Does Medicare cover the cost of your over-the-counter health products?

Over-the-counter medications, also known as OTC or nonprescription medicine, are medications that you can buy without a prescription. The U.S. Food and Drug Administration (FDA) says they are safe and effective as long as you follow the directions on the label and as directed by your doctor. According to the National Institutes of Health (NIH), older adults aged 65+ are the largest consumers of OTC medications. In addition to medications, there are other health and wellness items such as digestive health products, incontinence supplies, supports and braces and other things you may need for the life you lead.

Does Medicare cover the cost of your OTC health products?

We’ve already discussed how Original Medicare (Parts A and B) does not include prescription drug coverage. This can be purchased through a Medicare Part D plan or by enrolling in a Medicare Advantage (MA) plan with Part D coverage (MAPD). But what about health and wellness items that do not require a prescription?

Unfortunately, Original Medicare and Medicare Part D do not pay for OTC drugs. However, Medicare Advantage plans can offer OTC allowances for members so that they can purchase certain medications, first aid supplies, vitamins and other health and wellness products that you may need.

What is a Medicare OTC allowance?

Some Medicare Advantage plans offer OTC benefits with a monthly or quarterly allowance so you can buy health items to help you stay healthy. Just remember the exact OTC allowances and other benefits of Medicare Advantage plans may vary.

Does ApexHealth offer an OTC allowance for members?

ApexExtras are designed to help you get more out of life. Every ApexHealth Medicare Advantage member has access to hundreds of health and wellness products through our OTC allowance. Allowance amounts vary by plan. We partner with NationsOTC®, to offer brand-name or generic items across variety of categories including cold, flu, and allergy products, eye and ear care, first aid supplies, and dental/denture care products. Products can be ordered online, over the phone or by mail. Refer to your Medicare OTC Product Catalog for more information and explore features and more online.

If you need assistance ordering OTC products, our team of ApexAssistants are available at (844) 279-0508 (TTY 711). Our hours of operation are Monday through Friday 8 a.m. – 8 p.m. (local time) from Apr. 1 through Sept. 30 and seven days a week 8 a.m. – 8 p.m. (local time) from Oct. 1 through Mar. 31.

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