Anti-Fungal Treatments: FSA Eligibility

Anti-fungal treatment reimbursement is eligible with a prescription from a doctor with a flexible spending account (FSA), health savings account (HSA) or health reimbursement arrangement (HRA). Anti-fungal treatment reimbursement is not eligible with a limited care flexible spending account (LCFSA) or a dependent care flexible spending account (DCFSA).

What are anti-fungal treatments?

Fungal germs, also known as fungi, exist naturally in many forms throughout nature, be it on food, plants and other places throughout the environment. However, some fungi have the ability to grow and thrive on various surfaces of the body, particularly the nails, skin, mouth and genital areas. These fungal infections vary from minor everyday issues like athlete's foot to more advanced, potentially life-threatening, conditions like fungal meningitis.

Anti-fungal treatments are designed to combat the growth of these fungal cells by infiltrating the cellular walls of the fungi cells and causing them to die soon after. The primary forms of anti-fungal treatments include:

Topical anti-fungal treatments

The most common ingredients in topical antifungal creams, liquids, shampoos and sprays include Amorolfine, Clotrimazole, Econazole, Ketoconazole, Miconazole, Tioconazole and Terbafine. These products are primarily used to treat mild to medium fungal infections of the skin, scalp and nails. These anti-fungal ingredients are typically combined with other substances to provide a wide spectrum of care, such as hydrocortisone to combat rashes that are sometimes associated with fungal infections.

Anti-fungal pessaries

These are primarily used to treat yeast infections, also known as vaginal thrush, and are inserted into the vagina. The primary ingredients used to treat this condition are Clotrimazole, Fenticonazole, Econazole and Miconazole. These tablets gradually release active ingredients into the effective area and break down over time.

Anti-fungal oral medication

Oral fungi growth is typically a minor medical issue that can be treated by anti-fungal oral medications, but if the immune system is weak, the growth of this fungi may be more severe and difficult to control. Oral thrush is an example of this and is the result of an overgrowth of the fungus candida albicans, which naturally occurs in the mouth. Anti-fungal treatments for the mouth are typically gels, liquids and tablets, and use the active ingredients Miconazole, Terbinafine, Itraconazole, Fluconazole, Posaconazole and Voriconazole.

Anti-fungal injections

In the most severe cases, anti-fungal injections will be needed to treat fungal infections that threaten the well-being of internal organs. Depending on the type of fungal infection, the most common anti-fungal injections include Micafungin, Anidulafungin, Caspofungin, Amphotericin, Flucytosine, Itraconazole and Voriconazole.

Why do anti-fungal treatments require a prescription for reimbursement?

As a result 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 spending 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 is an exception to this rule), but common OTC products like pain relief medications, cold & flu products and more require a prescription for reimbursement.

Eligibility Table

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

Not eligible without a prescription.

Legal Information / Regulations

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

 


AZ-PROD-WEB01 10/23/2017 2:58:39 PM