Medicare Advantage Over-the-Counter Benefits and More (2026)

The short answer

Many Medicare Advantage plans give members a set amount each month or year to spend on health items from a catalog or a card. In 2026, 68% of individual-plan enrollees have one. It is not cash, it is for the member only, and it covers health items, not tablets or gadgets. For bigger costs, look to Medicaid waivers, PACE, the VA, state assistive technology programs and HSA money.

This guide is for families pricing out the gadgets and home changes that help a parent stay independent, from a medical alert button to a shower chair, and finding out Medicare won't pay. The one thing to know: "Medicare doesn't cover it" is rarely the end of the story. An Advantage plan's extras, Medicaid, the VA, your state's assistive technology program or pre-tax health money can each take a bite out of the bill, as long as you know the rules.

What Original Medicare covers vs. what it does not

Original Medicare (Parts A and B) pays for medical equipment a doctor orders for use at home, such as walkers and hospital beds. Most of the tech and safety items families buy are not on that list.

Item	Original Medicare (Parts A and B)	Where help may come from
Walker, wheelchair, hospital bed	Covered as durable medical equipment if you qualify	You pay 20% after the $283 Part B deductible (2026)
Hearing aids and fitting exams	Not covered	Advantage hearing benefits, VA for eligible veterans, HSA or FSA money
Medical alert system and monthly fee	Not covered	Some Advantage plans, Medicaid waivers, VA
Automatic pill dispenser	Not covered	Some Medicaid waivers, HSA or FSA money
Grab bars, bath seats, raised toilet seats	Not covered	Some Advantage plans, Medicaid waivers, VA home improvement grants
Ramps and accessible showers	Not covered	Medicaid waivers, VA grants; may count as a medical expense for taxes
Tablet, digital calendar, video phone	Not covered	State assistive technology programs (loans and reused devices)

The $283 deductible is the 2026 Part B amount on Medicare.gov. Medicare's list of what Original Medicare doesn't cover includes "hearing aids and exams for fitting them." For item by item answers, see our coverage guides on hearing aids, medical alert systems, pill dispensers and walkers, wheelchairs and lift chairs.

Medicare Advantage over-the-counter benefits: how they work

Medicare Advantage (Part C) plans are run by private insurers and can add extras that Original Medicare doesn't include. The over-the-counter (OTC) benefit is one of the most common. In 2026, 68% of enrollees in individual Advantage plans are in a plan with an OTC benefit, down from 79% in 2025, according to a June 2026 KFF analysis.

CMS's Medicare Managed Care Manual, chapter 4 sets the ground rules:

It is not cash. A plan "may not give enrollees money to purchase covered OTC items." It can instead reimburse receipts for eligible items, let members order from a catalog, or issue a debit card that only works for eligible items.
There is a set dollar amount per month or per year, chosen by the plan.
It is for the member only. Items can't be bought for a spouse or other family member.
Only health items count. Examples CMS lists as eligible include first aid supplies, incontinence supplies, pain relievers and antacids, compression stockings, toothbrushes and denture care. Blood pressure monitors and other home testing equipment are "dual purpose," so a plan may require a talk with your doctor first.
Some things never count. CMS lists convenience and comfort items such as scales, fans, magnifying glasses and gloves, plus cosmetics, herbal products and baby items, as not eligible.

So an OTC allowance can cover a pill organizer, a thermometer or a blood pressure cuff if the plan's catalog lists one. It won't buy a tablet or a digital calendar. If an item isn't in the catalog, the allowance won't pay for it.

Tip: Ask the plan whether unused OTC dollars carry over to the next month or quarter, or expire. Rules differ by plan, so ask before the period ends.

"Flex cards": what is real and what is an ad

A flex card is simply the debit card some Advantage plans use to deliver extras like the OTC allowance, dental copays or, for certain members, a grocery allowance. It comes from the plan, not from the government. AARP's flex card guide puts it plainly: "Medicare doesn't issue flex cards."

The ads you see on TV and online are another matter. Many promise hundreds of dollars "from Medicare" for groceries or bills. In reality:

Grocery money is limited. Food and produce benefits are a special supplemental benefit for people with certain chronic illnesses. Only 8% of individual Advantage enrollees, about 1.8 million people, are in a plan offering them in 2026, according to KFF.
The card is tied to one plan. Getting it usually means leaving Original Medicare or your current plan. AARP warns that some salespeople use the card to push people into switching without understanding the trade-offs, such as a narrower doctor network.
Some offers are pure scams. AARP describes fake ads that lead to sites collecting Social Security, bank or card numbers, and callers who "offer" a card to get your Medicare number.

CMS has tightened the rules. Its 2024 Medicare Advantage final rule prohibits "ads that do not mention a specific plan name" and ads that use "Medicare logos in a way that is misleading, confusing, or misrepresents the plan." An ad that won't name the plan is a reason to be careful.

Never give your Medicare number to get a "flex card." The FTC's Open Enrollment alert notes that caller ID can be faked and that real Medicare doesn't call out of the blue to sell anything. Its September 2026 alert adds that scammers pay for top spots in search results, so type Medicare.gov yourself instead of clicking an ad. Report suspected fraud to 1-800-MEDICARE (1-800-633-4227) and at ReportFraud.ftc.gov.

Other Advantage extras worth checking

Beyond OTC, KFF's 2026 data show how common other extras are among individual-plan enrollees: hearing exams or hearing aids (95%), meals (65%), transportation (22%), bathroom safety devices (21%, down from 32%) and in-home support (10%). Some plans also include a medical alert device. These change every year, so read the Annual Notice of Change each fall and compare plans during Open Enrollment, October 15 to December 7.

