Toothpaste: FSA Eligibility

Toothpaste is not eligible for reimbursement with a flexible spending account (FSA), health savings account (HSA), health reimbursement arrangement (HRA), limited care flexible spending account (LCFSA) or a dependent care flexible spending account (DCFSA).

What is toothpaste?

Toothpaste is an Over-the-Counter (OTC) toiletry item that can't be considered eligible for reimbursement, generally, unless it is a specialized form of toothpaste that has been prescribed by a medical doctor for the treatment, alleviation or prevention of a medical condition or disease, and/or is prescription-only because of its controlled ingredients. Medicated toothpaste is considered eligible for reimbursement with a consumer-directed healthcare account, but regular toothpaste is not (Dental Health Foundation).

What is medicated toothpaste?

Medicated toothpaste is a type of toothpaste that applies a medicine to the teeth, gums and mouth. Toothpaste is an effective way to apply medicine to the teeth, mouth and gums when treating certain diseases or conditions in those areas. Common conditions for which medicated toothpaste are typically prescribed include bacterial and fungal infections, cavities, gingivitis, root exposure, dry mouth, enamel demineralization, lesions, and furcation (bone loss).

Medicated toothpaste must be prescribed to treat a disease or condition of the teeth, gums or mouth in order to be eligible for reimbursement with a consumer-directed healthcare plan. Medicated toothpaste must be prescribed to treat a disease or condition of the teeth, gums or mouth, and not simply for cosmetic purposes, in order to be eligible for reimbursement.

Most medicated toothpastes have specific instructions on their labeling or packaging that describe how to use the toothpaste. Some medicated toothpastes require specific application techniques or a set duration of contact with the teeth, gums and mouth in order to provide a medical benefit. Some medicated toothpastes require a specific periodicity of use, or should not be used too often, in order to maintain a healthy mouth. Medicated toothpastes will have instructions detailing all risks, side effects, warnings, and specific instructions for use. The medical professional who prescribes the medicated toothpaste will also be able to explain the purpose of the toothpaste, and how to integrate it into a healthcare treatment plan for a medical condition or disease.

Medicated toothpaste may be brand-name or generic, Over-the-Counter (OTC) or prescription only. A prescription must be acquired, regardless, for reimbursement eligibility. Medicated toothpaste may be one part of a treatment plan for a disease or condition of the teeth, gums or mouth, or it may be the entirety of the treatment. Only the excess cost of the medicated toothpaste is eligible.

Eligibility Table

Flexible Spending Account (FSA) Limited Care FSA Dependent Care FSA Health Savings Account (HSA) Health Reimbursement Account (HRA)


Eligible with Rx

Eligible with LMN

Not Eligible

Additional Information'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-WEB02 10/21/2018 10:50:52 AM