Understanding Arizona Medicaid (AHCCCS) OTC Benefits: What's Covered & How to Use Your Card
Arizona Medicaid (AHCCCS) members may have access to OTC benefits, but many families do not know how to use them. These benefits can cover everyday essentials like pain relievers, cold medicine, vitamins, first aid supplies, and dental products. Some plans offer quarterly allowances that help reduce out of pocket costs for basic health needs. This guide explains how OTC benefits work in Arizona and how to make the most of them. You can also learn more about care options in Maricopa County and Mohave County.
What Are Arizona Medicaid (AHCCCS) OTC Benefits?
Arizona Medicaid (AHCCCS) OTC benefits provide eligible members with an allowance to purchase over the counter medications, health products, and personal care items at no cost. These benefits are offered through certain Medicaid health plans and help families access essential items without added expense.
Who gets OTC benefits in Arizona?
OTC benefits in Arizona are not available to all AHCCCS members. Availability depends on your specific health plan.
In general:
Some AHCCCS plans include OTC benefits as an added benefit
Benefits are more commonly offered through specialized plans or enhanced benefit packages
Standard AHCCCS coverage may not include OTC allowances
Plans that may offer OTC benefits include:
Arizona Complete Health
Mercy Care
Banner Health plans
Blue Cross Blue Shield of Arizona plans
UnitedHealthcare Community Plan
Check your member materials or call your plan to confirm if your coverage includes OTC benefits.
How much do you get each quarter?
If your plan includes OTC benefits, you may receive:
$50 to $86 per quarter in OTC benefits
Higher allowances in some plans
Automatic quarterly reloads
Most plans do not allow unused funds to roll over, so it is important to use your full balance before the end of each quarter.
What Items Are Covered by Arizona Medicaid (AHCCCS) OTC Benefits?
Arizona Medicaid OTC benefits cover a wide range of health and wellness products. Covered items vary by plan, so always check your plan’s OTC catalog.
Commonly covered OTC categories
Pain relief and fever reducers
Acetaminophen
Ibuprofen
Aspirin
Naproxen
Arthritis and topical pain relief
Cold, flu, and allergy
Cough medicine
Decongestants
Antihistamines
Throat lozenges
Chest rub
Digestive health
Antacids
Anti diarrhea medicine
Laxatives
Fiber supplements
Acid reducers
First aid and wound care
Bandages and gauze
Antibiotic ointments
Hydrogen peroxide
Medical tape and wraps
Cold and hot packs
Vitamins and supplements
Multivitamins
Prenatal vitamins
Vitamin C, D, and B
Calcium and iron
Fish oil
Diabetes care
Test strips
Lancets
Alcohol swabs
Glucose tablets
Monitors in some plans
Dental care
Toothbrushes and toothpaste
Floss and mouthwash
Denture care
Personal care and hygiene
Soap and shampoo
Deodorant
Hand sanitizer
Incontinence products
Feminine hygiene products
Baby and children’s items
Baby wipes
Diaper rash cream
Children’s medicine
Thermometers
Infant formula in some plans
Eye and ear care
Eye drops
Reading glasses
Contact solution
Ear drops
Other health products
Blood pressure monitors
Thermometers
Sunscreen
Sleep aids
Motion sickness relief
Items typically not covered
Tobacco products
Alcohol beverages
Cosmetics
Food items unless specifically included
Non medical personal care
Prescription medications
How to Access and Use Your OTC Benefits
Arizona Medicaid plans offer several ways to use OTC benefits, often through a prepaid card.
Getting your OTC card
If your plan includes OTC benefits, your card is usually mailed after enrollment. It may come as a separate prepaid card or be linked to your health plan ID.
Three ways to shop and order
Online ordering
Visit your plan’s OTC website
Create an account
Shop approved products
Get delivery within 7 to 10 days
Phone or mail ordering
Call your plan’s OTC number
Place an order with support
Receive items by mail
In store shopping
Shop at CVS, Walmart, Walgreens, or approved pharmacies
Bring your OTC card or ID
Follow checkout instructions
Pay using your benefit
Important shopping tips
Check your balance before shopping
Use benefits before they expire each quarter
Keep your product catalog
Save receipts
Tips for maximizing your benefits
Use your full quarterly allowance
Stock up on essentials
Plan for seasonal needs
Focus on preventive items like vitamins
Set reminders each quarter
Common Questions About OTC Benefits
Do OTC benefits roll over?
No. Most Arizona plans do not allow rollover. Benefits expire at the end of each quarter.
Can I use benefits for my family?
Yes. You can purchase items for eligible family members on your plan.
What if I lose my OTC card?
Call your plan to request a replacement. Some plans allow temporary use of your ID card.
Do I need a prescription?
No. OTC items do not require a prescription, but your provider can recommend options.
Are name brands covered?
Yes. Both name brand and generic items are typically covered.
How do I check my balance?
You can check through:
Your plan’s portal or app
Customer service
Store receipts
What if I need more than my allowance?
You can wait until the next quarter, pay out of pocket, or ask your provider about prescription options.
OTC Benefits and Your Nest Health Care
Your OTC benefits are just one part of your Medicaid coverage. Nest Health helps Arizona families who are eligible for our services use all their benefits through convenient care options.
How Nest Health providers help
Recommend the right OTC products
Prescribe stronger treatments when appropriate
Guide you on symptom care
Manage medications across your care
Nest Health services covered by Arizona Medicaid (AHCCCS)
In home visits
24/7 virtual care
Same day or next day appointments
Whole family care in one visit
Chronic condition support
Preventive care
Nest Health partners with select Medicaid health plans in Arizona to determine eligibility. Not all families on these plans are eligible. Please call your health plan if you are interested in Nest’s services.
Get Help Using Your Benefits
If you have been contacted by Nest Health or think you and your family may be eligible for our services, our team can help you understand and use your OTC benefits. Call 866-222-NEST (6378) to learn more about your Arizona Medicaid (AHCCCS) coverage and how to access the care and support available to you.
