A popular commodity among Medicare beneficiaries, flex cards offer convenient access to Medicare Advantage funds with one quick swipe. Benefits on these cards may include allowances for over-the-counter medications, copays, groceries, and much more, helping cardholders save on out-of-pocket expenses.
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What Is a Medicare Flex Card?
Some, not all, Medicare Advantage plans offer Medicare flex cards that give qualified members immediate access to their account’s benefits. Without exception, Medicare Advantage must follow set rules and provide at least equivalent benefits to government-sponsored Original Medicare. However, since private insurance companies oversee these policies, spending limits and criteria will vary depending on your plan and carrier.
In some combination or another, your insurer will preload funds into separate categories, applicable toward qualified expenses like vision and dental care, over-the-counter medication, copays and deductibles, groceries, and more, all determined by your policy details.
How Often Do These Cards Refill?
Flex card funds reload quarterly or annually, depending on your plan and insurer. Some policies may employ both methods. For example, you might receive a quarterly stipend for OTC drugs with a separate annual limit to spend on eyeglasses from an in-network specialist. Regardless, your Medicare Advantage provider will set rules for how and when you can spend the money on your flex card.
Benefits of a Flex Card — Why It May Be a Perk to Consider
While not everybody will be eligible for or have access to these cards through their Medicare Advantage plan, you should still check with your current insurer about your potential options or speak with a trusted agent to seek out a policy that offers one. These cards provide many perks that could help you cut down on out-of-pocket expenses directly and indirectly related to medical care, as listed below.
Get Help Paying For Covered Items
The preloaded funds on your card can help pay for categorized health-related items up to a specified limit each year, including but not limited to the following:
- Over-the-counter medications
- OTC medical supplies, such as bandaids or disinfectants
- Dental hygiene items, such as toothpaste or floss
- Assistive devices, such as wheelchair ramps and shower stools
- Diagnostic tools, such as glucose monitors or blood pressure cuffs
- Equipment, such as crutches or walkers, not included in your durable medical equipment coverage
- Certain prescription drugs not already included in your insurer’s formulary
- Eyeglasses or contacts from approved optometrists
- Prescription hearing aids
- Necessary items for ADA service dog care, like leashes, harnesses, and food
Get Help Paying For Covered Appointment Fees
Even with Medicare Advantage, patients will still have to pay the copayment, coinsurance, and deductible due with every medical appointment, up to their plan’s annual out-of-pocket maximum. Luckily, these cards can help absorb some of these costs, including:
- Copays for dental appointments
- Copays for optometrist appointments
- Copays for ear doctor appointments
- Part of your annual deductible for medical service
- Part of the coinsurance due with each doctor’s service (generally 20% of the total service cost with an in-network doctor)
- Repeat diagnostic services, such as X-rays, SET scans, mammograms, and blood tests that exceed traditional annual Medicare coverage limits
Get Help Paying For Covered Benefits
Depending on your plan, your card may include funds for services not directly related to healthcare or medicine, including but not limited to:
- Healthy groceries and cooking classes
- Meal delivery
- Rides to and from the doctor
- Pest control
- Indoor air quality equipment and services, such as dehumidifiers
- Fitness expenses, such as gym memberships, golf course fees, or swimming pool access
- Social needs benefits, such as club memberships, marital counseling, or park passes
- Rent and utilities
To use your flex card toward some of these expenses, you may need to be eligible for Special Supplemental Benefits for the Chronically Ill (SSBCI) under your Medicare Advantage policy.
Use One Card To Streamline Your Benefit Spending
Even with multiple accounts, you can streamline your benefit spending with a single Medicare flex card. Swipe your card, and it should automatically register which allowance and account to draw funds from, saving you time and concern.
For example, using your card after a routine teeth cleaning procedure should automatically route funds from your dental allowance toward your copay. You could then stop on the way home and buy toothpaste using the same card, automatically withdrawing funds from your OTC allowance.
Limitations to Keep In Mind
Remember that not every Medicare Advantage plan offers a flex card, and participating policies still require members to meet specific criteria. For example, some plans may require a doctor to determine that you are eligible for SSBCI benefits to use your card on rent, utilities, or transportation. Other plans may have fewer restrictions on flex card usage. Each benefit period has a capped allowance, applicable only toward approved items and services.
Beware of companies offering “government-issued” cards with thousands of dollars in preloaded benefits. First off, flex cards are only available through private Medicare Advantage plans. The government does not issue flex cards through Original Medicare. Secondly, these card benefits rarely exceed $500 annually. Interested parties should disregard any advertisement boasting significantly more in benefits as a scam.
Who Should Consider Getting a Medicare Flex Card?
Medicare flex cards may prove worth it for eligible adults on participating Medicare Advantage plans who want to reduce accumulative out-of-pocket expenses, such as over-the-counter drugs and copays, or subsidize costlier equipment like eyeglasses or wheelchair ramps. Chronically ill Medicare beneficiaries have the most to gain from these cards, as their spending allowances may extend to include groceries, transportation, rent, and much more.
If you believe you could benefit from a Medicare flex card, speak with a trusted insurance agent for more information on a suitable Medicare Advantage plan. You may also speak with a representative about the steps needed to activate your card if you know that your MA Plan provider offers a flex card and you meet its eligibility requirements.