What To Know About Medicare Over The Counter Benefit
Question: My Medicare Advantage Plan includes an Over The Counter benefit. I haven’t used it all, does it roll over into the next year (2025)?
Answer: In the last few years, we have seen many of the Medicare Advantage Plans offering an Over The Counter (OTC) benefit. These benefits are usually allocated quarterly. Some of the plans allow the benefits to accumulate for the calendar year, but for others plans the benefits expire at the end of the quarter. ALL the plans dictate that the unused benefits will expire at the end of the calendar year.
If you have a Medicare Advantage Plan, and you aren’t sure you have this OTC benefit, look at your 2024 material, or call your customer service number on the back of your insurance card. Ask them if you have this benefit and to send you a catalog to review. Most plans allow you to order via a website, over the phone or using a paper form. Having the catalog makes it possible to review the many items available, mark off the items you want and then determine how to best spend the money you have allocated.
Also remember to ask how much money you have available to spend before December 31st. I am very pleased you are giving me an opportunity to review this topic. When looking at the utilization of this OTC benefit, we find that a very small percentage of individuals use their OTC allotment. This is a wonderful reminder for those individuals who have NOT used their OTC benefit, or maybe forgot they had this OTC benefit at all. With this reminder, they can still get some products from the OTC catalog before December 31st.
In reviewing the catalog, individuals almost always say the products are overpriced compared to what they can find them for in the store. I agree but remember that you are getting these products with a free credit allowance from your insurance company. So, evaluate what is useful to you and start with those items.
If you don’t find enough to spend, I have a great idea to share with you! I would suggest that you evaluate what in that catalog could be useful to a local charity. If you can’t spend your annual allowance, I want to suggest you order products that you can donate to a local charity. This could be toothpaste, shampoo, soap, deodorant, vitamins, Band-Aids, or maybe pads. These are items that those charities could use to help individuals in our community. Or maybe donate to the local animal shelter. Call the charity of your choice and see what items would be useful to them and donate them. This allows you to get the credit you are promised and help a local charity and your community. This is definitely a win-win situation. Not matter how you use this OTC benefit, it is something I don’t want you to put off.
I also want to mention that for many of you this OTC benefit increases in value in 2025. Look into this OTC benefit, buy the products available now, and then set up a reminder on your phone or your calendar to order each quarter for 2025, to continue receiving the products you are promised and that are paid for by your Medicare Advantage Plan.
Janell Sluga is a Geriatric Care Manager helping seniors in our community access services and insurance. To reach her, please email editorial@post-journal.com.