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Medicare Advantage grocery, OTC and flex cards: what they cover and what to check before December 7

Before you pick next year’s plan, find out whether a card is really part of it, whether you would qualify for it, and what it can buy.

Last reviewed September 27, 2026

The short answer. Grocery, over-the-counter (OTC) and “flex” cards are extra benefits that some Medicare Advantage plans offer. They are not money from Medicare or Social Security. Many of them go only to members with certain long-term health conditions whom the plan has approved, and next year’s card can differ from this year’s. Check your plan’s Annual Notice of Change and Evidence of Coverage, call member services with the questions below, and make any change by December 7.

What are these cards, exactly?

They are a way for a Medicare Advantage plan to pay for extra benefits that Original Medicare does not cover. The card is only a way of paying. The benefit is whatever the plan says it covers.

A Medicare Advantage plan is a private plan, approved by Medicare, that takes the place of Original Medicare. It may add “supplemental benefits” such as dental, hearing, OTC items or healthy food, and it may load some of them onto a prepaid card:

  • An OTC card covers approved health items, such as pain relievers or first-aid supplies.
  • A grocery or healthy food card covers approved food. It is often limited to some members (see the next section).
  • A “flex” card is an advertising name, not a Medicare term. It can pay for several benefits, such as dental costs, groceries or some utility bills, depending on the plan.
Original Medicare Medicare Advantage
Grocery, OTC or flex card Not offered Offered by some plans, not all
Who decides what it covers Not applicable The plan, within Medicare rules
Where the details are Not applicable Evidence of Coverage and Annual Notice of Change

Source: 42 CFR 422.102, supplemental benefits; 42 CFR 422.111(b)(6), plan disclosure.

Does everyone on the plan get the card?

Not always. Some benefits go to every member. Others are Special Supplemental Benefits for the Chronically Ill (SSBCI), which the plan can give only to members who meet strict tests.

To get an SSBCI benefit, you must meet all three of these tests:

  1. You have one or more serious long-term conditions that are life-threatening or significantly limit your health or daily function.
  2. You are at high risk of going into the hospital or of other serious health problems.
  3. You need intensive care coordination, meaning close, ongoing help to manage your care.

Having a diagnosis is not enough on its own. The plan has to confirm all three tests, often through a health questionnaire (called a health risk assessment) or a review of your medical claims. You cannot qualify just by ticking a box to say you are eligible. The plan can take things like income or housing into account, but it cannot use them as the only reason.

This is why ads for grocery cards list health conditions in small print. Any ad that mentions an SSBCI benefit must name the qualifying conditions and say that having one does not guarantee the benefit.

Source: 42 CFR 422.102(f); 42 CFR 422.2267(e)(34), SSBCI disclaimer.

Is this money from Medicare or Social Security?

No. The card comes from your plan and pays only for what that plan covers. Medicare does not hand out grocery cards, and neither does Social Security.

Be careful with television ads, mailers and calls that promise a “free grocery card”, “money back” or a “giveback”. Some of them come from real plans, and some are scams. Medicare’s rules say a plan cannot offer you cash, or gifts worth more than $15, to get you to join. A plan also cannot ask for payment over the phone or online. Never give your Medicare number, bank details or card numbers to someone who contacts you out of the blue, even if caller ID shows “Medicare”.

Where to report it:

  • Suspected Medicare fraud, or a plan breaking marketing rules: call 1-800-MEDICARE (1-800-633-4227). TTY: 1-877-486-2048.
  • Someone pretending to be from Medicare: call 1-800-MEDICARE, then report it to the Federal Trade Commission at ReportFraud.ftc.gov.
  • Help looking into it: your Senior Medicare Patrol, 1-877-808-2468.

Source: Medicare.gov, marketing rules for health plans; Medicare.gov, reporting fraud; FTC, Medicare Open Enrollment scams; SMP Resource Center.

What changed for 2026 and 2027?

Medicare has tightened the rules on these benefits. From 2027, plans have to explain more clearly who qualifies and what the card buys. Plans can still advertise dollar amounts.

Since 2026. Medicare listed things a plan cannot pay for as an SSBCI benefit, including non-healthy food, alcohol, tobacco, life insurance, funeral costs and purely cosmetic procedures. For 2027, Medicare made clear that cannabis products that are illegal under state or federal law are also excluded.

Starting January 1, 2027, plans must:

  • Post their SSBCI eligibility rules on their public website, so you can read them before you join.
  • List the OTC items they cover, and say which benefits you can use the card for.
  • Link the card to covered items so it works only for approved purchases at the register.
  • Give you instructions for the card and a customer service line for card problems.
  • Offer another way to get paid back when the card cannot be used, for example if it malfunctions.
  • Limit the card to the plan year, so money cannot carry over into the next year.

What did not change. Medicare considered banning ads that show the dollar value of these benefits, or that focus on the card itself, but decided not to. You will still see dollar figures in ads this fall, so check them against the plan’s own documents.

A reminder letter that will not come. A planned summer letter listing the extra benefits you had not used was never enforced and has been removed. Don’t wait for one.

Source: CMS, Contract Year 2027 final rule fact sheet (April 2, 2026) and Federal Register, 91 FR 17384 (applies to coverage beginning January 1, 2027); CMS, Contract Year 2026 final rule fact sheet; 42 CFR 422.102(f) and (g).

