Your Over-The-Counter Benefit Manager of Choice

Friday, December 28, 2018

In 2017, roughly 19 million of the 57 million Medicare beneficiaries were enrolled in Medicare Advantage (MA) plans. Today’s enrollment rate in MA plans is 33%, which is triple that from 2004.[1] With this growth, also comes competition. In 2017, the average Medicare beneficiary had access to 19 MA plans,[2] and access to supplemental benefits has become a differentiator when comparing those plans. Even if the supplemental benefits are not used, the Medicare member enjoys having more benefits available from the plan.[3] So when marketing your plan to the over 19 million Medicare beneficiaries why not highlight differentiators – such as an Over-the-Counter (OTC) benefit?

Is offering an OTC benefit solution important to your plan?

OTC medications provide $102 billion in value to the US healthcare system annually ($77 billion in clinical office visit savings and $25 billion in prescription drug savings). With 93% of adults often preferring to treat minor ailments with OTC medications before seeking professional care, you also have roughly 60 million Americans that would not seek treatment for their illnesses at all without the availability of OTC medications. Essentially, every dollar spent on OTC saves the US healthcare system $6-$7. In providing expanded access to OTC products, your plan can see both reduced clinical visits and prescription medication costs.[4]

What does this mean for you?

When shopping for an OTC benefit manager, it’s worth keeping a few things in mind. Your investment to enroll an MA member is roughly $11.25 per member, per month in marketing efforts, plus an additional $17.44 per member, per month in account and membership administration.[5] It PAYS to have happy members and increase your retention rate.

Convey Health Solutions (Convey) clients cite a 10-20% increase in member retention among their members that are utilizing the OTC benefit (versus those who do not). And let’s not forget about growth. High Net Promotor Scores (NPS) are often closely associated with higher growth businesses, and Convey’s OTC clients have reported NPS as high as 80%. With this feel-good OTC benefit, less than 0.1% of calls taken by Convey customer service representatives have actually resulted in a grievance.

How does Convey operate as your OTC benefit manager?

So now that you are interested in offering the OTC benefit to your MA members, you might be wondering how Convey operates their OTC benefit program.

The answer is that Convey offers a home delivery, member-centric solution with incorporation of full CMS compliance as well as technology and infrastructure supported by HITRUST CSF certification. Convey assures quality and adherence to regulation, from start to finish. Convey’s OTC catalog program aids in development of the product listing and distribution of the branded catalog to your members, ensuring 508 compliance for digital hosting on your corporate website. You provide Convey with the eligibility file, and Convey handles it from there. Members can mail or call their order in, as well as utilize a health plan-branded website – after which the products are delivered directly to the member’s home.  Convey provides comprehensive reporting related to the performance of the OTC benefit, and works in collaboration with your compliance teams to ensure complete adherence to regulations.

With Convey’s OTC benefits management program you can offer a helpful and healthy benefit to your members, with no additional burden or stress on your staff and resources!

What do I do next?

Want to learn more? Reach out to us at or (855) 219-2578.


[1] “Medicare Advantage”, 2018, The Henry J. Kaiser Family Foundation,

[2] “Medicare Advantage Plans in 2017: Short-term Outlook is Stable”, 2016, The Henry J. Kaiser Family Foundation,

[3] “How are Seniors Choosing and Changing Health Insurance Plans?”, 2014, The Henry J. Kaiser Family Foundation,

[4] “The Value of OTC Medicine to the United States”, 2012, Booz & Co and Consumer Healthcare Products Association

[5] “Plan Management Navigator”, 2016, Sherlock Company,

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