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NC Medicaid OTC Benefits 2027: Allowances by Plan and How to Use Them

By Modinul Islam Khan Updated November 2, 2026

Reviewed November 2, 2026. NC Medicaid OTC benefits come from two places. NC Medicaid’s pharmacy benefit covers many over-the-counter (OTC) products when a provider writes a prescription, and some NC Medicaid health plans add OTC or grocery money as an extra (value-added) benefit. The only Standard Plan that publishes a general OTC dollar amount is Carolina Complete Health, at $30 per member per quarter for CVS OTC items.

Quick answer: NC Medicaid itself doesn’t give you an OTC card. If you’re in Carolina Complete Health, you can order $30 of CVS OTC products each quarter. UnitedHealthcare Community Plan lists a prepaid OTC card without publishing the amount, AmeriHealth Caritas North Carolina lets you spend CARE Card rewards on children’s OTC medicine, and Healthy Blue lists pain-management products and grocery help instead. If you have Medicare and Medicaid, a 2027 dual plan (D-SNP) may include a monthly OTC credit of $100 to $230 or more.

Does NC Medicaid cover over-the-counter products?

Yes, with a prescription. NC Medicaid Clinical Coverage Policy 9A says covered OTC products must be “dispensed by a pharmacist pursuant to a lawful prescription.” The product must fall in a therapeutic class NC Medicaid lists in the policy, the manufacturer must have a federal rebate agreement, and prior approval or quantity limits can apply. The one listed exception is the Opill birth control pill, which NC Medicaid covers without a prescription for up to a three-month supply. (NC Medicaid Policy 9A, amended July 1, 2026)

Managed care plans follow the same rule. Healthy Blue’s January 2026 pharmacy tip sheet says “All covered OTC products are available for pharmacy billing with a valid prescription.” (Healthy Blue NC) NC Medicaid’s copay is $4 per prescription, generic or brand, but many members pay nothing, including people under 21, pregnant or postpartum members, hospice patients, tribal members and people with services covered by both Medicare and Medicaid. Nicotine replacement and opioid overdose reversal drugs have no copay. (NC Medicaid copays)

Ask your doctor to prescribe items such as a pain reliever, allergy tablet or vitamin you use often, then fill it at an in-network pharmacy. Shampoo, cosmetics and most personal care items are only available through a plan’s extra benefits.

NC Medicaid OTC benefits by health plan

NC Medicaid Managed Care has four Standard Plans in 2026: AmeriHealth Caritas North Carolina, Carolina Complete Health, Healthy Blue and UnitedHealthcare Community Plan of North Carolina. WellCare of North Carolina merged into Carolina Complete Health on April 1, 2026; members moved automatically and their Medicaid benefits didn’t change, but the value-added services did. (Carolina Complete Health: merger) These are the OTC-type extras each plan lists today:

Health plan	OTC-type extra benefit	What the plan says
Carolina Complete Health	$30 per member per quarter ($120 a year)	For CVS OTC items, ordered online or by phone once a quarter or bought in OTC-enabled CVS stores. Unused money doesn’t roll over.
UnitedHealthcare Community Plan of North Carolina	Prepaid card for OTC products (amount not published)	Lists a “prepaid card for over-the-counter products” and a prepaid card for healthy foods. Its July 2026 provider guide limits the food card to members 18 and older who get SNAP.
AmeriHealth Caritas North Carolina	CARE Card rewards, up to $75 per fiscal year	Rewards can be spent on children’s OTC medicines, healthy foods and diabetic supplies at stores such as Walmart, Food Lion, Walgreens, CVS, Dollar General and Family Dollar.
Healthy Blue (Blue Cross NC)	No general OTC allowance	Lists up to $25 in pain-management products, three months of produce or a $120 grocery card, and an asthma kit for qualifying members.

Sources: each plan’s official NC Medicaid extra-benefits page (see Sources below). Value-added benefits can change during the year.

