2 minute read
What are “Over the Counter” Benefits and What Are the Risks?
By Crystal A. Manning
A 2018 Centers for Medicare & Medicaid Services (CMS) final rule added flexibility to Medicare Advantage (MA) plans in determining supplemental medical and non-medical benefits available to beneficiaries. This change allows MA plans to tailor benefits to specific medical problems and patient needs to improve preventative care and reduce health complications or costs. One popular feature is the over-the-counter (OTC) benefit (medicine that is purchased without a prescription). It allows you to get select items like vitamins, cold medicine and more at no extra cost.
When Medications Don’t Mix
Chances are good that you are taking a number of medications for a number of reasons. You may think that over-thecounter medications are always safe. But if you are over 65 and also taking prescription medications, this kind of thinking can get you into some trouble.
This situation is complicated by the fact that older people use more medications. The average number of prescription medications taken by people over 65 is five or six. It is not uncommon for older people to take 10 or more medications.
Be Safe, Tell your Doctor or Pharmacist
The key to safe medication usage is to keep your doctor and/ or your pharmacist informed about all of the prescriptions you are taking including those you buy without a prescription – like OTC drugs and herbal supplements. Most of the Medicare Advantage OTC benefits are online through an associated pharmacy, but it is still wise to seek the approval from your primary care doctor or the specialist that prescribes your medications.
Safety: Use One Pharmacy
If you fill all prescriptions at one pharmacy, all the important information about what you take and when you take it is in a central location. This allows the pharmacist to keep a complete record of all your medications.
Medicare Advantage plans have increased the benefits to more than OTC medications. They also include meal delivery services, transportation options for medical appointments, telehealth options to prevent unnecessary movement, home improvement installation (e.g., wheelchair ramps, bathroom grab bars), in-home support services as well as adult day care services.
Relaxed guidance on supplemental benefits allows more robust MA plans to be offered in the market, leading to greater product innovation, heightened competition and improved care management across the consumer engagement model. The prevalence of offering OTC benefits is on the rise, and Medicare recipients should be informed of the best plan for their needs. Contact Crystal Manning, Licensed Medicare Advisor at 412-716-4942 or email crystalmanning33@gmail.com to assist you with your Medicare questions or concerns. n
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Crystal A. Manning Medicare Advisor
