Over-the-Counter Medicine: FSA Eligibility

Over-the-counter medicine is eligible for reimbursement with a flexible spending account (FSA), health savings account (HSA), health reimbursement arrangement (HRA) and limited care flexible spending account (LCFSA) with a prescription from a physician. Over-the-counter (OTC) medicine is not eligible for reimbursement with a dependent care flexible spending account (DCFSA).

Why do over-the-counter medicines require a prescription?

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.

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 are marked with a blue "Rx" symbol for those that require a prescription for reimbursement, as well as red checkmarks that mark the products as free to purchase without a prescription.

Over-the-Counter Medicine: Best Sellers


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 prescription

Legal Information / Regulations

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

 


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