beyond what Original Medicare provides. The card functions much like a debit card but is restricted to specific purchases at select retailers. Eligibility and the exact rules for use are determined entirely by the individual health plan providing the benefit.
Identifying Authorized Retail Locations
The primary factor determining where you can use your OTC card is the specific network established by your health plan. These networks typically include major national pharmacy chains, mass-market retailers, and some grocery chains that stock a wide range of approved health products. Shoppers must confirm that the store is explicitly part of their plan’s network before attempting a purchase.
In addition to physical stores, most plans allow the card to be used for online or mail-order shopping directly through a plan-specific catalog or a partner website. When shopping in person, the transaction occurs at the point-of-sale terminal, where the card is swiped like a normal bank card. Verify with the retailer that they accept the specific OTC card network.
Categories of Eligible Health Purchases
The items available for purchase with an OTC card fall into several distinct health and wellness categories. Non-prescription medications, first aid supplies, health monitoring devices, and personal care items are commonly covered.
Eligible items often include:
- Non-prescription medications, such as internal pain relievers, cold and flu remedies, and various digestive health aids.
- First aid supplies, including bandages, gauze, antiseptic wipes, and medical tape.
- Health monitoring devices, like thermometers, blood pressure cuffs, and blood glucose meters for diabetic testing.
- Personal care items, such as toothbrushes, toothpaste, and denture care supplies.
- Durable medical equipment, including canes, walkers, or various orthopedic braces and supports.
Certain enhanced OTC benefits may extend eligibility to cover healthy foods and produce. These allowances broaden the card’s utility beyond traditional medical supplies to support general nutrition. Only specific items or brands listed in the plan’s formulary or catalog will be approved for purchase.
Navigating Card Balances and Usage Rules
Managing your OTC card requires attention to the card’s logistics and funding schedule. The card is pre-loaded with a set allowance that is typically refreshed on a monthly or quarterly basis, depending on the specific health plan’s structure. To avoid issues at the register, members should check their current balance through the plan’s dedicated member portal, mobile application, or by calling the toll-free number printed on the back of the card.
A significant rule to understand is the “use-it-or-lose-it” policy that most plans employ. Unused funds from a specific loading period, whether monthly or quarterly, generally do not roll over to the next period or the next calendar year, meaning the allowance will expire. Therefore, planning purchases to fully utilize the funds before the expiration date is necessary to maximize the benefit.
When making a purchase, the OTC card must be processed as a credit transaction, even though it is a prepaid debit card, and usually does not require a Personal Identification Number (PIN). The card will only cover the cost of eligible items, and if the total exceeds the card’s available balance, the user must pay the difference with another form of payment. It is not possible to receive cash back from an OTC card transaction.