Pain Relievers: FSA Eligibility

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

What are pain relievers?

Pain relievers are analgesic medications. They are Over-the-Counter (OTC) but require a medical doctor's prescription in order to be considered eligible for reimbursement with a consumer-directed healthcare account.

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.

What are 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.

Combinations

Pain relievers 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?

OTC pain relievers like ibuprofen 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 like ibuprofen under FSAs, HSAs and other consumer-driven healthcare accounts, account holders must submit a prescription from a physician for each product.

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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

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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