Is it covered?
Can I use my WEX card for prescriptions?
No
Where is the WEX job aid located?
Knowledge Base
I ordered a replacement WEX card. When will it arrive?
Allow up to 14 days for standard requests. Expedited requests may arrive within 5 days.
For members requesting a list of OTC items, we should...
Direct the member to the member portal to see a general list.
Educate members can order by phone, or online through the OTC store where items are always approved.
Advise members they may download the Essence Flex Spend Mobile App to easily scan items for eligibility.
In addition to OTC items, what else can the WEX card be used for?
Some plans may offer non-Medicare covered Dental, Vision, and Hearing costs.
Some plans may offer use for covered medical cost-shares.
ALWAYS review the members benefits before giving information.
I bought an item without my WEX card. Can I be Reimbursed?
No. When using the card in person, the member must use the card at the point of sale. The member cannot buy an item out-of-pocket and get reimbursed.
Where do we go to locate the member's card balance?
We should visit the WEX Health Cloud Administration Portal.
My OTC card was stolen, and purchases were made. Can I file a dispute?
Yes, the member has the right to dispute the transaction within a timely manner. The member must complete a Transaction Dispute Form to make this dispute. This form must be completed and mailed directly to WEX who will handle the review of the form. If the card is lost/stolen or the member believes there is fraud, we should issue a new card.
For members calling about Wex card being declined at the checkout counter, we should...
Ask the member what they attempted to purchase. Review the WEX portal to find out why the transaction denied, confirm the merchant is participating, and review the member’s current Wex balance to see if the member was spending more than the balance on the card.
What are the top three reasons members call in regarding their FLEX card?
Can I use my WEX card for OTC items online at Amazon?
No. The card may only be used online at the Essence OTC Store.
Name the three ways to purchase OTC items using the WEX card.
Members can order online by visiting the WEX Consumer Portal and click the "Essence OTC Store" button on the Home screen.
Members can order by phone at 833-881-1425. (approved list of items available)
At approved stand-alone merchant locations. Members can use the merchant locator on the WEX portal.
When a member calls with a complaint about a change to the OTC credit or dental amounts, what should the CSR do to resolve the issue?
Review the member's benefits within DASH and educate on what changes took place effective January 1.
Advise the member an Annual Notice of Change was sent to members in October showing these plan changes. We should offer to mail a copy and educate where this can be found on the member website.
We should educate this information is also in the Evidence of Coverage. We should offer to mail a copy and educate where this can be found on the member website.
Educate the member: "Annually, we make updates to member benefits to ensure they align with the evolving needs of all our member's needs and to deliver greater value. We want to ensure that we make the most out of your Medicare benefits."
For members calling about a product purchased with their Wex card being defective, we should...
Direct the member to speak to the merchant where the product was purchased to either get a refund or have the product replaced.
If I change from an HMO to a PPO plan, will I get a new flex card?
The member's member ID with the plan will change. This will cause previous member ID to be deactivated, and associated WEX card to be deactivated as well. Member will receive a new WEX card with a new WEX card number with a full allowance.