Why do I need a prescription for Tylenol when it's OTC?

Update: As of March 2020 with the passage of the CARES Act, the OTC Rx requirement has been repealed and prescriptions are no longer necessary to purchase over-the-counter medicines with an FSA or HSA. Additionally, menstrual care products like tampons and pads are fully FSA-/HSA-eligible. Learn more here.


You'll need a prescription for Tylenol even though it's an over-the-counter product if you're looking to get reimbursed by your Flexible Spending Account (FSA). The IRS made changes as of January 1, 2011, that any OTC products containing medicine will require a doctor's prescription for FSA reimbursement. This means that FSA eligible items such as Tylenol, Advil, and Zyrtec will require a prescription. But that excludes thousands of other products – not containing medicines – that are FSA eligible expenses such as sunscreen, first aid kits, breast pumps, and so much more.

You may be thinking, “Why would I buy these OTC drugs with a prescription? It's such a hassle."

We completely understand this frustration, and have an easy Rx Process that lets you submit prescriptions. We give you multiple options to easily process your prescriptions – you can use our “Call My Doctor" feature and we'll take it from there; you can mail the prescription to us directly; or you can ask your doctor to fax or call the prescription over to our pharmacy partner.

If you're not sure if a specific item requires a prescription, browse our FSA Eligibility List to get an overview of FSA Eligible products.

Top FSA Eligible Products