How do I check whether my plan has a card next year?

Use four places, in this order: two letters from your plan, Medicare’s online plan comparison tool, and a phone call to the plan.

  1. The Annual Notice of Change. This is the letter your plan must send by September 30 each year. It lists what changes on January 1. Look for “supplemental benefits”, “over-the-counter”, “healthy food” or “special supplemental benefits for the chronically ill”. If you did not get it, call your plan.
  2. The Evidence of Coverage. This is the full rulebook for your plan, and it must reach you by October 15. It says what the card covers, how much is loaded and how often, who qualifies, and when unused money expires.
  3. Medicare Plan Finder at Medicare.gov/plan-compare. Use it to compare next year’s plans in your area, including their extra benefits.
  4. Member services. The number is on the back of your plan card. Use the questions in “What to ask, and in what order” below.

Source: Medicare.gov, Annual Notice of Change; Medicare.gov, Evidence of Coverage; 42 CFR 422.111(a)(3) and (d)(2).

Does unused money roll over, and what happens if I switch plans?

Not from one year to the next. Starting in 2027, a plan’s card is limited to the plan year, so whatever is left on December 31 does not carry over. Your plan may let you keep the same physical card, but the balance starts fresh.

Many plans also load money monthly or every three months, and some let it expire at the end of each period. That is the plan’s choice, so check your Evidence of Coverage rather than assume.

If you switch plans, the card belongs to the plan you are leaving. Expect it to stop working when your coverage with that plan ends, and ask the plan for the exact date so you can use what you are owed before then.

Source: 42 CFR 422.102(g)(2)(iv); Federal Register, 91 FR 17384.

Which dates matter?

When What you can do When it takes effect
By September 30 Your plan’s Annual Notice of Change should arrive Not applicable
By October 15 Your plan’s Evidence of Coverage should arrive Not applicable
October 15 to December 7 Open Enrollment: join, switch or drop a Medicare Advantage plan or drug plan, or move between Original Medicare and Medicare Advantage January 1. The plan must get your request by December 7.
January 1 to March 31 Medicare Advantage Open Enrollment, only if you are already in a Medicare Advantage plan: switch to another Medicare Advantage plan or go back to Original Medicare. One change only. The first of the month after the plan gets your request

If you leave Medicare Advantage for Original Medicare, you may not be able to buy a Medicare Supplement Insurance (Medigap) policy, a private policy that helps pay your share of Original Medicare costs. Ask a SHIP counselor before you switch.

Source: Medicare.gov, joining a plan; Medicare.gov, Open Enrollment.

Should I choose a plan for its card?

Not on its own. A plan whose network leaves out your doctors, or whose drug list leaves out your prescriptions, can cost you far more than the card is worth.

Before you switch for a card, check that your doctors and hospitals are in the plan’s network, that your prescriptions are on its drug list and what they will cost, and what you would pay for a hospital stay or a specialist visit. Then check whether you would qualify for the card at all.

For free, unbiased help comparing plans, call your State Health Insurance Assistance Program (SHIP). SHIP counselors are trained and do not sell insurance. Find your local SHIP at shiphelp.org or call 1-877-839-2675.

Source: shiphelp.org; Medicare.gov, Your Medicare in 2027.

What to ask, and in what order

Have your plan card and a pen ready. Call member services and ask:

  1. “Does my plan have an OTC, grocery or flex card next year? Is anything changing from this year?”
  2. “Is it for all members, or is it a special supplemental benefit for the chronically ill?”
  3. “If it is special: what are the eligibility rules, am I already approved, and how do I get assessed? Where on your website are the rules posted?”
  4. “How much is loaded, and how often: monthly, quarterly or yearly? When does unused money expire?”
  5. “What exactly can I buy with it, and where can I use it? Is there a list?”
  6. “If the card is declined for something covered, how do I get paid back?”
  7. “If I switch plans, on what date does my card stop working?”

Write down the date, who you spoke to and what they said. If you are comparing plans, ask the new plan questions 1 to 5 as well, then take the answers to a SHIP counselor before December 7.

Common questions

Can I get a grocery card with Original Medicare?
No. These cards come only from some Medicare Advantage plans.

I have diabetes. Do I automatically qualify for a food card?
No. A condition on the plan’s list is a start, but the plan must also confirm that you are at high risk and need intensive care coordination. Ask the plan how it assesses members.

The ad said I would get hundreds of dollars. Is that true?
Maybe, for some members of some plans. Medicare still allows ads to show dollar amounts, so check the plan’s Evidence of Coverage for who qualifies and how often money is loaded.

Will my plan remind me to use my balance?
Don’t count on it. Check your balance yourself and mark the reset dates on your calendar.

Someone called offering me a free card if I switch. What should I do?
Hang up, and don’t share your Medicare number. Call 1-800-MEDICARE to report it.

How a Parlor advocate can help
A Parlor advocate can go through your Annual Notice of Change and Evidence of Coverage with you, and join the call to member services. If you are a Parlor patient, your advocate can help you work out what your card covers and what to ask your plan before December 7. Parlor doesn’t sell or recommend insurance plans. To compare plans, we’ll point you to your local SHIP counselor.

Sources