How to Apply for an OTC Card From Your Health Plan

An Over-The-Counter (OTC) card functions as a prepaid debit card designed to help individuals manage health and wellness expenses. These cards are provided by specific health insurance plans and are pre-loaded with a predetermined amount of funds. The purpose of an OTC card is to enable beneficiaries to purchase eligible non-prescription items for health maintenance and minor ailments.

Understanding Eligibility for an OTC Card

Eligibility for an OTC card is not universal, as these cards are offered as a supplemental benefit by specific health insurance plans. Individuals typically qualify for an OTC card if they are enrolled in a Medicare Advantage (Part C) plan that includes this benefit. While Medicare Advantage plans are not required to offer OTC benefits, some Medicaid managed care plans or other private health plans may also provide OTC card benefits, though the specific coverage can vary significantly. Original Medicare (Parts A and B) does not include this particular benefit.

To determine if a current or prospective health plan offers an OTC card, individuals should review the plan’s benefits documentation. This document outlines the specific benefits, allowances, and any conditions for use. Alternatively, contacting the health plan provider directly is an effective way to inquire about OTC card availability and specific eligibility requirements.

Receiving Your OTC Card

Unlike a credit or debit card, an OTC card is generally not applied for independently. Instead, it is typically issued automatically to eligible members once they successfully enroll in a health plan that includes this benefit. The card is usually mailed directly to the beneficiary’s address, often accompanied by a benefits catalog. This catalog details the eligible items and participating retailers where the card can be used.

Upon receiving the OTC card, activation is typically required before it can be used for purchases. This activation process is generally straightforward and can be completed by calling a toll-free number provided on the card or its accompanying materials. Many card issuers also offer a dedicated website where activation can be completed online. During activation, individuals may need to provide the card number and sometimes a member ID or other personal verification details.

Using Your OTC Card

Once activated, an OTC card functions much like a prepaid debit card for purchasing eligible health items. It can be used at approved retail locations, including major pharmacies, grocery stores, and sometimes online stores. When making an in-store purchase, the card is typically swiped at the point of sale, similar to a regular debit card. If a Personal Identification Number (PIN) is required, it should be entered as prompted.

The cost of eligible items is deducted directly from the card’s available balance. Funds are often loaded onto the card on a monthly, quarterly, or annual basis, depending on the specific health plan. If a purchase includes items not covered by the card, the individual will need to use an alternative payment method for those specific items. Funds on OTC cards commonly expire at the end of each benefit period and typically do not roll over to the next, although some plans may allow limited rollovers. To check the card balance or find participating stores and eligible items, individuals can usually visit a dedicated website, use a mobile app, or call the customer service number provided by the card issuer. Eligible items often include common health and wellness products such as pain relievers, cold and flu remedies, vitamins, first-aid supplies, and certain personal care items.