Supplements: FSA Eligibility
Prescription Required for most. Information Letter (IL) 2009-0209; Notice 2010-59.
Over-the-counter medicines are eligible with a prescription from a doctor. Over-the-counter items not containing a medicine are eligible without a prescription.
What are supplements?
Vitamin and nutritional supplements constitute a multi-billion dollar industry that design and market a wide range of vitamin and mineral supplements, herbal supplements and sports nutrition products. While these products undoubtedly can play a tangible role in improving a person's overall health and can help to fill nutritional gaps that may be present in one's diet, the IRS considers the vast majority of these products as items that will support an individual's "general health," and will not aid in the treatment or prevention of a legitimate medical conditions.
However, while by and large most vitamin supplements are not covered by consumer-directed healthcare accounts like FSAs and HSAs, there are some exceptions to this rule that would make them eligible for reimbursement with a prescription from a physician. For instance, the supplements glucosamine and chondroitin form the building blocks of healthy cartilage in our joints, and they are taken by individuals with osteoporosis or at a high risk of the condition to slow the breakdown of joint cartilage and to relieve pain. These supplements would be eligible for reimbursement without requiring a prescription. (National Center for Complementary and Integrative Health).
In addition to glucosamine and chondroitin, prenatal vitamins are also eligible for reimbursement without the need for additional documentation. But the vast majority of supplements fall outside IRS rules for product eligibility and are handled on a case-by-case basis by benefits administrators who have to determine whether these products are medically necessary in the treatment of a medical condition.