When Pam O’Neill underwent a total knee replacement, her Medicare Advantage plan picked up nearly all the costs. But one aspect of her coverage surprised her.
“I get $250 per quarter to spend on a flex card,” says O’Neill, 73, who lives in Wayland, Massachusetts. “That’s a lot of money, but I can’t use it for a lot of things.”
She was hoping to use those funds, which expire at the end of each quarter, to cover the cost of a walker to help with her recovery from surgery. Her plan’s flex spending card, however, only covers basic health care products, like bandages, Tylenol, Q-tips and bunion pads, not walkers.
Medicare flex cards can be an enticing option for some beneficiaries, but others — like O’Neill — might find that this benefit falls short of what it promises. Here’s everything you need to know about these debit cards, including how they work, what you can use them for and whether they’re right for you.
[Read: Medicare Advantage vs. Medicare Cost Plans: What’s the Difference?]
What Is the Medicare Flex Card for Seniors?
Medicare flex cards, a fairly recent addition to the Medicare benefits universe, cover certain health-related services and products. They are not issued by the federal government and are not part of original Medicare, which consists of Part A and Part B.
Rather, these cards are made available to enrollees by some insurance companies sponsoring Medicare Advantage plans, explains Bob Rees, chief sales officer with eHealth Inc., a health insurance broker and online resource provider headquartered in Austin.
Benefits are provided on a prepaid plastic card, similar to a credit card, that is separate from your Medicare Advantage health insurance card and other Medicare-related cards. These cards may go by different names depending on the plan, and not all Medicare Advantage plans offer them.
[HSA and Medicare: Using HSA To Pay for Medicare Premiums]
How Medicare Flex Cards Work
Typically, flex cards come in the form of prepaid debit cards with a specific dollar amount allotted per year, like O’Neill’s $1,000 issued in quarterly payments.
There are usually two ways benefits tied to these cards are structured:
| Flex card benefit structure | How it works |
| Incremental payments | Some plans add money to the card throughout the year in quarterly or even monthly increments. |
| Annual benefit payment | Other plans add money once a year. After you spend it all, more money won’t be added until your next plan year commences. |
You should also keep in mind:
— The dollar amount and what’s covered varies from plan to plan.
— Benefits don’t roll over from one year to the next, and may expire quarterly if they’re incremental payments. If you don’t use all of the benefits, you’ll forfeit that money.
— Not all retailers and health care professionals accept payments via Medicare flex cards. Your plan will typically provide you with a list of places where you can use this benefit.
What a Medicare Flex Card Can Be Used For
Generally speaking, Rees says that you may be able to use a flex card to pay for health and wellness-related items, such as:
— Over-the-counter drugs
— Glasses
— Some nonmedical transportation
— Insurance copayments
In some cases, groceries, cell phone bills and even service dog support may be included as covered items, while other plans may limit use of your flex card to certain retailers. It all depends on the specifics of the Medicare Advantage plan you’re enrolled in.
O’Neill notes that the plan provider issues a list of items that are included in the flex card spending benefit, but “it’s so complicated to use” because many things she would expect to be on the list — like walkers — simply aren’t.
[READ: Benefits Offered by Medicare Advantage]
Medicare Flex Cards vs. Health Allowance Cards
Some Medicare Advantage plans refer to their flex card programs as a health allowance card or spending account card. Some also use the term Medicare spending card. No matter what name they go by, these prepaid debit cards are effectively all the same as a Medicare flex card.
If your plan includes this perk, the card will will be preloaded with a set dollar amount on a regular basis — monthly, quarterly or annually — and you can use it to purchase certain health-related items, such as over-the-counter medications.
Who Qualifies for the Medicare Flex Card?
Seniors who are enrolled in a qualifying Medicare Advantage plan may be eligible to get a Medicare flex card. Each plan sets its own eligibility rules, and not every enrollee will be qualified for a Medicare flex card.
Some plans restrict these cards to individuals with chronic conditions.
How to Get a Medicare Flex Card
To get a Medicare flex card, you’ll need to enroll in a Medicare Advantage plan that offers one.
