OTC Plus | PriorityMedicare D-SNP (2024)

Looking for 2024 information?

Over-the-counter health purchases can really add up over time. That's why we include a monthly allowance on many of our plans so you can purchase thousands of health and wellness products to support your health.

You’ll receive a Priority Health Medicare OTC Plus card loaded with an allowance you can use on things like aspirin, cold medicine, compression socks and more.

  • Your OTC Plus card will come in the mail and will be automatically reloaded.
  • There are four ways you can use your OTC Plus card to buy health items:
    • Order Online. View and purchase products online anytime at PriorityHealth.com/OTC.
    • Shop in-store. Shop for OTC items and if eligible, healthy food and produce at Kroger, CVS, Walgreens, Walmart, Dollar General or Family Dollar and other participating store locations near you. *Coming in 2024, Meijer will be in network to shop in-store.
    • Call for delivery. Call 800.688.1838 (TTY 711) Monday through Friday 8 a.m. to 11 p.m. or Saturday and Sunday 8 a.m. to 8 p.m. EST to place an order after reviewing the items in your OTC catalog. Have your product names, OTC Plus benefit card number, and shipping information available.
    • Mail order. Use your OTC mail order delivery form (included in catalog packet) to place an order via mail.
  • Your card will be re-loaded monthly with your allowance. Your balance will not roll over and funds expire at the end of each calendar month.

Important OTC updates

  1. Double Allowance:If you have a monthly OTC allowance, you will have a double funds available in April. The amount loaded to your card will be automatically loaded on April 1. Funds will not rollover. Shop in-store, online, by phone or through the OTC-Anywhere app.
  2. Discount Offer:Receive a 20% discount by entering the code OTC20 when placing your next order online, via the OTC app, or by phone. This one-time discount can be applied to an order of $10 or more placed between April 1– June 30.
  3. Price Adjustment: As of Mar. 15, you will see a price adjustment on highly utilized items when shopping online or through the OTC-Anywhere app, including incontinences, vitamins, and pain relievers. Prices are for mail-order purchases only; in-store prices will not be adjusted.
    View adjusted items
  4. App Release: If you haven't done so already, manually update the OTC-Anywhere app to see improvements such as check your benefit balance, browse products and order right from their smartphone, scan items in-store at Kroger, CVS, Walgreens, Walmart, Dollar General, Family Dollar and other participating locations to verify it's a qualified item and check pricing, track and review orders, and much more.
  5. Improved Catalog: A new version of the OTC catalog that includes pictures of the most purchased items will be available digitally to members in April.

Your unused OTC allowance does not rollover. Funds expire at the end of each month

For more program detail, or to place an order, visitPriorityHealth.com/OTC, the OTCAnywhere mobile app or call800.688.1838(TTY 711)

*To find out if you’re eligible to receive healthy food and produce, fill out the eligibility formor contact one of our Medicare experts at the number listed on our website.

PriorityFlex (formerly OTC Plus)

Available on: PriorityMedicare D-SNP and PriorityMedicare D-SNP Advantage

Meeting you where you are in your health journey is important to us. That is why we are offering a PriorityFlex card to all of our members who receive Extra Help (LIS).*

A PriorityFlex debit card will be issued for members to use for select utilities (water, sewer, gas, electric, trash, septic internet and phone bills), pest control services, healthy food and produce and over-the-counter (OTC) items.

  • Your PriorityFlex card will come in the mail and will be automatically loaded.
  • To purchase OTC items and healthy food and produce:
    • Order OTC items Online. View and purchase products online anytime at PriorityHealth.com/OTC.
    • Shop in-store. Shop for OTC items, healthy food and produce at Meijer, CVS, Walgreens, Walmart, Family Dollar and other participating store locations.
    • Call for OTC delivery. Call 800.688.1838 (TTY 711) Monday through Friday 8 a.m. to 11 p.m.and Saturday or Sunday 8 a.m. to 8 p.m. EST to place an order after reviewing the items in the OTC catalog. Members should have the product names, their PriorityFlex benefit card number, and shipping information available.
    • Mail order for OTC items. Use the OTC mail order delivery form (included in catalog packet) to place an order via mail.
  • Your card will be re-loaded monthly/quarterly with your allowance. Your balance will now roll over.

