Ashford Insurance

What is a Medicare Advantage Flex Card?

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Sarah Fuhrmann

Sarah Fuhrmann is an agent of Ashford Insurance an independent health insurance agency specializing in Texas Medicare insurance.

Flex cards are like prepaid debit cards beneficiaries can use to pay for medical expenses or purchase medical equipment and related items.

What is a Medicare Advantage Flex Card?

Many people have heard of the new Flex Cards related to Medicare Advantage coverage. Ashford Insurance is glad to offer clarification and help you assess if a Flex Card would be a good addition to your overall healthcare coverage.

The Centers for Medicare and Medicaid Services (CMS) has allowed private insurance companies to offer a new benefit-like-debit card (flex card). This card would allow beneficiaries to use funds from the private insurance carrier for medical services.

Medicare Flex Cards Explained:

Flex cards are like prepaid debit cards beneficiaries can use to pay for medical expenses or purchase medical equipment and related items. Typically linked to a flexible spending account or a certain dollar amount each month or quarter, these cards are a benefit linked to qualifying Medicare Advantage health plans throughout Texas.

These cards are issued by private insurance companies and are only available on specific Medicare Advantage plans. These cards have spending limits that vary by plan and carrier. The amount that comes preloaded on the card and the services and items you are allowed to spend it on is determined by the Medicare Advantage provider. The flex card benefit is not a common feature of Medicare Advantage plans, but you can find it in a handful of plans in Texas.

Medicare Advantage plans can use a debit card to reduce your overall cost-sharing for select services. However, there is no set amount of money an insurance carrier must provide. Therefore, the amount will be different with each carrier and plan.

Many people mistakenly assume that Medicare Advantage Flex Cards are like a Flexible Spending Account (FSA). Some competitors confuse the two and spread misinformation about flex cards. Understanding how a Medicare Advantage Flex Card works can help you decide if it’s a viable option for you to help cover your healthcare expenses.

It’s important to note that Medicare Advantage Flex Cards are not affiliated with the government, and these types of payment cards are not an option if you have Original Medicare. Only private insurance carriers offer Medicare flex cards, not the federal government. The plans will vary by zip code and carrier. Since Original Medicare does not provide flex cards, these debit cards are not widely available to all Medicare beneficiaries.


How Do Medicare Advantage Flex Cards Work?

If you have a Medicare Advantage plan that offers a Medicare Advantage Flex Card, you’ll get the card in the mail along with your plan information and important documents. You’ll use your Medicare Advantage Flex Card just like a debit card. Some cards come preloaded with a certain amount, while others may be linked to a spending account that can be reloaded.

Each Medicare Advantage provider has different spending rules and funding amounts for their flex cards. You can expect to start with several hundred dollars preloaded onto the card, and you can only spend those dollars on healthcare services.


What can a Flex Card be used for?

Flex Cards are for use to cover qualifying medical expenses only. These may include:

• Medical equipment
• Copayments
• Deductibles
• Dental, vision, and hearing services
• Prescription and OTC medications
• Dental, vision, and hearing care
• Diagnostic devices
• Other medically necessary expenses – check your plan details for a complete list

You may be able to use your flex card for other medical services, but you would need to check your plan’s details to know for sure.


Do I qualify for a flex card?

You must be enrolled in Medicare Part A and Part B to qualify for a Medicare Advantage plan. Medicare Advantage plans are not available in every zip code, and not every insurance carrier offers a flex card.

Flex cards are an additional benefit to Medicare Advantage plans. So, to qualify, you must have a participating policy.

Not all Medicare Advantage plans participate in this program. A small percentage of plans available in Texas offers this benefit. So, you must live in an area where at least one of these plans is available and sign up during a qualifying Medicare enrollment period.

Some Advantage plans are specific for Dual Eligible beneficiaries, meaning you must have Medicare and Medicaid to enroll in that plan. So, you will want to verify what kind of Advantage plan you would be enrolling in to ensure you qualify.

Medicare Advantage plans do not typically include the flex card benefit. Although some major carriers offer plans with flex cards, they are not part of most available plans.

The flex card benefit can be more prevalent with Dual Eligible Advantage plans, but it truly varies with each zip code and carrier. If one is available in your zip code, your doctors accept that plan, and it is not specific to Dual Eligible beneficiaries, you can enroll in it.

Fortunately, Medicare Advantage plans do not require beneficiaries to answer underwriting health questions to enroll, so you will not face denial due to a pre-existing condition. However, to participate in a Medicare Advantage plan, you must be willing to abide by strict networks and higher out-of-pocket costs. So, you will need to make sure your new plan’s network covers your physicians.


Before you enroll in a Flex Card plan

Before you enroll in a Medicare Advantage plan that offers the flex card benefit, look carefully at the plan’s other benefits. For example, are your doctors in the network? If not, you will need to choose a different doctor or pay the total cost for your doctor’s visit.

Another thing to look at is the Part D drug formulary. Are your important medications listed? If not, you will pay the total price for your prescriptions when you pick them up at the pharmacy if you don’t have other drug coverage.

You will want to be careful enrolling in a plan just for one specific benefit. Medicare Advantage plans can change every single year, so it could stop offering the Flex Card benefit the following year. Therefore, you will want to carefully review your Annual Notice of Change document to be aware of any changes the carrier made to your plan.

Are Flex Cards Available with Medicare Supplement Plans?

Medicare Supplement plans do not include flex card benefits. Medigap plans are a direct extension of Original Medicare, available through private insurance companies. Medicare Supplement plans help beneficiaries reduce out-of-pocket spending by covering the holes in Original Medicare.

Private insurance carriers sell Medigap and Medicare Advantage plans. However, these debit cards are only a part of Medicare Advantage plans, not Medigap plans. Medicare Advantage plans can use a debit card to reduce your overall cost-sharing for select services. However, there is no set amount of money an insurance carrier must provide. Therefore, the amount will be different with each carrier and plan.

Flex cards are not a necessary benefit of a Medicare Supplement plan because Medigap beneficiaries typically save on out-of-pocket costs compared to Medicare Advantage plans.

Sometimes, Medicare Advantage plans have high maximum out-of-pocket costs. Companies offer additional benefits to make the policies more attractive to consumers by balancing these high costs. On the other hand, Medicare Supplement plans allow beneficiaries to save money while receiving the benefits they need to reduce Original Medicare costs.


When you work with Ashford Insurance agents, we will look at the health plan details for you. We’ll ensure you make the most cost-effective choice, and the plan will cover your healthcare needs. Our team will thoroughly discuss the potential benefits of a Flex Card with you, including its nature, ultimate cost to you through premiums, and other considerations. Our experts are here to answer all your questions.


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Sarah Fuhrmann

Sarah Fuhrmann has been helping Medicare eligibles in Texas with their Medicare Insurance since 2018.