Medicaid waivers and PACE

If your parent has limited income and savings, Medicaid can pay for much more than Medicare does. Medicaid home and community-based services (HCBS) waivers help people who would otherwise need nursing home care stay at home. According to Medicaid.gov, each state designs its own waivers and chooses "the maximum number of people that will be served," which is why some have waiting lists.

Iowa's elderly waiver is a good example of what a waiver can include (Iowa Admin. Code r. 441-78.37):

Home modifications such as grab bars and handrails, ramps and lifts, accessible showers, bath chairs, wider doors, keyless entry and slip-resistant flooring, when they meet a medical need and are approved in advance.
Personal emergency response systems, with installation and up to 12 months of service per state fiscal year.
Assistive devices for daily living, such as dressing aids and long-reach brushes.

Other states use different names and limits, so ask the state Medicaid agency or your local Area Agency on Aging. The Eldercare Locator (1-800-677-1116), run by the federal Administration for Community Living, can connect you.

PACE (Programs of All-Inclusive Care for the Elderly) is another route. According to Medicare.gov, it is for people 55 or older who live in a PACE service area, need a nursing home level of care as certified by the state, and can live safely in the community with PACE's help. It covers all Medicare and Medicaid covered care plus other services the PACE team decides your parent needs, with no deductibles or copays for approved care. People with Medicaid pay no monthly premium.

Help for veterans

The VA's Home Improvements and Structural Alterations (HISA) grant pays for medically needed changes to a veteran's home. According to the VA's Prosthetic and Sensory Aids Service, the lifetime benefit is up to $6,800 for projects related to a service-connected disability (or a non-service-connected one if the veteran has a service-connected rating of at least 50%), and up to $2,000 for other disabilities.

Covered work includes roll-in showers and other accessible bathrooms, lowered sinks and counters, permanent ramps, and electrical or plumbing upgrades needed for home medical equipment. It does not cover portable ramps, porch lifts, stair glides, home security systems or routine repairs. The process starts with a prescription from a VA doctor and VA Form 10-0103. Veterans enrolled in VA health care may be able to get some devices, such as hearing aids, through the VA, so ask the VA care team before buying.

State assistive technology programs

Every state, the District of Columbia and the U.S. territories have an Assistive Technology Act program. The AT3 Center directory lists what each one offers, which usually includes:

Device demonstrations, so your parent can try a magnifier, amplified phone or tablet setup before anyone buys it.
Short-term device loans, a low-risk way to test whether something will actually get used.
Device reuse, where donated equipment is cleaned and passed on, often at low or no cost.
Financial loans in some states, for larger purchases.

This is one of the few places that helps with everyday tech like big-button phones and tablets. Pick your state in the directory to get the program's phone number. Our guides to phones for seniors and tablets for seniors can help you decide what to try first.

HSA and FSA money

Money in a health savings account (HSA) or flexible spending account (FSA) can pay for many devices tax free. IRS Publication 502 lists hearing aids and wheelchairs as medical expenses, and counts home changes made for a medical condition, such as entrance ramps, wider doorways, bathroom railings and support bars, and grab bars, as medical expenses too, with special rules when the change adds value to the home.

The catch for people on Medicare: under IRS Publication 969, "beginning with the first month you are enrolled in Medicare, your contribution limit is zero." Your parent can't add new money, but can still spend what is already in the account. An adult child with an HSA can't use it for a parent's purchase unless the IRS rules for dependents apply, so check with a tax adviser.

How to check your own plan

Read the Evidence of Coverage. Search it for "over-the-counter," "supplemental benefits," "bathroom safety," "personal emergency response" and "hearing." The OTC catalog often comes as a separate booklet or web page.
Call the plan. Use the number on the member card. Ask how much the OTC allowance is, how often it resets, whether unused money carries over, and whether the item you want is in the catalog.
Call 1-800-MEDICARE (1-800-633-4227) to compare plans, especially during Open Enrollment.
Get free counseling from your local SHIP. State Health Insurance Assistance Programs give unbiased Medicare help. Find yours at shiphelp.org.

For the bigger picture on keeping a parent safe at home, see our aging in place checklist and the rest of the Medicare section.

Common questions

What can I buy with a Medicare Advantage OTC allowance?

Health items your plan lists in its catalog, such as first aid supplies, pain relievers, incontinence supplies and dental care items. CMS does not allow plans to give cash, and convenience items like fans, scales and magnifying glasses are not eligible.

Is the Medicare flex card real?

Some Medicare Advantage plans use a debit card to deliver benefits like an OTC allowance. Medicare itself does not issue flex cards, and ads promising hundreds of dollars from Medicare are often a sales pitch or a scam.

Can I use an HSA to pay for hearing aids if I'm on Medicare?

Yes, if there is money in the account. Hearing aids count as a medical expense, but once you enroll in Medicare you can no longer add new money to an HSA.

Will Medicaid pay for grab bars or a ramp?

Often, through a home and community-based services waiver, for people who qualify. Each state sets its own list, limits and waiting lists, so ask your state Medicaid agency or Area Agency on Aging.

Does the VA pay for home modifications?

The VA's HISA grant pays up to $6,800 over a lifetime for service-connected needs, or up to $2,000 for other disabilities, for changes like roll-in showers and permanent ramps. It starts with a prescription from a VA doctor.

Where can my parent try a device before buying it?

Your state's Assistive Technology Act program. Most offer demonstrations, short-term loans and reused equipment. Find yours in the AT3 Center directory.

Sources

We checked these sources on October 31, 2026.

This guide is general information, not medical, legal or financial advice. Medicare Senior is independent and is not affiliated with Medicare or any government agency. No company paid to be mentioned here.

Coverage rules can change every year and Medicare Advantage benefits vary by plan. To confirm your own coverage, call your plan or 1-800-MEDICARE (1-800-633-4227), or get free help from your State Health Insurance Assistance Program at shiphelp.org.