What Is a Medicare Flex Card?


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Updated: August 5, 2024

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The Medicare Flex Card is a specialized benefit offered through certain Medicare Advantage plans and is not available with Original Medicare (Parts A and B). It can be used to cover the cost of services and items such as dentures, eyeglasses, etc., which are often necessary as you get older but can be expensive.

However, not every Medicare Advantage plan includes a Flex Card and the funds available can vary significantly between plans. The card typically operates on a use-it-or-lose-it basis within a plan year without the ability to roll over unused funds.

What Is the Flex Card From Medicare?

The Flex Card from Medicare is a special card available through certain Medicare Advantage plans — not through Original Medicare (Medicare Part A and Part B) — that helps you pay for certain health care costs not usually covered by traditional Medicare plans. This includes expenses like getting braces and hearing services. Some plans might even allow you to buy approved groceries.

Many private insurance companies that offer Medicare Advantage plans include the Flex Card as a benefit to make their plans more appealing.

However, not every Medicare Advantage plan offers a Flex Card, and the amount of money available on the card can vary by plan and insurance company. Check the specifics of your plan or any plan you're considering to understand what the Flex Card covers and its limits.

Who Qualifies for a Medicare Flex Card

To get a Medicare Flex Card, you must first switch from Original Medicare to a Medicare Advantage plan that offers it as a benefit. Original Medicare, which includes Part A and Part B, does not offer Flex Cards.

  • Enroll in a Medicare Advantage Plan: These plans are an alternative to Original Medicare and are offered by private insurance companies approved by Medicare. You need to be enrolled in both Medicare Part A and Part B to switch to and qualify for a Medicare Advantage plan.

  • Find a Plan That Offers Flex Cards: Not all Medicare Advantage plans offer Flex Cards. You’ll need to check the specifics of each plan to see if it includes it as a benefit.

  • Check for Specific Eligibility Requirements: Some Medicare Advantage plans that offer Flex Cards might have specific eligibility criteria. For example, certain plans might provide Flex Cards only to seniors with chronic illnesses.

Enrolling in Medicare Part A and Part B to Get a Medicare Flex Card

Enrolling in Medicare Part A and Part B (Original Medicare) is a prerequisite for joining a Medicare Advantage plan that may offer a Flex Card. You can enroll in Original Medicare if you're approaching age 65 or are under 65 with certain disabilities.

For Individuals Turning 65:

  • Automatic Enrollment: If you receive Social Security benefits, you will automatically be enrolled in Medicare Part A and B when you turn 65. Your Medicare card will be sent to you about three months before your 65th birthday.

  • Manual Enrollment: If you are not receiving Social Security benefits, you need to sign up during the Initial Enrollment Period, which begins three months before and ends three months after the month you turn 65. You can enroll via the Social Security Administration’s website, by calling them or by visiting your local office.

  • General and Special Enrollment Periods: If you don't enroll during your Initial Enrollment Period, you can register from January 1 to March 31 each year during the General Enrollment Period. If you're employed and covered under a group health plan, you may also qualify for a Special Enrollment Period, which begins when your employment or group coverage ends.

If You are Under 65 With Disabilities, then you can opt for one of the two;

  • Automatic Enrollment After Receiving SSDI: If you're under 65 and receive Social Security Disability Insurance (SSDI) benefits, you'll automatically be enrolled in Medicare after 24 months of disability benefits.

  • Immediate Enrollment for ALS or ESRD: Individuals with amyotrophic lateral sclerosis (ALS) are automatically enrolled the month their disability benefits begin. Those with End-stage renal disease (ESRD) need to apply, but there is no waiting period.

What Medicare Flex Card Covers

The Medicare Flex Card helps you cover various costs not typically paid for by Original Medicare. Some of these include:

1
Dental Services

Many people need dental care like check-ups, cleanings, fillings and even dentures. Medicare usually doesn’t cover these, but with a Flex Card, you can use the funds to pay for these necessary dental services.

2
Vision Care

Taking care of your eyes might mean needing eyeglasses or contacts and having regular eye exams. Original Medicare does not cover these vision care services, but they can be paid for with your Flex Card.

3
Hearing Services

As you get older, you might need a hearing aid or require hearing exams. These are services typically not covered by Original Medicare, but you can use your Flex Card to help cover these costs.

4
Over-the-Counter (OTC) Supplies

Some Medicare Advantage plans allow you to use your Flex Card for over-the-counter items like pain relievers, first aid supplies and other health-related products that you usually buy at a pharmacy.

5
Copayments, Deductibles and Co-insurance

You may be able to use your Flex Card to handle copayments, deductibles and co-insurance related to doctor visits.

6
Medical Supplies and Equipment

You might be able to pay for essential items like wheelchairs, crutches and other medically necessary equipment with your Flex Card.

7
Health and Wellness Programs

Some plans allow the use of Flex Cards for wellness programs, including mental health therapy, alternative therapies like acupuncture and even fitness-related expenses such as gym memberships or sports equipment.

8
Groceries and Meal Delivery

For those with chronic conditions, the Flex Card might contribute towards the cost of healthy groceries, although it generally does not cover processed or prepared meals. Some plans allow the Flex Card to cover meal delivery services for a limited time, usually after you have stayed some time at a hospital.

9
Medical Transportation

Funds from the Flex Card might also cover transportation costs related to medical appointments, including rideshares or public transportation.

How Medicare Flex Cards Work

A Medicare Flex Card operates similarly to a prepaid debit card, which your Medicare Advantage plan loads with funds to cover specific health care-related expenses. To use your Flex Card, simply present it during payment at eligible locations, much like you would with a conventional debit card. Always verify the specifics with your plan provider to make the most out of your Flex Card benefits.

  • Scheduled Reloads: Your Flex Card is typically reloaded at set intervals — monthly, quarterly or annually — depending on your specific plan's rules. This structured funding helps you plan for upcoming health care expenses throughout the year.

  • Annual Lump Sum: Alternatively, some plans might load the entire yearly benefit onto the card at once. Once these funds are spent, you'll need to wait until the next enrollment period for a refill.

  • Designated Use: Some plans allow you to select the type of expenses you want to use your Flex Card for, such as dental or vision care, while others may assign the card for general medical costs.

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WHAT TO REMEMBER WHEN USING A MEDICARE FLEX CARD

To maximize the benefit of a Medicare Flex Card, you should keep several key points in mind.

  • The funds on your Flex Card generally do not carry over to the next year. You must utilize all the benefits within the given year, or you risk losing them.

  • Some plans might offer these cards only to members with specific needs, such as those with chronic conditions, providing them with targeted financial support.

  • The Flex Card is accepted at specific retailers and health care providers that are pre-approved by your Medicare Advantage plan, which helps ensure that the expenditures are for eligible services.

About Mark Fitzpatrick


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Mark Fitzpatrick is a Licensed Property and Casualty Insurance Producer and MoneyGeek's Head of Insurance. He has analyzed the insurance market for over five years, conducting original research and creating personalized content for every kind of buyer. He has been quoted in several insurance-related publications, including CNBC, NBC News and Mashable.

Fitzpatrick earned a master’s degree in economics and international relations from Johns Hopkins University and a bachelor’s degree from Boston College. He is passionate about using his knowledge of economics and insurance to bring transparency around financial topics and help others feel confident in their money moves.