Tailored Plans, which serve people with serious mental illness, substance use disorders, intellectual or developmental disabilities or traumatic brain injury, don’t list a general OTC allowance. Trillium lists home-delivered meals, and Alliance lists no OTC or food benefit. (Trillium; Alliance Health)

Carolina Complete Health OTC catalog

Carolina Complete Health’s OTC benefit is run by CVS OTC Health Solutions. You can place one online or phone order per quarter using your Carolina Complete Health member ID, and the order must be in by 11:59 p.m. Eastern on the last day of the quarter. Call 1-888-262-6298 (TTY 711), Monday to Friday, 9 a.m. to 8 p.m. Eastern, or shop in a CVS store that accepts OTC benefits. The plan’s other listed extras include a $150 household grocery allowance, medically tailored meals after a hospital stay and a $125 vision allowance. (Carolina Complete Health: OTC catalog; value-added services) For dental extras, see Carolina Complete Health dental.

UnitedHealthcare Community Plan of North Carolina OTC card

UnitedHealthcare lists a prepaid OTC card and a healthy food card among its NC Medicaid extras, plus 14 days of meals after a hospital discharge, but it doesn’t post the dollar amounts. Call Member Services at 1-800-349-1855 or check the member handbook before you count on a specific amount. (UnitedHealthcare Community Plan of NC)

AmeriHealth Caritas North Carolina CARE Card

AmeriHealth Caritas North Carolina doesn’t list a monthly OTC allowance. Instead, members can earn CARE Card rewards, capped at $75 per fiscal year, and can spend them on children’s OTC medicine and other approved items at participating stores. (AmeriHealth Caritas NC: CARE Card) See AmeriHealth Caritas NC dental for the plan’s dental coverage.

How to use OTC benefits with NC Medicaid

Find your health plan. It’s printed on your NC Medicaid ID card. If you’re not sure you’re covered, see how to check your Medicaid status.
For OTC medicine, get a prescription. Ask your provider to prescribe the product, then fill it like any other prescription.
For plan extras, follow the plan’s steps. Carolina Complete Health uses CVS ordering by member ID; AmeriHealth Caritas loads rewards on the CARE Card; UnitedHealthcare explains its prepaid cards in the member handbook and by phone.
Use it before it expires. Carolina Complete Health’s quarterly amount doesn’t carry over.

For typical items, see our list of what you can buy with an OTC card and how CVS OTC benefits work. Our guide on how to apply for an OTC card with Medicaid covers the general steps.

Can I switch NC Medicaid plans to get a better OTC benefit?

Sometimes. NCDHHS says you can change health plans for any reason in the first 90 days after you enroll, and again during a 90-day choice period each year; the enrollment broker mails you the dates. You can also change “with cause” at any time, for example if you move or your providers aren’t in the plan. Changes take effect on the first day of the next month. (NCDHHS: how to change plans)

To compare plans, call the NC Medicaid Enrollment Broker at 1-833-870-5500 (TTY 711 or RelayNC.com), Monday to Friday, 7 a.m. to 7 p.m., or visit ncmedicaidplans.gov. The NC Medicaid Contact Center is 1-888-245-0179. (NC Medicaid Enrollment Broker, April 2026) An OTC benefit is worth far less than keeping your doctors and pharmacy in network, so check those first.

If you have Medicare and NC Medicaid: 2027 dual plans

People with both Medicare and Medicaid can join a Dual Eligible Special Needs Plan (D-SNP). These Medicare Advantage plans run on the calendar year and often include a monthly OTC credit much larger than any Medicaid allowance. Examples from the carriers’ own 2027 plan documents:

2027 plan	OTC benefit (2027 plan documents)
UnitedHealthcare Dual Complete NC-Q2 (HMO-POS D-SNP), H5253-217-001	$230 credit every month for OTC products; healthy food and utilities only for members with qualifying chronic conditions
UnitedHealthcare Dual Complete NC-S2 (PPO D-SNP), H1889-034-000	$210 credit every month; for members with full Medicaid (FBDE, QMB+, SLMB+)
Humana Dual Select (HMO-POS D-SNP), H6622-027	$100 a month Healthy Options Allowance on a prepaid spending card; rolls over month to month and expires at the end of the year. Groceries, rent and utilities need a qualifying chronic condition
UnitedHealthcare Dual Advantage NC-V1 (HMO-POS D-SNP), H5253-116-000	$53 a month for OTC and wellness on the UnitedHealthcare UCard (2027 enrollment guide)

Amounts vary by plan and county. Check each plan’s Summary of Benefits and Evidence of Coverage before you enroll.

