What foods can I purchase with the OTC card?

According to the Centers for Medicare & Medicaid Services, supplemental benefits like OTC cards are a growing feature in Medicare Advantage plans, helping beneficiaries cover costs for health-related products and, increasingly, eligible foods. Knowing what foods you can purchase with the OTC card is essential for maximizing your plan's value and supporting your health goals.

Quick Summary

This guide provides a comprehensive overview of the foods eligible for purchase with an OTC card, which can include fresh produce, dairy, meat, and pantry staples. It covers the specifics of these food benefits, highlights key differences from programs like SNAP, and offers practical advice on where and how to shop.

Key Points

• Eligible Food Categories: OTC cards that include a food benefit typically cover a range of healthy items like fresh and frozen fruits and vegetables, dairy, eggs, meat, seafood, healthy grains, and pantry staples.

• Plan-Specific Eligibility: The list of covered items and the benefit amount depend entirely on your specific health plan. Always check your plan's catalog or portal for the definitive list.

• Participating Retailers: Your card can be used at a network of approved retailers, which often includes major chains like Walmart, Kroger, CVS, and Walgreens, as well as some online platforms.

• Shopping Verification Tools: Many plans offer mobile apps that allow you to scan product barcodes in-store to check for eligibility instantly, making shopping easier and avoiding checkout surprises.

• Benefit Limits and Rollover: OTC food allowances usually reset on a monthly or quarterly basis, and any unused balance often expires at the end of the benefit period.

• Distinction from SNAP: OTC food benefits are different from SNAP. OTC programs have a more limited, health-focused list of eligible items, are plan-specific, and unused funds generally do not roll over.

• Dual Payment Readiness: When shopping, be ready with a second form of payment for any items not covered by your OTC benefit or if your total exceeds your card's balance.

Your OTC Food Benefit: What's Covered?

An OTC (Over-the-Counter) card, often provided through Medicare Advantage plans, can be used for much more than just health supplies. A growing number of plans offer a food benefit, allowing members to purchase specific healthy food items at participating retailers. However, eligibility can vary significantly depending on your specific plan and provider.

The primary focus of most OTC food benefits is on nutritious items that support a healthy diet. While exact lists differ, here are the typical food categories covered:

• Fresh Fruits and Vegetables: A wide variety of fresh produce is almost always included, encouraging a diet rich in vitamins and minerals.
• Dairy and Eggs: Milk, cheese, yogurt, and eggs are standard eligible items. Some plans may also cover non-dairy alternatives.
• Meat and Seafood: Eligible proteins often include fresh, frozen, and canned meat and seafood.
• Healthy Grains: Bread, pasta, and cereals are frequently covered, with many plans favoring whole-grain options.
• Pantry Staples: Essential items like flour, sugar, spices, beans, and legumes are often included to help you cook healthy meals at home.
• Canned and Frozen Goods: Canned fruits and vegetables, frozen produce, and some frozen meals are typically eligible, making it easier to stock up.
• Nutritional Shakes and Bars: Specific nutritional supplement products, like shakes and protein bars, are often covered, especially those with a "Nutrition Facts" label.
• Soups: Hearty, healthy soups are also commonly on the list of approved items.

Where to Shop with Your OTC Food Benefit

The list of participating retailers can vary by plan but generally includes major stores. Many plans partner with nationwide chains, and some offer online ordering with home delivery.

• Major Grocery Chains: Stores like Walmart and Kroger are frequent partners.
• Pharmacies: CVS and Walgreens are often included, though their food selection may be more limited.
• Discount Retailers: Chains like Dollar General and Family Dollar are also common participants.
• Online Platforms: Some plans allow you to use your card on websites like Instacart or dedicated OTC portals for home delivery.

