Vlada · Research · 2026-10-14 · comparative
UNH's OTC allowance is going away
How many UnitedHealthcare Medicare Advantage members still have an allowance for over-the-counter items, and how does that compare with every other plan?
| UnitedHealthcare Medicare Advantage plans and the whole individual Medicare Advantage market | 2026 | 2027 |
|---|---|---|
| UnitedHealthcare PPOregular plans, no card | 80.6 | 25.9 |
| Rest of market PPOregular plans, allowance or card | 87.5 | 41 |
| UnitedHealthcare HMOregular plans, no card | 93.8 | 62.7 |
| Rest of market HMOregular plans, allowance or card | 93.5 | 63.1 |
Member-weighted share of members whose plan files an over-the-counter allowance (its own allowance or inside a card), inside one product type. 2022 to 2025 weighted by December enrollment and 2026 by September 2026 enrollment, every member that year; 2027 is the same members followed from their September 2026 plan to its 2027 successor (CMS crosswalk). · CMS Plan Benefit Package filings CY2022 to CY2027 (sections B13b and D); CMS monthly enrollment by plan and county; CMS 2027 plan crosswalk. Vlada benefit vector v20261007a and locked 2027 benefit tables, Edition 1.1. · 4 rows
The posted figure
Read with
- 2022 to 2026 count every member that year; 2027 follows the September 2026 members into their 2027 plan. On the same-members basis 2026 reads 47.1% for UnitedHealthcare PPO (44.7% on every member), so the 2026 to 2027 drop is not a basis artifact.
- This is the filed plan design. It does not say how many members used the allowance or how much they spent.
- UnitedHealthcare's regular-member allowance is filed as an OTC card in Section D (Combined Benefit 1: codes 13b and 14c8, no other benefits), which Vlada reads as the OTC allowance; B13b carries only flags. Plans that file a card covering OTC plus other items count as offering OTC in the market lines.
- Employer group plans, special needs plans other than the dual-eligible beat, and stand-alone drug plans are not in the lines.
- The comparison does not explain why plans cut the allowance; no cause is claimed.
- Plans for people on both Medicare and Medicaid (D-SNPs) are out of this drop. UnitedHealthcare's keep the allowance on a broader card, a separate story.
- UNH's PPO membership shrank from about 2.0 million to 1.4 million weighted members between 2025 and 2026, so the 2025 to 2026 step mixes a membership change with the benefit change. The 2026 to 2027 step follows the same members.
- Some insurers kept their offered share flat for 2027 (Kaiser HMO, Alignment HMO, Clover PPO); the post speaks about the market in aggregate, not every insurer.
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