Under CMS’s 2027 rule, supplemental benefit cards must be linked to plan-covered items at the point of sale and limited to the plan year, so 2026 balances don’t carry into 2027. (CMS: CY 2027 final rule) You can compare 2027 plans during Medicare Open Enrollment, October 15 to December 7, 2026. See UnitedHealthcare OTC benefits, the Humana OTC catalog and our dual eligibility guide.

NC Medicaid changes that affect your benefits in 2027

Work and community engagement rules start January 1, 2027. NCDHHS says most adults 19 to 64 will need to earn at least $580 a month or spend 80 hours a month in approved activities such as work, school or volunteering, unless an exemption applies. People eligible for Medicare and people getting SSI or SSDI are among those exempt. (NC Medicaid: work requirements)
Renewals every six months for adults covered through Medicaid expansion starting in 2027, instead of once a year. Watch your mail so you don’t lose your plan’s extra benefits along with your coverage.
Medicaid expansion continues. Adults 19 to 64 with income up to 138% of the federal poverty level have been eligible since December 1, 2023. (NC Medicaid expansion) See NC Medicaid income limits.
Healthy Opportunities food services are paused. State funding for the Healthy Opportunities Pilots lapsed after July 1, 2025. The General Assembly approved $9 million for state fiscal year 2027 to restart services for a subset of members, and NCDHHS says it is still deciding how. (NCDHHS: Healthy Opportunities Pilots)

NC Medicaid OTC phone numbers

Need	Number or website
Compare or change NC Medicaid health plans	NC Medicaid Enrollment Broker, 1-833-870-5500 (TTY 711), ncmedicaidplans.gov
NC Medicaid questions	NC Medicaid Contact Center, 1-888-245-0179
Carolina Complete Health OTC orders	CVS OTC Health Solutions, 1-888-262-6298 (TTY 711)
UnitedHealthcare Community Plan of NC	1-800-349-1855
Healthy Blue	844-594-5070
AmeriHealth Caritas North Carolina	The Member Services number on your ID card

Frequently asked questions

Does NC Medicaid give you an OTC card?

No. NC Medicaid doesn’t issue an OTC card. Some health plans add OTC benefits: Carolina Complete Health gives $30 per member per quarter for CVS OTC items, and UnitedHealthcare Community Plan lists a prepaid OTC card.

Which NC Medicaid plan has the best OTC benefit?

Carolina Complete Health is the only Standard Plan that publishes a general OTC amount ($30 a quarter). AmeriHealth Caritas offers CARE Card rewards and Healthy Blue offers product and grocery benefits instead. Doctors and pharmacies in network matter more for most people.

Does NC Medicaid cover Tylenol, allergy medicine or vitamins?

NC Medicaid covers OTC products in listed therapeutic classes when a provider prescribes them and a pharmacist dispenses them, and prior approval or quantity limits may apply. Ask your pharmacist whether your product is covered.

What happened to WellCare of North Carolina OTC benefits?

WellCare of North Carolina merged into Carolina Complete Health on April 1, 2026. Former WellCare members now get Carolina Complete Health’s value-added services, including the $30 quarterly CVS OTC benefit.

Can I get an OTC card if I have Medicare and Medicaid in North Carolina?

Often, through a D-SNP. For 2027, UnitedHealthcare Dual Complete NC-Q2 lists a $230 monthly OTC credit and Humana Dual Select H6622-027 lists a $100 monthly Healthy Options Allowance.

For other states, see our Medicaid OTC benefits guide, Virginia Medicaid OTC benefits and Florida Medicaid OTC benefits. To learn how plan cards work in general, read does Medicaid give you an OTC card and the Medicaid food card.

This article is general information. Medicare365 is not affiliated with or endorsed by NC Medicaid, NCDHHS, any NC Medicaid health plan, Medicare or any U.S. government agency. Benefits vary by plan and program and can change; check your member handbook or call the number on your member ID card.