Food and OTC benefit cards are funded cards issued by national and regional health plans to help Medicare Advantage and Medicaid members purchase approved items, generally OTC and healthy grocery items. These cards are increasingly used to support healthier food choices and essential OTC items.

These cards go by many names, including:

• Healthy Benefits+
• Medicare grocery card
• Medicare flex card
• Grocery benefit card

Although the names differ, the purpose is the same: each card allows shoppers to spend their health plan benefit dollars on a list of approved items.

Each purchase made with a benefit card must be verified against a health plan's approved product list, or APL. Each of the ~2,500 health plans determine and maintain their own APLs. These lists can include thousands of items.

Every benefit card managed by the health plan is connected to a card processor. These processors fall into two groups:

• Closed loop processors (e.g., Solutran, InComm) – settle transactions directly with retailers.
• Open loop processors (e.g., FIS, Soda Health) – settle transactions separately.

The industry is shifting toward open loop or dual network cards, which means grocers will be able to accept more types of benefit cards.

Because plans don't always classify products the same way, an item approved for one card may be rejected for another. This inconsistency, along with differences in product taxonomies used by independent grocers, makes benefit card acceptance challenging.

Fincretive's Universal Processor Gateway provides a single POS-integrated connection that works across many different processors. This helps:

• Minimize declines
• Improve approval rates
• Reduce operational complexity
• Keep POS systems aligned with health plan requirements

To process benefit cards, grocers submit product and department files so the system can match items against thousands of APLs. Fincretive's Product Trust™ automates this step.

Here's how it works:

1. Merchants upload product data daily through an automated SFTP feed.
2. Product Trust™ standardizes and aligns all product formats—including PLUs and variable weight items.
3. The system maps these products to the health plans' APL requirements.
4. Plan administrators receive correctly formatted and validated product data for approval.

This alignment improves approval rates and reduces confusion over inconsistent product classifications.

It's important to understand that applying the Product Trust™ procedure to a product file does not guarantee that an item will be approved, as each health plan has its own criteria. However, it does ensure that every item in the basket is submitted in a standardized format that processors recognize, giving each one the best possible chance for approval.

Health and wellness benefit programs are becoming an important part of how people shop for groceries and everyday necessities. These programs can drive additional spending, increase customer loyalty, bring new shoppers into your store, and support healthier communities.

For a deeper look at the opportunity, many retailers refer to the Oliver Wyman Retail Consulting Group's article "How Healthy Benefits Programs Can Be a Boon for Retailers."

Each health plan manages its own card balances. Cards can be loaded monthly or quarterly with anywhere from $50–$250 for use on eligible items. Customers can check their balance directly with their plan—usually through their plan's website, mobile app, or by calling the number on the back of their card. For many benefits cards, merchants can also check their card balance from the POS, after integration.

Eligibility depends on how each health plan categorizes products. Plans interpret product categories (such as grocery or OTC) differently and some plans provide different benefits based on health conditions.

As a result:

• An item may be eligible with one plan but not another.
• Some plans have broader or narrower definitions.
• Eligibility varies between cards even within the same store.

The decision comes from the health plan, not the retailer nor Fincretive. This is different than how SNAP/EBT programs operate. Eligible items for SNAP do not vary with each cardholder or plan and are the same for all recipients within the state where they reside.

Enrollment is handled entirely by Medicare Advantage or Medicaid health plans. Retailers do not enroll customers and cannot change or influence their benefits. Customers need to contact the plan they are interested in directly.