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Basics

Flex-Ed: Using an FSA to cover prescription medicines

If you have any prescription medications you take on a regular basis, you probably have a routine - go to the pharmacy, wait in line, hand over your insurance card and pay for the prescription with your debit or credit card.

Even with your insurance chipping in, chances are you end up paying a decent chunk of the bill out-of-pocket. If you're battling a chronic condition, those costs can really add up over time. But what if you could get that medicine at a cheaper price without using your insurance card?

It might sound crazy, but billing your insurance isn't always the most cost-effective option. Here's what you should know about the alternatives, and how your FSA card can save you even more.

Pay for prescription medicine instead of using insurance

A recent investigative report from The New York Times and ProPublica found that 40 common prescriptions were cheaper using GoodRx, a prescription discount card, than billing insurance.

GoodRx is the most common type of prescription discount card, and it's completely free. Blink Health, SingleCare and WellRx are some of the other cards available. All you have to do is print one out or have it mailed to you.

These discount cards only apply if you don't bill the prescription to your insurance. Here's how it works: You fill the prescription at a pharmacy, present the GoodRx or similar discount card and then pay for the remainder with your FSA card. Some pharmacies will even have the cards sitting out for anyone to use.

Discount prescription services list their prices before you buy, so you can see if it will be cheaper than using insurance and which pharmacy has the best price. As with most cost-saving measures, shopping around is a step toward saving the most money.

Pay for over-the-counter medicine

You can use your FSA card to pay for over-the-counter (OTC) medicine if a qualified professional has prescribed it (note that OTC items which do not contain an active medical ingredient will not require a prescription and you can shop for thousands of qualified items here). The prescription must be written before you buy the drug and generally within the FSA plan year in which you purchase it. .

You can use your FSA card when you buy the item at the drugstore. You can also pay with a regular debit or credit card and then request reimbursement from your FSA provider. Keep the receipt and the prescription to prove it's a qualified medical expense.

Pay for prescription medicine after insurance

If billing your insurance is still the cheapest way to buy a prescription, you can use your FSA card to save even more money.

When you fill the prescription, give the pharmacist your insurance card. They'll run the prescription and bill you for any leftover amount. You can pay for that directly with your FSA card or use a debit or credit card and then file a claim with your FSA provider. And of course, keep the receipt to prove it was an FSA-eligible expense.

Eligible with Rx

Flonase Allergy Relief Nasal Spray

Relieve seasonal and year round allergies.

Aleve All Day Strong Pain Reliever

Get you back on track, all day long.


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New to FSAs? Need a refresher course in all things flex spending? Our weekly Flex-Ed column gives you a weekly dose of FSA Living 101, offering tips for making the most of your tax-free funds. Look for it every Thursday, exclusively on the FSAstore.com Learning Center.

Basics

Real Money: How much is "too much" when it comes to FSA spending?

If you're like most folks, by this time of year, you may be sitting on a big pile of FSA money. According to our estimates, employees hand over up to $400 million of unused cash every year. Those are your hard-earned dollars disappearing back into your company's pockets.

Of course, you don't want to abandon these funds. But you don't want to blow it with your plan administrator, either. So, what's an FSA "hundredaire" to do? Start by checking out these tips.

Be strategic with your FSA balance

Spending down your FSA balance shouldn't be like an episode of "Supermarket Sweep." Instead, take a few minutes to make a list of all the things you actually need. (And if you haven't seen "Supermarket Sweep" make sure you do that right after creating the list.)

Smart spending could include replacing expired products. If you haven't purchased new glasses because the price tag scared you but you could benefit from an updated pair, now may be a good time to do it. For example, it's possible you don't have sunscreen for your upcoming cruise. If you're low on that ointment that your dermatologist recommended, call their office for a prescription.

(And once you have it in hand, our Prescription Process makes the rest of the process a snap.)

Once the panic of missing your FSA deadline dies down, it may be easier to remember all the things you've been too frugal to buy.

Your year-end FSA shopping spree could be scrutinized

The problem with "use-it-or-lose-it" rules is by the time you learn them, it may be too late. Or you hear about them with only a few days to spare. And the latter can lead to sprinting through the aisles of your local drugstore, pitching dozens of family-sized boxes of band-aids into your cart. Both are far from ideal — and stockpiling could get the stink eye from your administrator.

As a general rule of thumb, resist the urge to buy more than three of any single item. It's common for folks to try to stockpile over-the-counter items in December to spend down their FSA balances. But doing so could backfire and your plan administrator may not reimburse you.

If you know you will use the products within the plan year, that's may be enough to pass your plan administrator's sniff test. You are less likely to see a claim rejection if you buy reasonable amounts of FSA-eligible products.

If you're still worried, you can always contact your plan administrator first. Asking them for the specifics of what FSA spending is and it's allowed may ease your mind. If you received a copy of your Summary Plan Description during open enrollment, it may also spell out these rules, too.

Keep a list for next year's FSA spending

Once your FSA deadline passes, the clock starts ticking again for next year's spending. There is always room for improvement, and the end of the year is the perfect time for reflection. If you're not happy with this year's spending, shift next year's priorities accordingly. Instead of beating yourself up for past mistakes, take the opportunity to learn from them. The new year is a chance to start fresh and avoid a big balance next December.

Whether you budget week-to-week, or plan to use your FSA for bigger things, our weekly Real Money column will help you maximize your flex spending dollars. Look for it every Tuesday, exclusively on the FSAstore.com Learning Center. And for the latest info about your health and financial wellness, be sure to follow us on Facebook, Instagram and Twitter.