Your customer’s OTC and healthy benefits cards work differently in 2026 from how they worked last year. This may change what items a customer can buy at checkout, even if they used the same card last year. Our mission is to make sure our retailers, partners, and their communities have all the information they need to manage these changes. This article is the first in a series created for this purpose- to discuss ongoing changes to OTC and Healthy Food benefits.
These articles will contain the most up-to-date information that we have. We will do our best to share new information as we learn it, and release new articles accordingly.
In 2026, Medicare changed how it issues OTC and healthy food benefits. The new model requires the member to have one or more long-term health conditions (chronic conditions) to qualify for healthy food benefits. Many Medicare members do, so these members will keep their benefits - members without chronic health conditions will not be able to purchase healthy foods with their benefits.
Benefit amounts and rules change from year to year. These are set by health plans and benefit processors to match Medicare and Medicaid rules—not by ProHealth Connect (PHC). This year’s changes are quite big, and will impact many shoppers.
That’s why a customer who used both Over-the-Counter (OTC) and Healthy Food benefits in 2025 might only have OTC in 2026.
PHC does not get member lists of what benefits a customer has on their card. Stores and PHC usually cannot know a customer’s exact benefits ahead of time. Because of that, your PHC app checkout screen on ProHealth Pay, Link, or Go is now the best way to see what benefits members have.
One benefit card can have one or more benefit purses. A benefit purse is a bucket of money that can only be used for certain items.
Common purse codes you may see*:
'OTC’ and ‘HFE’ codes are the codes most relevant for eligible products in the ProHealth Connect system. Rewards programs may also provide health food and OTC benefits depending on the plan
*IMPORTANT: This list is not complete and can change. PHC does not create or maintain these codes.
The purse codes decide what items are approved. Only a matching code can pay for matching items. Even if several codes show, each purse works on its own.
A [NO BENEFITS] result after you correctly scanned/swiped a card the card means the card does not have funds available in the correct purse for the items being purchased. This does not mean there's no money on the card.
You might see this result when the customer has already spent their eligible benefits, or that the member does not have the appropriate OTC or HFE benefit needed for their items.
As an example, to buy a gallon of milk, a member must have a benefits card that shows ‘HFE’ (Healthy Food). If HFE does not show, the purchase may decline with [NO BENEFITS],” even if the card has money in a different purse (like OTC).
When this happens, the customer should call their health plan using the phone number on the back of their card.
Sometimes a code can start with a plan label, like “UHC.” In a busy lane, that label can look like a benefit code. We know that your stores can get busy and lines can create pressure for cashiers. Taking a moment to read the full code will prevent confusion and save time in the long run.
We know these 2026 changes can be confusing at checkout. ProHealth Connect is here to support you as you support your community, and more articles on this topic will be coming. Keep an eye on the PHC Community Page for more information
Questions? Email support@prohealthconnect.com or call our Support Team at 718-791-9733
Grocery stores are re-evaluating long-standing senior discount programs. A report from Saving Advice shows that following the 2024–2025 holiday season, several national chains have quietly reduced or eliminated senior-specific perks, including designated discount days and automatic savings at checkout.
Rising inflation, labor and distribution costs, as well as changing consumer demographics seem to make these once long-standing discounts untenable.While such factors are consistent with broader retail cost pressures, their downstream effects on seniors—particularly those on fixed incomes—are both predictable and significant.
Largely left out of the conversation, however, is what is replacing those senior discount days.
Historically, senior grocery discounts functioned as a low-friction affordability mechanism; a modest percentage reduction, for example 5–10%, applied automatically on a specific day of the week. There’s minimal customer action involved, and the discount is simply applied at checkout. Current retail strategies increasingly replace these programs with generalized loyalty systems, many of which are digital-first. Enrollment, tracking, and redemption are now done through mobile applications or online accounts.
This is part of an overall trend moving towards individualized pricing driven by behavioral incentives.
For businesses, this makes sense. Rather than simply offering a broad-class discount, it’s far more valuable for companies to capture what exactly those seniors are buying. And with the sometimes controversial growth of digitized pricing, we may see those discounts applied not at checkout but at product selection. But that data capture comes at a cost for seniors who may struggle with technology. Elimination of senior-discounts creates a service gap between those seniors who are digitally fluent and those who aren’t. Those struggles to navigate through an app (and speaking plainly, not every app is designed with seniors in mind), may turn into a struggle to afford groceries.
We’ve said it before and it bears repeating: technology is moving fast, and it’s changing how grocery savings are delivered. Digital loyalty tools can help retailers become more efficient, more knowledgeable, and more profitable—but when savings become “app-first,” seniors may be left out through no fault of their own.The result is a new kind of affordability gap: not based on what you buy, but on whether you can navigate the system.
At PHC, we’re a fintech company—we understand why data matters. But we also believe the benefits of modernization shouldn’t require seniors to trade away basic access to savings and affordability, especially as food costs remain elevated. When new systems unintentionally exclude the people who most need relief, it’s worth calling attention to the tradeoff.
We can’t and won’t pretend to be the solution to end all senior hunger. What we can do, in partnership with participating grocery stores and pharmacies, is help independent retailers accept OTC and healthy food benefits that eligible seniors already have.
If your store hasn’t activated these benefit programs yet, reach out to us to get set up—so your customers can use the resources available to them to help mitigate today’s grocery costs.
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