Headache Medications: FSA Eligibility

Headache Medications: requires a prescription to be eligible with a Flexible Spending Account (FSA)

Headache medications are eligible over-the-counter (OTC) products with a prescription with a flexible spending account (FSA), health savings account (HSA) or a health reimbursement arrangement (HRA). Headache medications reimbursement is not eligible with a limited care flexible spending account (LCFSA) or a dependent care flexible spending account (DCFSA).

What are headaches?

Headaches are among the most common everyday maladies that individuals of all ages contend with, and they can arise suddenly without warning to last for as little as an hour and as long as multiple days. Headaches can affect nearly every portion of the head and can vary in their severity, from dull pain to sinus pressure to sharp pain that can be extremely debilitating.

There are two types of headaches: primary and secondary headaches. Primary headaches are common occurrences that relate to chemical activity in the brain or stress and are not indicative of an underlying medical condition, which include migraines, cluster headaches, tension headaches and those related to one's lifestyle caused by alcohol consumption, stress, lack of sleep, and diet. However, secondary headaches are a symptom of a disease that can activate the pain-sensitive nerves in the head and are indicative of a larger issue. These maladies can include brain tumors, acute sinusitis, concussion, stroke and many more (Medical News Today).

What are the most common headache medications?

Analgesics (pain relievers) are the most common options to treat headaches, and the vast majority of these products are available over-the-counter, but require a prescription for reimbursement through an FSA, HSA or HRA. Common medications like aspirin , acetaminophen, ibuprofen and others work by going directly to the source of headache pain by interfering with the body's production of prostaglandins that send pain signals to the brain and contribute to bodily inflammation that causes pain. Some of these medications have secondary effects, such as acetaminophen functioning as a fever reducer while aspirin doubles as an anti-inflammatory to treat aches, pains and other maladies (WebMD).

Why do I need a prescription for headache medications reimbursement?

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.

Additional Information

FSAstore.com'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.