Highmark OTC: Store, Catalog and Allowance by Plan (2026)
Reviewed October 10, 2026. Highmark OTC is the over-the-counter allowance that comes with many Highmark Blue Cross Blue Shield and Highmark Blue Shield Medicare Advantage plans. You spend it on approved health items through the Highmark OTC store at ShopHighmarkOTC.com or by phone at 1-800-560-9712 (TTY 711), and the amount, usually a set dollar figure each quarter, depends on your plan and county.
Quick answer: On the 2026 Highmark plans we checked, the OTC allowance ranged from $40 to $95 per quarter, and some plans had no OTC benefit at all. The 2025 Highmark OTC catalog says unused allowance expires at the end of each quarter. Highmark’s D-SNP plans (Highmark Wholecare and Highmark Health Options) use a different product, the My Healthy Flex Card. Your plan’s Summary of Benefits and Evidence of Coverage list your exact amount.
How the Highmark OTC benefit works
Highmark’s Medicare Advantage Summaries of Benefits describe the OTC benefit as an allowance “once per quarter.” Each quarter you get a set dollar amount to spend on eligible over-the-counter products, such as pain relievers, cold and allergy medicine, vitamins, first-aid supplies and personal care items. The benefit runs through Highmark’s OTC store and catalog rather than a debit card you swipe at the register.
- Who gets it: members of Highmark Medicare Advantage plans that include an OTC benefit. Not every plan does.
- How often: a new allowance each calendar quarter (January, April, July and October).
- Rollover: the 2025 catalog says “any unused OTC allowance will expire at the end of the quarter.” Check your 2026 catalog or Evidence of Coverage to confirm the rule for your plan.
- What you can buy: only items listed in the Highmark OTC catalog or online store.
- Where: online at ShopHighmarkOTC.com or by phone; we found no in-store option for Highmark Blue Cross Blue Shield plans.
2026 Highmark OTC allowance by plan
Here’s what Highmark’s 2026 Summaries of Benefits list for several plans. Allowances vary by plan and county, so these are examples, not a promise of what your plan includes.
| 2026 plan and service area | Monthly plan premium | OTC allowance |
|---|---|---|
| Complete Blue PPO Signature (western PA: Allegheny, Armstrong, Beaver, Butler, Washington) | $0 | $95 per quarter |
| Complete Blue PPO Distinct (same western PA counties) | $23 | $95 per quarter |
| Community Blue Medicare HMO Signature (western NY: Allegany, Cattaraugus, Chautauqua) | $0 | $75 per quarter |
| Community Blue Medicare HMO Distinct (same western NY counties) | $55 | $55 per quarter |
| Community Blue Medicare HMO Signature (central and northeastern PA counties listed in the plan’s summary) | $0 | $40 per quarter |
| Community Blue Medicare HMO Distinct (same central and northeastern PA counties) | $50 | $75 per quarter |
| Freedom Blue PPO ValueRx, Select and Classic (western PA) | Varies | Not covered |
| Freedom Blue PPO Standard (West Virginia) | Varies | Not covered |
Sources: Highmark 2026 Summaries of Benefits for Complete Blue PPO (western PA), Community Blue Medicare HMO (western NY and central/northeastern PA) and Freedom Blue PPO (western PA and West Virginia), linked at the end of this article.
One detail worth knowing: Highmark’s 2026 Annual Notice of Change for Complete Blue PPO Signature shows the plan replaced a $445 prepaid flex card (offered on its 2025 predecessor, Complete Blue PPO Choice) with the $95-per-quarter OTC benefit. If you remember having a Highmark flex card in 2025, your benefit may have changed.
How to shop the Highmark OTC store
Order online at ShopHighmarkOTC.com
- Go to ShopHighmarkOTC.com and create an account or sign in with your Highmark member information.
- Check your current quarter’s balance on your account page.
- Browse or search the catalog and add eligible items to your cart.
- Check out; the cost comes out of your OTC allowance and items ship to your home.
Order by phone
Call the Highmark OTC store at 1-800-560-9712 (TTY 711). The 2025 catalog lists phone hours of Monday through Friday, 8 a.m. to 8 p.m. Eastern. Have your member ID card and the item numbers from the catalog ready.
Get the Highmark OTC catalog
The Highmark OTC store’s help center explains how to download and print a product catalog, or you can ask for a printed copy when you call the store. The catalog lists every eligible product with its price and item number, which makes phone orders faster. Catalogs change each year, so use the 2026 catalog for orders this year and watch for the 2027 version in January.
