On January 14, the Department of Housing and Urban Development (HUD) released its anticipated frequently asked questions (FAQs) on “HUD-assisted Housing and Medicare Advantage Supplemental Benefits.” After housing providers’ confusion and concern about how to treat Medicare Advantage (MA) supplemental benefit cards for the purposes of HUD assistance eligibility and benefit level, and as part of the broader LeadingAge advocacy on flex cards across the aging services continuum, LeadingAge urged HUD to resolve a range of questions on whether, how, and when the funds provided by these “flex cards” should be treated as income.

According to the FAQ, HUD providers should only count flex card supplemental benefits used to pay for rent or utilities as income. The FAQ states that housing providers should generally assume that benefits administered through flex cards have not been used to pay for rent and utilities, unless the housing provider has information to suggest otherwise, or the beneficiary has indicated that they receive and have used (or will use) the supplemental benefit for rent and utilities.

According to HUD, MA benefits administered through flex cards should be excluded from income without additional documentation unless available information indicates that the beneficiary is using the benefit for rent and utilities. The FAQs seem to offer advice along the lines of “don’t ask, don’t tell” or “don’t say, don’t pay.”

“The vast majority of MA supplemental benefits will be excluded from income determinations, and thus do not need to be verified, including benefits on Flex Cards that are used for anything other than rent and utilities,” the FAQ says.

LeadingAge is grateful for HUD’s partnership to clarify whether, how, and when these flex cards should be counted as income. We will continue to work with members to assess any clarification gaps remaining for providers on how to consider flex cards.

Read the FAQ here. And keep up on all Medicare Advantage-related developments, including advocacy initiatives, via our Improving Medicare Advantage serial post.