OTC Benefit Program Setup

We have been administering OTC Benefit Catalog Programs for Medicare Advantage Health Plans since 2008. Year after year, our dedicated OTC Benefit team evaluates each program’s performance to ensure continued success. As a result, we’ve seen considerable growth over the last few years and we currently serve over 100,000 members across the United States.

We make designing and implementing OTC Supplemental Benefit Programs simple, and there are no setup or administration fees. We only bill Health Plans for items that members purchase along with a flat rate shipping fee.

To get started, the Health Plan provides us with:

– Benefit plan information

  • Member population size and geographic location(s)
  • Benefit frequency and amount

– Branding guidelines

  • Logos and additional branding materials
  • Color schemes
  • Stock images

– Member eligibility data files

That’s it! We take care of the rest. First, we provide a product list of over 600 brand name and generic CMS approved OTC items. Once the Health Plan approves the product list, we then design a print product ready catalog along with mail-in order forms. It is then the responsibility of the Health Plan to print and distribute product catalogs. From there, we will work to develop call scripting for our experienced call center representatives. At program launch, members will have a dedicated 1-800 customer service phone line in addition to a customizable store for ordering. Lastly, we handle order fulfillment, data interoperability, reporting, tracking and shipping.

Example of our OTC Benefit custom webstore

How It Works

Our overall goal is to make administering an OTC Supplemental Benefit simple. Because all aspects of our programs are customizable, we work with Health Plans to design their benefit from the ground up. We have developed an efficient system that allows us to create custom programs at any scale. Our team of experts will be there during every step of the process to ensure that the program meets and exceeds the needs of both you and your members.

Setup Timeline

We generally request a minimum of 2-3 months so that we have adequate time to build your custom OTC Benefit Program.

Click on the image above to visit our demo store