Headache Medications: FSA Eligibility

Headache medications are eligible over-the-counter (OTC) products with a prescription from a doctor 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.

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.

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, 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-directed 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, but common OTC products like pain relief medications, cold & flu products and more require a prescription for reimbursement.

However, not every OTC product falls under this distinction, as products like bandages, first aid supplies, diagnostic products and more do not require a prescription. For more information on a specific product, please 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

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.

 


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