Chest Rub: FSA Eligibility

Chest rub is an eligible over-the-counter (OTC) product with a prescription with a flexible spending account (FSA), health savings account (HSA) or a health reimbursement arrangement (HRA). Chest rub reimbursement is not eligible with a limited care flexible spending account (LCFSA) or a dependent care flexible spending account (DCFSA).

What are chest rubs?

Chest rubs have traditionally been one of the most popular methods of treating nasal congestion and increasing a person's ability to fall asleep when suffering from a cold or flu and its associated symptoms. These topical products are fortified with menthol, camphor and eucalyptus oil, which are common ingredient used in lozenges, nasal sprays, inhalers and cough syrups for its role in treating rhinitis, upper respiratory tract infections and allergic symptoms. By placing this substance on the chest, the active ingredients work to open up nasal passages and soothe coughing so an individual has the ability to sleep through the night as comfortably as possible (Healthline).

The placement of chest rubs also factors into the products' efficacy, as it should be placed on the upper chest below the chin where it can gently waft up into the nostrils and improve cold and nasal congestion symptoms. Chest rubs should never be used on children younger than 2 years old, and they should be applied 30 minutes before sleep to ensure a restful sleep for the individual who is suffering from nasal congestion symptoms. Chest rubs should not be placed by a person's mouth, along tight bandages, inside the nostrils or on wounds or damaged skin. With proper usage, chest rubs can be extremely effective in combating cold, flu and allergy symptoms in both adults and children (

Why does chest rub reimbursement require a prescription?

As a result of the passage of the Patient Protection and Affordable Care Act (PPACA), as of January 1, 2011, OTC items containing an active medical ingredient require a prescription for reimbursement with an FSA, HSA or HRA. To reimburse the cost of OTC medicines and drugs under FSAs, HSAs and other consumer spending accounts, account holders must submit a prescription for each product.

However, not every OTC product falls under this distinction and thousands of products continue to remain eligible without a prescription including bandages, first aid supplies, most sunscreens, diagnostic products, products for infant care and so much more. For more information on a specific product, be sure to consult our Eligibility List.

Eligibility Table

Flexible Spending Account (FSA) Limited Care FSA Dependent Care FSA Health Savings Account (HSA) Health Reimbursement Account (HRA)


Eligible with Rx

Eligible with LMN

Not Eligible

Additional Information's Prescription Process can help. Click Here to learn more.

Specifically Not Covered

Not eligible without a prescription.

Legal Information / Regulations

Prescription Required. Information Letter (IL) 2009-0209; Notice 2010-59.