The CDPHP Medicare Advantage OTC card is one of the most practical and popular benefits offered to Medicare members. Through this benefit, CDPHP (Capital District Physicians’ Health Plan) aims to improve access to everyday health items without members having to spend money out-of-pocket. However, the OTC card is just one part of a more comprehensive Medicare Advantage package that includes dental coverage, drug benefits, vision, Medicaid coordination, and more. Below is a full breakdown of how to maximize your CDPHP Medicare Advantage OTC card and other related member services.
What Is the CDPHP Medicare Advantage OTC Card?
The CDPHP Over-the-Counter (OTC) benefit provides a quarterly allowance—typically up to $100—to spend on eligible health-related products. These include cold and flu medications, pain relievers, allergy products, first aid supplies, dental items, and more.
Your OTC benefit is loaded onto a prepaid Benefits Mastercard® that can be used online, by phone, or at participating stores like CVS, Walgreens, Walmart, and Rite Aid.
How to Use the OTC Card
In-Store Purchases
Swipe your prepaid Mastercard at the register of participating retailers to buy eligible products. Always check that the product qualifies under your current OTC allowance.
Online and Phone Orders
You can place an order:
- Online via the Benefits Pro Portal
- By Phone at 1-877-200-3449 (TTY: 711)
Quarterly Reload
Each quarter, your card is automatically reloaded with your eligible allowance. Unused funds do not carry over, so use them before the end of each quarter.
Login and Member Portal Access
To access your benefits, including OTC balance and purchase history:
- Visit https://cdphp.nationsbenefits.com
- Register or log in with your CDPHP Member ID
Customer Service Phone Number:
- General Inquiries: 1-888-248-6522
- OTC Assistance: 1-877-200-3449
Dental Coverage With CDPHP
In addition to the OTC allowance, CDPHP Medicare Advantage plans often include dental benefits. The prepaid Mastercard can be used to pay for:
- Preventive services (cleanings, X-rays)
- Restorative treatments (fillings, crowns)
- Major services (dentures, root canals)
Dental care is a major area of need for seniors, and CDPHP helps meet that need by offering flexible coverage and nationwide dental provider access.
Drug Coverage (Part D) and Formulary Information
CDPHP Medicare Advantage HMO plans often include Part D drug coverage, allowing members to receive prescription medications affordably. A comprehensive drug formulary is published annually, listing:
- Tier levels
- Copayment amounts
- Covered generics and brand-name drugs
Popular covered medications include:
- Atorvastatin
- Metformin
- Lisinopril
- Omeprazole
The 2025 drug formulary can be accessed at www.cdphp.com/medicare/formulary.
Medicaid and Dual Eligibility
CDPHP offers plans that coordinate benefits with Medicaid for those who qualify for both programs (dual-eligible). These members may receive:
- Extra OTC credits
- Lower out-of-pocket drug costs
- Transportation benefits
- Enhanced dental and vision coverage
To check eligibility for dual coverage or Medicaid-coordinated Medicare plans, call New York Medicaid Helpline or CDPHP Member Services.
Provider Portal and Doctor Search
Doctors and healthcare providers can use the CDPHP Provider Portal to:
- Verify member eligibility
- Submit claims
- Access patient histories
- Review medication authorizations
Providers can log in at https://healthlink.cdphp.com.
CDPHP Medicare HMO Plans
Most CDPHP Medicare Advantage plans are structured as HMOs (Health Maintenance Organizations). These plans:
- Require members to select a Primary Care Provider (PCP)
- Offer coordinated care within a defined network
- Often include prescription drug coverage, dental, vision, and wellness extras
The HMO model is designed to provide lower costs and streamlined services, making it a preferred choice for many New York State residents.
Participating Retail Locations
Use your CDPHP OTC card at the following stores:
- Walmart
- CVS
- Walgreens
- Rite Aid
- Family Dollar
- Dollar General
When shopping in-store, bring your card and review the OTC catalog to ensure products are eligible.
Final Tips for Maximizing CDPHP Medicare Advantage Benefits
- Use Your OTC Allowance Early – Don’t let it expire unused.
- Coordinate With Medicaid – You might qualify for more benefits.
- Use the Provider Portal – Ensure providers are in-network.
- Print the Drug Formulary – Know which prescriptions are covered.
- Activate Your Card – Before your first use at cdphp.nationsbenefits.com/activate.
- Stay Informed – Check your plan’s Evidence of Coverage (EOC) for details.
Conclusion
The CDPHP Medicare Advantage OTC card is more than just a quarterly allowance—it’s part of a much broader, member-centered approach to healthcare. Whether you’re using the prepaid card to buy health essentials, manage your prescription drugs, or receive dental services, this program is built for convenience, cost savings, and comprehensive care.
For more information, log in to your member portal or call CDPHP at 1-888-248-6522.
