Over-the-counter allowance

Allowance is available on PriorityMedicare Key, PriorityMedicare Edge, PriorityMedicare Align and PriorityMedicare Latitude.  

Depending on your plan, you have access to using the allowance on your OTC card toward items to help you stay healthy. You can find your OTC or wellness allowance amount in your plan documents or on the Plan Features page. Any unused OTC allowance does not roll over.

Using your OTC card  

Your OTC card comes preloaded with funds and is ready to use when your plan begins. Create an account at priorityhealth.com/shopOTC to manage your benefits online.  

Through your online account, you can:

• Check your available balance
• Shop online
• Find participating stores
• Search eligible products
• View transaction history

Ways to Shop

Order Online

Shop anytime through your online account at priorityhealth.com/shopOTC or the Priority Health OTC mobile app.

Shop In Store

Use your benefit card at participating retailers nationwide. Search for nearby participating locations using the “Find a Store” tool in your OTC account.

Call to Order

Call 833.415.4380 (TTY 711) to place an order. Have your benefit card number, selected products, and shipping information available. From Oct. 1-Mar. 31, we're available seven days a week from 8 a.m.-8 p.m. ET. From Apr. 1-Sep.30, we're available Mon.-Fri. from 8 a.m.-8 p.m. and Sat. 8 a.m.-noon ET.

Participating Retailers

Participating retailers include:

Additional participating retailers may be available. Use the Find a Store tool in your OTC account for the most current list.

Reimbursement

If you purchase an eligible item out of pocket from a participating retailer and have available benefit funds, you may be able to request reimbursement through your OTC account at PriorityHealth.com/shopOTC or the Priority Health OTC mobile app. Reimbursement requests must be submitted within 90 days of purchase and include a copy of the receipt.

Members with an Edge plan are not required to shop at participating retailers to submit for reimbursement.

Need Help?

For questions about your benefit or assistance placing an order, call 833.415.4380 (TTY 711).

Additional Benefits for Eligible Align and Latitude Members

Members enrolled in a PriorityMedicare Align or PriorityMedicare Latitude plan who qualify for Special Supplemental Benefits for the Chronically Ill (SSBCI) may be able to use their benefit card for healthy food and produce. Refer to your plan-specific benefit details for more information.

To qualify for SSBCI benefits, you will need to partner with your treating provider to complete an SSBCI Provider Attestation form. Your provider can access the form through their online portal, or you may print and bring it to your provider to complete. We'll use information available to us to determine your eligibility for SSBCI benefits.  

Eligibility is determined annually each plan year and is based on CMS requirements and our eligibility criteria. To be considered for SSBCI benefits, you will be asked to work with your treating provider to complete an SSBCI Provider Attestation form. The information submitted is used to help determine whether:  

• You have one or more qualifying chronic conditions that are life-threatening or significantly limit your overall health or function;
• You are at high risk of hospitalization or other adverse health outcomes;
• You require intensive care coordination; and  

• The SSBCI benefit has a reasonable expectation of improving or maintaining your health or overall function.  

After reviewing all available information, we will notify you of our eligibility determination. Submission of an attestation form does not guarantee eligibility for SSBCI benefits. Members determined eligible will receive information regarding the SSBCI benefits available to them and how to access those benefits. Eligibility may be reassessed periodically, including annually. For more details, go to the Special Supplemental Benefits for the Chronically Ill row in the Medical Benefits Chart of your Evidence of Coverage (EOC) or contact Customer Care team.