Over-The-Counter Items: FSA Eligibility

Over-the-counter (OTC) items are eligible on an FSA without a prescription. OTC drugs and medicines are eligible as well, but require a prescription from a doctor for reimbursement. These items are marked with a blue "Rx" logo on our website, while items not requiring a prescription are marked with a red check mark. OTC items reimbursement is eligible with a flexible spending account (FSA), health savings account (HSA) or a health reimbursement arrangement (HRA). Over-the-counter items reimbursement is not eligible with a limited care flexible spending account (LCFSA) or a dependent care flexible spending account (DCFSA).

What are over-the-counter items?

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 over-the-counter 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, but common everyday products like pain relief medications, cold & flu products and many more will require a prescription for full reimbursement.

A 2012 study commissioned by the Consumer Healthcare Products Association found that the use of OTC medicine would save the U.S. healthcare system $102 billion per year, as much of the savings comes from the utilization of low-cost medicines as opposed to drugs that must be filled by a pharmacist. However, not every OTC product is covered under this distinction, as products like bandages, first aid supplies, diagnostic products and more do not require a prescription. Only over-the-counter items that contain a medical ingredient require a prescription for reimbursement, so this is a helpful piece of information to keep in mind when purchasing OTC products with a consumer-directed healthcare account.

How does the prescription process work?

The reimbursement of OTC medicines begins by requesting prescriptions for medications during a routine doctor's appointment, or by following the Prescription Process found on FSAstore.com and HSAstore.com. Each of our products that require a prescription for reimbursement are marked with a blue "Rx" symbol, as well as red check marks that mark the products as free to purchase without a prescription.

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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

 


AZ-PROD-WEB01 11/18/2017 12:12:08 PM