What is a Medicare flex card or OTC card?
Often referred to incorrectly as a "cash card," the official benefits are provided as a prepaid debit card through specific Medicare Advantage (Part C) plans. These are not issued by the federal government but by private insurance companies that manage Medicare Advantage plans. The two main types of these benefits cards are the Flex Card and the Over-the-Counter (OTC) card.
How Flex and OTC cards work
Instead of being true cash, these cards are preloaded with a set allowance that can only be spent on a list of approved health and wellness items. The allowance is typically reloaded monthly, quarterly, or annually, and any unused funds may or may not roll over, depending on the plan. The key difference from a regular debit card is the restriction on what can be purchased and where the card can be used, with the plan dictating both the eligible items and participating retailers.
What is covered by these benefits cards?
The specific items covered by a flex or OTC card vary significantly depending on your Medicare Advantage plan. It is crucial to check your plan's Evidence of Coverage or Summary of Benefits to understand what your specific card covers.
Commonly covered items include:
- Over-the-Counter (OTC) Products: A wide range of items such as cold medicine, pain relievers, first-aid supplies, vitamins, and dental hygiene products.
- Groceries: Some plans, especially Special Needs Plans (SNPs) for those with specific chronic conditions or dual eligibility, provide a monthly allowance for approved healthy food items, like fresh produce, dairy, and lean proteins.
- Vision and Hearing Care: The card can often be used for copayments or to purchase items like eyeglasses, contact lenses, and hearing aids.
- Utilities: Some plans offer an allowance for certain household utilities, including electricity, gas, and water.
- Transportation: A benefit that may cover rideshare services or transportation to medical appointments.
- Fitness Programs: Coverage for gym memberships or fitness classes is another potential benefit.
Who is eligible for a cash card for seniors on Medicare?
Eligibility for a flex or OTC card is not universal across all Medicare beneficiaries. To receive one, you must be enrolled in a Medicare Advantage (Part C) plan that offers this specific benefit. Original Medicare (Parts A and B) and Medicare Supplement (Medigap) plans do not offer these types of spending cards.
Some plans, particularly Special Needs Plans (SNPs), target specific groups and may require that you meet additional criteria, such as:
- Having a specific chronic health condition, like diabetes or heart disease.
- Being dual-eligible for both Medicare and Medicaid.
Comparison of cash card options for seniors on Medicare
| Feature | Flex Card | OTC Card |
|---|---|---|
| Availability | Available through select Medicare Advantage plans, including SNPs. | Available through select Medicare Advantage plans. |
| Coverage | Often covers a broader range of expenses, including groceries, utilities, and dental, vision, and hearing costs. | Typically limited to over-the-counter health and wellness products. |
| Allowance | Can vary significantly, from a few hundred to over a thousand dollars annually, depending on the plan. | Can vary by plan, often a monthly or quarterly allowance. |
| Use Case | Ideal for managing a variety of health-related expenses and some daily essentials. | Best for covering routine purchases of common health and hygiene products. |
| Eligibility | Depends on enrollment in a specific plan; often includes those with chronic illnesses or dual eligibility. | Requires enrollment in a Medicare Advantage plan that offers the benefit. |
Avoiding scams and misleading claims
The high demand for extra financial assistance has led to a rise in scams related to these cards. Be extremely cautious of unsolicited calls, advertisements, or emails promising a free, unlimited-use "cash card" from Medicare.
Red flags to watch for:
- Unsolicited Contact: Legitimate Medicare plans and representatives will not call you out of the blue to offer a card.
- Federal Government Claim: A card offered directly by the "federal government" or "Medicare" is fake, as these cards are only provided by private Medicare Advantage plans.
- Request for Personal Information: Never provide your Medicare number, Social Security number, or banking details to an unverified source.
- "Unlimited Cash" Promise: These cards have strict limits and can only be used for approved items. Claims of unlimited cash are fraudulent.
Conclusion
The term cash card for seniors on Medicare is a misnomer, as these are actually prepaid benefits cards, like flex cards and OTC cards, provided by certain private Medicare Advantage plans. These cards offer an allowance for specific health-related purchases but cannot be used as general cash. Eligibility depends on your plan and potentially your health status, not on Original Medicare. To maximize your benefits and avoid scams, understand your plan's specific coverage and be wary of any unsolicited offers for a universal cash card. For more information on Medicare options, you can consult with your State Health Insurance Assistance Program (SHIP) or visit the official Medicare website.
Understanding how to get a card
If you believe you may be eligible, the first step is to review your current plan or explore options during the Annual Enrollment Period (October 15–December 7). Contact your plan provider to confirm if a flex or OTC card is a feature and if you qualify. For those with dual Medicare and Medicaid eligibility or specific chronic conditions, Special Needs Plans are often the source for these benefits. Always verify your benefits and eligibility directly with your insurance provider to ensure you are receiving accurate information and are protected from scams.
For more detailed information, consult the National Council on Aging's guide on Medicare flex cards: https://www.ncoa.org/article/what-is-the-flex-card-for-medicare/.