Using Your OTC Card: Shopping Tips

Navigating your OTC food benefits can be straightforward with a few key strategies:

1. Check Your Plan's Specific List: The most important step is to consult your plan's benefit information. Your provider will send you a catalog or have a website portal detailing the exact eligible products. This is critical because the items covered can differ widely between plans.
2. Look for In-Store Labels: Many participating retailers use shelf tags or have separate sections to clearly mark eligible OTC food items. This saves time and prevents confusion at the checkout.
3. Scan with an App: If your plan offers a mobile app, use it to scan barcodes while shopping. This will instantly tell you if a product is covered and is a foolproof method for verifying eligibility.
4. Use a Backup Payment Method: Always be prepared to use a second form of payment. If you have non-eligible items or your total exceeds the card's balance, you will need to pay the difference out-of-pocket.
5. Understand Your Balance: Most OTC food benefits reset on a monthly or quarterly basis, and unused funds often do not roll over. Check your balance regularly to ensure you use your full benefit amount.

OTC Food Benefits vs. EBT/SNAP

It's important to differentiate OTC food benefits from other food assistance programs like EBT/SNAP. While both provide food aid, they have distinct rules.

Feature	OTC Food Benefits	EBT/SNAP Benefits
Funding Source	Specific Medicare Advantage plans or other health insurance.	Federal nutrition programs (e.g., food stamps).
Eligibility	Depends on specific health plan enrollment and features.	Income and household size requirements set by the federal government and state.
Covered Items	A curated list of approved healthy food items and potentially OTC health products.	A very broad range of groceries, excluding hot foods, alcohol, and non-food items.
Retailers	A specific network of participating retailers, which can vary.	All authorized retailers displaying the Quest logo.
Benefit Rollover	Typically, unused funds expire at the end of the period.	Unused benefits often carry over from month to month.

Conclusion

Understanding what foods you can purchase with the OTC card is key to leveraging this valuable health plan benefit. By reviewing your plan's specific details, using available tools like mobile apps, and shopping at participating retailers, you can consistently access a range of healthy and nutritious food items. Always keep your plan's specific rules in mind and be prepared with a backup payment method for non-eligible purchases. This proactive approach ensures you maximize your benefit and support your overall well-being. For further details on your specific plan's benefits, visit your provider's website or portal.

Frequently Asked Questions

Can I buy meat with my OTC card?

Yes, many OTC cards with a food benefit allow for the purchase of eligible meat and seafood, including fresh, frozen, and canned options. However, check your specific plan's details to confirm eligibility.

Can I use my OTC card at any grocery store?

No, you can only use your OTC card at participating retailers approved by your health plan. These often include major grocery stores and pharmacies like Walmart, Kroger, and CVS.

Do unused OTC food benefits roll over?

Typically, no. Most OTC card benefits are allotted for a specific period (e.g., monthly or quarterly), and any unused funds are lost when the period ends.

Is my OTC card the same as an EBT card?

No, an OTC card and an EBT card are not the same. EBT is part of a federal program (SNAP) and covers a broader range of food items. The OTC food benefit is specific to your health insurance plan and has a curated list of approved foods.

What if my purchase total is more than my OTC card balance?

If your purchase exceeds your card's balance, you will need to pay the remaining amount using a separate form of payment, like a credit, debit card, or cash.

Can I purchase frozen meals with my OTC card?

Yes, some frozen meals are typically eligible for purchase with an OTC food card, especially those that are nutritionally balanced. Always check your plan's specific catalog to be certain.

How can I check if a food item is eligible while shopping?

Many health plans offer mobile apps that allow you to scan a product's barcode to instantly check for eligibility. Some retailers also use specific shelf tags to mark approved items.

Are vitamins and supplements covered by my OTC food benefit?

Some nutritional supplements, shakes, and bars with a "Nutrition Facts" label may be eligible, but items with a "Supplement Facts" label are typically not. The exact coverage depends on your specific plan.

What if I purchase non-eligible items with my OTC food card?

The transaction will likely be declined if you try to use your OTC card for an ineligible item. You will need to use a different payment method for that item.