You may have seen ads by some insurers for a Medicare “flex card,” short for flexible benefits card. But don’t let the name fool you. This debit card, which provides additional benefits for certain health related services, is not issued by traditional Medicare, and the federal government is not involved.
Rather, some private Medicare insurers who manage Medicare Advantage (part C) plans have added new benefits, which allow enrollees to use a specific dollar amount for services like over-the-counter drugs, eyeglasses, non-medical transportation, or, in some cases, even certain groceries, according to the Centers for Medicare and Medicaid Services (CMS). But not every plan offers a flex card, which may go by different names, depending on the insurer. Eligibility, dollar amounts, and allowable purchases also vary widely by plan and location.
For example, United Health Care, one of the county’s largest Medicare Advantage insurers, offers the UCard, combining a member ID card, “access to the rewards, gym membership, and credits for over-the-counter products included with your plan,” according to the company. That means if you wanted to help pay for hearing aids, upgrade your eyeglasses, or buy health-related products at the drugstore, the flex card could help pay for some or all of the cost at participating locations.
Anthem, another large insurance company, provides a quarterly “spending allowance” which varies depending on plan and member eligibility. Beneficiaries can use the flex card for everyday purchases like toothpaste and vitamins at participating retailers, assistive devices like grab bars or shower stools, service dog support, or even healthy groceries, like fruits and vegetables. Some Anthem plans even allow you to use your flex card toward utilities like a cell phone bill, or for fees at sports facilities.
How Medicare flex cards work
Not everyone in a Medicare Advantage plan will qualify for a flex card, and if you’re enrolled in traditional Medicare, you can’t get one. Spending limits vary by plan, insurance, whether you have special needs or a chronic illness, geography, and whether you qualify for both Medicare and Medicaid (are dual-eligible). Each plan sets its flex card allowance amount and spending rules.
There are generally two types of flex card approaches, notes Good Rx:
- Annual benefit: Your plan may give you a yearly “allowance,” to spend on preapproved items or services. For example, if there’s a $1,500 benefit for your plan, that’s all you get to spend for the year.
- Installments: Money may be added to your card throughout the year, either monthly or quarterly.
Plans currently offering some level of flex benefits include Humana (some locations only), WellCare, Anthem, United HealthCare, and some Blue Cross/Blue Shield plans.
Also, not every store or health professional may accept a flex card. Most plans will have a list of participating retailers, including pharmacies, grocery stores, and third-party providers (like dentists and opticians) where you can use them. Check your plan benefits section or contact the location directly to make sure you can use the card, since things can change.
How to get a Medicare flex card
If you don’t currently have this benefit and want it, you may have to change plans. Look for available Medicare Advantage plans in your area. Then check to see whether they offer the program and if you qualify. You can make the change during Medicare Advantage open enrollment, which takes place every year from January 1 through March 31.
However, it’s wise to carefully compare other costs before you make any changes, suggests Gretchen Jacobson, vice president, Medicare, at the Commonwealth Fund. While flex cards can be helpful to cover some common and necessary health expenses, there are some trade-offs. You may be forgoing other benefits, have higher copays or co-insurance, or have to change doctors if your existing provider does not accept the new plan.
If you’re considering such a plan, beware of false or misleading advertising. The fact-checking site Politifact found that “monetary limits are often much lower than advertisements indicated and what can be purchased with them is also limited.” Also, benefits do not roll over from one year to the next, so you will forfeit any funds not spent during the plan year. These additional benefits are still relatively new, and only about one-third of Medicare Advantage companies offered them in 2022, according to an analysis by the Government Accounting Office (GAO). But don’t be misled by thinking this is a government Medicare benefit—traditional Medicare and the supplemental Medigap plans are prohibited from offering these perks. Choosing a plan involves carefully weighing many pros and cons, and you can now add “flex cards” to that list.