“You can review the different Medicare Advantage plans available in your area during Medicare’s annual enrollment period in the fall or at other times of year if you qualify for a special enrollment period,” Rees says.
How to Know If a Medicare Flex Card Is Right for You
Some seniors love these cards and find them a valuable benefit, Rees says. He cautions, though, that you shouldn’t let the possibility of having one sway you toward one health insurance plan over another.
“We hear from a lot of Medicare beneficiaries looking for flex cards,” he explains. “Their enthusiasm is understandable, especially for anyone living on a tight budget. However, it’s important to note that picking the right Medicare plan for you should involve a holistic review of your personal health needs and what you can afford in terms of premiums and out-of-pocket costs.”
Suzanne Dods, an experienced medical billing professional working with a San Francisco oncology practice, says that a majority of Medicare Advantage plans, for instance, require prior authorization before you can access treatment. Some Medicare Advantage plans also include a high deductible that must be met before coverage kicks in for Part B drugs like chemotherapy.
What’s more, some plans offer a flex card in place of other benefits or alongside higher copays or coinsurance payments.
“You may be paying a smaller premium, and you may be getting these lovely little flex cards or a membership to the gym or two free taxi rides, but you have to pay $7,400 out of pocket for your chemotherapy,” Dods adds.
Plus, some may advertise a certain annual allowance that turns out to be much lower once you’re enrolled because of eligibility rules that might not be obvious upfront.
If the right plan for you does include a Medicare flex card, Rees recommends that you also make sure the plan covers the prescription drugs, doctors and hospitals you require.
Select a Medicare Plan That Meets All Your Needs
As you’re assessing different plans, make sure you understand all the specifics before you enroll because each plan has its own quirks and variations. You can also work with a licensed agent or contact your local State Health Insurance Assistance Program for help.
“The hardest thing when you go on Medicare is picking out a plan because they all act like they’re pretty much the same, but it’s really complicated for people to figure out which one they want,” O’Neill says.
You should also take a moment to consider whether your health needs are likely to change during the plan year. It’s impossible to know what the future will bring, but if you’re generally healthy, a Medicare Advantage plan might be a good choice, as these often have lower premium costs than original Medicare plans.
However, if you have one or more chronic health conditions or are at high risk of developing one, you may be better off with an original Medicare plan that doesn’t require prior authorization and may have a lower deductible.
“If you’re well, these (Medicare Advantage) plans are great. It is less expensive. But if you get sick, it can cost thousands of dollars,” Dods says.
And no flex card can bridge that gap.
FAQs
Can anyone apply for a Medicare flex card?
Medicare flex cards are available to qualified enrollees of certain Medicare Advantage plans. Not all Medicare Advantage plans offer these cards, and not everyone who’s enrolled in a plan that does offer this benefit will qualify for one.
Is the Medicare flex card legit?
Be wary of anyone offering a flex card to you that’s not specifically tied to a Medicare Advantage plan you’re considering. The federal government does not offer flex cards, and anyone who’s claiming to be offering Medicare flex cards directly to you without a Medicare Advantage plan is probably a scammer.
Are there specific medical services not covered by the Medicare flex card?The Medicare Advantage plan that issues the flex card sets its own rules for which services and products can be purchased. Check your plan’s details for more information about what’s covered and what’s not.
How long does it take to get approved for a Medicare flex card?
You can apply for a Medicare flex card during the open enrollment period when you elect your Medicare Advantage plan benefits. How long it takes to get approved and when you can start using the card depends on the card issuer and the details of your specific plan.
Are there any fees associated with having a Medicare flex card?
There are no additional fees associated with a Medicare flex card. This card is part of the benefits package for certain Medicare Advantage plans.
Can I use the Medicare flex card outside of my home state?
Each plan draws up its own rules about where and how you can use your Medicare flex card. Check the fine print of your plan’s details for more information.
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What Is a Medicare Flex Card? originally appeared on usnews.com
Update 11/26/25: This story was published at an earlier date and has been updated with new information.
