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Analgesics (painkillers): FSA Eligibility

Analgesics (painkillers) are eligible for reimbursement with a prescription from a doctor with a flexible spending account (FSA), health savings account (HSA) or health reimbursement arrangement (HRA). Analgesics are not eligible for reimbursement with a limited care flexible spending account (LCFSA) or a dependent care flexible spending account (DCFSA).

What are analgesics?

Analgesics is the blanket term for a wide range of drugs that are used to bring about "analgesia," or pain relief. Unlike anesthetics that eliminate sensations, analgesics are designed to treat both peripheral and central nervous systems to alleviate pain associated with both mild and severe medical conditions. These medications come in a variety of forms, such as over-the-counter pain relievers like Tylenol and Advil, to more advanced pain relievers like oxycodone or morphine. The most common classifications of analgesics include:

Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)

This classification typically refers to drugs that manage mild to moderate pain involving the musculoskeletal system. In addition to pain relief, these drugs have anti-inflammatory and fever-reducing properties, which makes them ideal for alleviating pain relating to joint and muscle issues, headaches, arthritis symptoms, and everyday aches and pains. The most common over-the-counter (OTC) drugs include Aspirin, Ibuprofen, Ketoprofen and Naproxen, while more advanced NSAIDs can also be found in prescription form.

Opioids

For more advanced pain symptoms that NSAIDs may not be able to alleviate, doctors may prescribe opioids for issues that may not respond well to OTC medications. Opioids bind to receptors in the brain, spinal cord, and other areas of the body to reduce pain by blocking pain signals on their way to the brain. Opioids come in a variety of strengths and prescription levels, but the most common forms include Codeine, Hydrocodone, Morphine, Oxycodone, Acetaminophen, Methadone and more.

Combinations

Analgesics are also frequently used in tandem to create synergistic effects to combat multiple sites of pain, treat non-pain symptoms, inflammation and even allergic symptoms. Typically, NSAIDs are combined with weaker opioids to attack multiple pain points, or matched with additional drugs to treat multiple symptoms. For instance, antihistamines are typically combined with NSAIDs to reduce allergic symptoms, while providing pain relief and anti-inflammatory properties.

How are analgesics reimbursed?

Analgesics like opioids are typically only available with a prescription from a physician, but OTC pain relievers require a prescription, as well. As a result of the passage of the Patient Protection and Affordable Care Act (PPACA), as of January 1, 2011, a new set of uniform standards were put into place regarding the reimbursement of medical expenses. To reimburse the cost of OTC medicines and drugs under FSAs, HSAs and other consumer-driven healthcare accounts, account holders must submit a prescription from a physician for each product. This does not apply to the reimbursement of the cost of insulin (insulin does not require a prescription), but common OTC products like pain relief medications, cold & flu products and many more require a prescription for full reimbursement.

 
Flexible Spending Account (FSA) Limited Care FSA Dependent Care FSA Health Savings Account (HSA) Health Reimbursement Account (HRA)
Eligible
Eligible with Rx
Eligible with LMN
Not Eligible
 
 
Additional Information

FSAstore.com's Prescription Process can help. Click Here to learn more.

Specifically Not Covered

Analgesics without a prescription.

Legal Information / Regulations

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