Use your card for Pest Control or Select utility services

Use your PriorityFlex card to purchase pest control services and select utilities anywhere that takes a Visa card and simply pay how you normally would.

*Must qualify for Extra Help (Low Income Subsidy) to use this benefit.

  • BrainHQ
  • D-SNP Health Journal
  • Bonus health assessment
  • PriorityCare
  • PriorityFlex
  • Silversneakers health and fitness program
OTC Plus | PriorityMedicare D-SNP (2024)

FAQs

Do D SNPs do not include prescription drug coverage? ›

All SNPs must provide Part D prescription drug coverage because special needs individuals must have access to prescription drugs to manage and control their special health care needs.

Can I buy food with my priority health OTC card? ›

Good news!

As a reminder there are multiple ways to use your card: Shop in-store for OTC items or healthy food and produce at Meijer, Kroger, Walmart, CVS, Rite Aid, Walgreens and more. Order your OTC items online.

Can I use my priority health OTC card at Walmart? ›

Shop for OTC items and if eligible, healthy food and produce at Meijer, Kroger, CVS, Walgreens, Walmart, Dollar General or Family Dollar and other participating store locations near you.

What is the OTC allowance card? ›

The OTC benefit — a common ingredient of Medicare Advantage plans4 — means funds to spend at pharmacies for OTC products. It might come as an OTC card you can use at participating retail stores. 5. With this coverage, you receive a certain dollar amount per year, per quarter or per month. (It varies by plan.)

What does D SNP mean in insurance? ›

Dual Special Needs Plans (D-SNPs) are Medicare Advantage (MA) plans that provide specialized care to beneficiaries dually eligible for Medicare and Medi-Cal, and offer care coordination and wrap-around services.

What does an OTC card not cover? ›

What does the OTC card not cover? A Medicare plan with an OTC allowance typically does not cover prescription medications, alcohol, tobacco products, cosmetics or items for general household use. Additionally, it usually cannot be used to purchase gift cards or pay for services such as doctor visits and lab tests.

Can you buy laundry detergent with an OTC card? ›

Use your $25 a month to get items like baby wipes, allergy products, pain relief medicine and more. You can also get everyday items like laundry detergent, soap and toothbrushes.

What kind of food can you buy with OTC card? ›

Examples of approved food items are fruits, vegetables, meats, poultry, seafood, eggs, dairy, rice, pasta, beans, and much more.

Do I get money on my OTC card every month? ›

Depending on your provider, OTC cards may be filled each quarter (every three months) or at the beginning of every month. Funds on OTC cards do not carry over to the next month or quarter. If you do not use your full quarterly allowance, any unused funds are lost.

Can I buy paper towels with an OTC card? ›

You can use your card to buy things like: Food and fresh groceries, like meat, vegetables, and canned goods. Everyday items, like toothpaste, shampoo, deodorant and shaving cream. Household goods, like laundry detergent, paper towels and tissues.

Can I withdraw money with my OTC card? ›

$500 withdrawal limit per day.

Do SNPs have drug coverage? ›

All SNPs must provide Medicare drug coverage (Part D).

Are Part D plans required to cover drugs in each therapeutic category? ›

All Medicare drug plans generally must cover at least 2 drugs per drug category, but plans can choose which drugs covered by Part D they will offer.

Would Medicare Part D be considered a prescription drug benefit? ›

Medicare Prescription Drug

This law includes a prescription drug benefit called Medicare Part D.

Does Part D cover compound drugs? ›

Key Points. All Part D plans must cover at least two drugs in each therapeutic class. There are many drugs that Part D plans do not cover, such as barbiturates, benzodiazepines, weight loss drugs, compound medications, vitamins, and more.

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