Over-the-Counter Medication Benefits for Clover Health Members

We understand that some of the medications and health-related items you purchase every day may not need a prescription. These commonly-used items are called over-the-counter items. All Clover Health Medicare Advantage plans include a quarterly allowance for over-the-counter items, which helps you save money and reduce your out-of-pocket expenses. It is one of our more popular benefits. In this guide, we’ll provide all the details you need about what’s covered by OTC coverage and how you can get over-the-counter benefits.

What Are Over- the-Counter Items?

Over-the-counter (OTC) items are everyday health-related items that don’t require a prescription and that most of us have in the medicine cabinet. Some relieve aches, pains, and itchiness. Some prevent or cure diseases, like tooth decay and athlete’s foot. Others help manage recurring problems, like migraines and allergies. Some are vitamins, toothpaste, bandages, and digestive aids. The list of covered OTC items is long.

Original Medicare (Part A and Part B) does not cover OTC items. Medicare Advantage plans are your best option if the OTC benefit coverage is important to you. All Clover Health Medicare Advantage plans include coverage for OTC items.

What OTC Items Are Covered by Clover Health?

Our OTC benefit helps you pay for non-prescription items. Every quarter, you will receive an allowance to purchase your items from an extensive catalog. (Please note, this allowance renews every quarter, and any unused amount does not carry over to the next quarter.) Over-the-counter items include:

  • Allergy medication
  • Cold and flu remedies
  • Lozenges and chest rubs
  • Digestive health supplements
  • Pain relievers
  • Eye and ear care
  • Oral care
  • Footcare
  • Personal care
  • Vitamins and minerals
  • First-aid supplies
  • A blood pressure monitor

For a complete list of items offered with Clover Health’s OTC benefit, check out our 2021 Over the Counter Item Catalog. Some limitations and copays may apply.

All of our plans offer the over-the-counter benefit. To find out your plan’s quarterly allowance amount, please refer to the OTC benefits section in your plan’s Evidence of Coverage.

How Do I Begin Taking Advantage of My Over-the-Counter Benefit?

Every Clover Health member should receive an OTC catalog at the beginning of the plan year or shortly after their effective date. In the catalog, you’ll find instructions on how to order and the complete list of OTC items included with your plan. You are able to order your OTC items by filling out the order form and mailing it in or by placing your order through the website. Once the order is received by our partner company, it will be mailed right to your home. Deliveries usually take 7 to 10 business days, so order your OTC supplies accordingly.

In Georgia and South Carolina, members can purchase their OTC products at Walmart locations.

OTC with Clover Health

All Clover Health Medicare Advantage plans include a quarterly allowance for OTC items. The OTC benefit is one of the more popular benefits among Clover members as it saves you money and reduces your overall out-of-pocket expenses.

If you have any other questions about your OTC benefit, You can call our Member Services team at 1-888-778-1478 (TTY 711) from 8 am to 8 pm local time, 7 days a week* and ask about your plan’s specific OTC benefit. They will be happy to help you.