While most of our plans provide Traditional OTC benefits, the amount you can spend varies by plan.
This chart outlines each plan’s OTC allowance for Traditional and Expanded OTC benefits. To see if you qualify for Expanded OTC benefits, you must first confirm eligibility.
| Elderplan Plus Long-Term Care | Elderplan for Medicaid Beneficiaries | Elderplan Extra Help | Elderplan Flex | Elderplan Select | Elderplan Advantage for Nursing Home Residents | |
|---|---|---|---|---|---|---|
| Wallet 1: OTC Allowance | $950 Quarterly (Balance roll over to the next quarter)1 | $660 Quarterly | $140 Quarterly | $140 Quarterly2 | $175 Monthly | $175 Monthly |
| Traditional OTC | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ |
| Expanded OTC3 | ||||||
| Cell Phone Bill Pay | ✓ | ✓ | Not Covered | Not Covered | ✓ | ✓ |
| Community Rides | ✓ | Not Covered | Not Covered | Not Covered | Not Covered | Not Covered |
| Fuel Purchase at the Pump | ✓ | Not Covered | Not Covered | Not Covered | Not Covered | Not Covered |
| Groceries | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ |
| Hair Salons and Barber Shops | Not Covered | Not Covered | Not Covered | Not Covered | ✓ | ✓ |
| Home Delivered Meals | ✓ | ✓ | ✓ | ✓ | ✓ | Not Covered |
| Internet+ Cable + Utility Bill Payments | ✓ | ✓ | Not Covered | Not Covered | ✓ | ✓ |
| Rent/Mortgage Assistance | ✓ | ✓ | Not Covered | Not Covered | Not Covered | Not Covered |
| Helper Bees Companion Care | Not Covered | Not Covered | Not Covered | Not Covered | Not Covered | ✓ |
| Wallet 2: Flex Benefit Allowance | ||||||
| Dental | $500 Annually | $500 Annually | $450 Annually | $450 Annually | $1,500 Annually | Not Covered |
| Hearing | $1,000 Annually | $1,000 Annually | ||||
| Vision | $150 Annually | $150 Annually | ||||
| Fitness | Not Covered | Not Covered | ||||
| Specialist Copays | Not Covered | Not Covered | Not Covered | ✓ | Not Covered | Not Covered |
| Transportation | Not Covered | Not Covered | Not Covered | Not Covered | $1,000 Quarterly | $1,000 Quarterly |
- TThe OTC card balance will be carried over to the next quarter but will expire at the end of the year.[↩]
- This applies just to members who chose OTC Benefit as their Select Extra.[↩]
- Eligibility is determined by whether you have a chronic condition associated with SSBCI benefit (expanded OTC). Examples of SSBCI conditions include but are not limited to, Cardiovascular Disorders, Diabetes, Arthritis, Chronic Lung Disorders and Chronic Kidney Disease. There are other eligible conditions not listed. Standards may vary for this benefit.[↩]