Highmark flex card: the My Healthy Flex Card on D-SNP plans
Highmark’s dual-eligible special needs plans (D-SNPs), for people with both Medicare and Medicaid, use a prepaid card called the My Healthy Flex Card instead of the OTC store. You can use it in participating stores, at MyHealthyFlex.com, in the myTotal Benefits app or by phone at 1-833-623-2619 (TTY 711). Unused funds don’t roll over. Members who qualify for Special Supplemental Benefits for the Chronically Ill (SSBCI) can also use it for food, utilities, gas and home safety items; other members can use it for OTC and home and bath safety items.
| D-SNP plan | 2026 with SSBCI | 2026 without SSBCI | 2027 with SSBCI | 2027 without SSBCI |
|---|---|---|---|---|
| Highmark Wholecare Diamond (PA) | $300/month | $100/month | Up to $300/month | $100/month |
| Highmark Health Options Duals (DE) | $235/month | $50/month | $212/month | $33/month |
| Highmark Health Options Duals Select (DE) | $250/quarter | $50/quarter | $198/quarter | $51/quarter |
| Highmark Health Options Duals (WV) | $235/month | $50/month | $175/month | $40/month |
Sources: Highmark Wholecare and Highmark Health Options flex card pages. Highmark Wholecare’s Ruby plan also has a flex card, but its page describes the 2027 amount both monthly and per three-month period, so call the plan to confirm. To qualify for SSBCI amounts, you must have a qualifying chronic condition and meet the plan’s other criteria. Our guide to the truth about flex cards for seniors explains how these cards work and how to avoid flex card scams.
Highmark OTC in 2027
In its October 1, 2026 announcement of 2027 Medicare Advantage plans, Highmark said quarterly OTC allowances “will remain a core benefit for many of our plans” and that it is keeping all of its 2026 counties. It didn’t publish plan-by-plan OTC amounts in that announcement. If you’re a member, your 2027 Annual Notice of Change (mailed by September 30) shows any change to your allowance. During Medicare Open Enrollment, October 15 to December 7, 2026, compare:
- The OTC allowance and whether it’s monthly or quarterly
- Whether unused money expires at the end of the period
- Whether the plan uses a catalog store or a card you can use in stores
- The plan’s premium, doctors and drug coverage, which matter more than the OTC allowance for most people
Our annual Medicare plan review checklist and the guide to Medicare Advantage plans with OTC benefits walk through the comparison. If you live in Pennsylvania, see our overview of Pennsylvania Medicare Advantage plans.
Tips for getting the most from your Highmark OTC allowance
- Set a reminder each quarter. If your plan’s allowance expires at the end of the quarter, order before March 31, June 30, September 30 and December 31.
- Order items you use regularly. Vitamins, pain relievers, toothpaste and bandages are easy ways to use the full amount.
- Watch the balance. Orders over your remaining allowance may need another payment method or won’t go through.
- Keep the catalog handy. Item numbers speed up phone orders.
- Don’t confuse OTC with Part D. Prescription drugs go through your plan’s drug coverage, not the OTC store.
For more on what these allowances cover in general, read Medicare OTC cards explained and how to check your OTC card balance.
Highmark phone numbers
| What you need | Number |
|---|---|
| Highmark OTC store orders | 1-800-560-9712 (TTY 711) |
| My Healthy Flex Card (Highmark Wholecare) | 1-833-623-2619 (TTY 711) |
| Plan member services | The number on the back of your Highmark member ID card (Highmark lists 8 a.m. to 8 p.m., 7 days a week) |
| Highmark Medicare sales | 1-844-614-0343 (TTY 711) |
Frequently asked questions
What is the Highmark OTC store?
It’s the online and phone store, at ShopHighmarkOTC.com and 1-800-560-9712, where Highmark Medicare Advantage members spend their quarterly OTC allowance on eligible health products.
How much is the Highmark OTC allowance in 2026?
It depends on the plan. The 2026 plans in our table range from $40 to $95 per quarter, and some Freedom Blue PPO plans have no OTC benefit. Check your Summary of Benefits.
Does the Highmark OTC allowance roll over?
The 2025 Highmark OTC catalog says unused allowance expires at the end of each quarter. Confirm the 2026 rule in your plan’s Evidence of Coverage.
Can I get a Highmark OTC catalog by mail?
Yes. You can download and print it from the OTC store’s help center or call 1-800-560-9712 to ask for one.
Does Highmark have a flex card?
Highmark’s D-SNP plans (Highmark Wholecare and Highmark Health Options) offer the My Healthy Flex Card. We didn’t find a 2026 flex card on Highmark’s regular Blue Cross Blue Shield Medicare Advantage plans.
Can I use my Highmark OTC benefit in a store?
For Highmark Blue Cross Blue Shield plans, ordering is online or by phone. The My Healthy Flex Card on D-SNP plans can be used in participating stores.
This article is general information. Medicare365 is not affiliated with or endorsed by Highmark, the Blue Cross Blue Shield Association or any U.S. government agency. Benefits vary by plan and county; check your plan’s Evidence of Coverage or call the number on your member ID card.
Sources
- Highmark OTC store help center: How do I order a catalog?
- Highmark OTC store help center: How do I print an OTC product catalog?
- Highmark 2026 Summary of Benefits: Complete Blue PPO (western PA)
- Highmark 2026 Annual Notice of Change: Complete Blue PPO Signature
- Highmark 2026 Summary of Benefits: Community Blue Medicare HMO (western NY)
- Highmark 2026 Summary of Benefits: Community Blue Medicare HMO (central and northeastern PA)
- Highmark 2026 Summary of Benefits: Freedom Blue PPO (western PA)
- Highmark 2026 Summary of Benefits: Freedom Blue PPO (West Virginia)
- Highmark Wholecare: My Healthy Flex Card
- Highmark Health Options (DE): Flex Card
- Highmark Health Options (WV): Flex Card
- Highmark: 2027 Medicare Advantage announcement (October 1, 2026)
- Highmark Medicare: Contact us