Microsoft word - eligible over the counter drugs.doc

Over-the-Counter (OTC) Medical Care Items
Eligible and Ineligible for Reimbursement
Over-the-counter (OTC) medicines and products are now reimbursable under a Health Care Flexible Spending Account when the OTC is used for medical purposes. OTC items generally fall into one of the following three categories: 1. Those eligible for reimbursement because they are used primarily for medical care. 2. Those ineligible for reimbursement because they are merely beneficial for general health. 3. Those eligible for reimbursement with a letter from the attending physician. The letter must cite the specific medical condition being treated and indicate that the OTC drug or medication will treat or alleviate the medical condition sited. **Please use the form letter on our website titled Letter of Medical Necessity Form**

Please note that the following are representative lists. They do not include all available OTC drugs and medical care items, and
the lists are subject to change.
Eligible OTC Expenses primarily used for Medical Care. These expenses are reimbursable with a third party receipt. No
recommendation from a health care provider is required.
Product Type
Examples include, but are not limited to:
Allergy Medicines – pill, liquid nasal spray (see also “Eye
Benadryl, Chlor-Trimeton, Claritin, Drixoral, NasalCrom, Antacids and acid reducers –pill, liquid, tablet
Alka-Seltzer, Beano, Gas-X, Lactaid, Mylanta, Maalox, Pepcid AC, Pepto-Bismol, Phazyme, Prilosec, Rolaids, Tums, Zantac 75 Antibiotic creams/ointments
Anti-diarrhea or Laxatives – pill, liquid
Imodium A.D., Kaopectate, Pepto-Bismol, Ducolax, Ex-Lax, Fleet Anti-Fungal Creams and Powders (e.g. for athletes foot )
Aftate, Cruex, Lamisil, Lotrimin, Micatin, Tinactin, Lamisil AT Anti-Itch Cream (Allergies, bug bites and poison ivy)
Bactine, Benadryl Cream, Cortaid, Hydrocortisone, Lanacort, Asthma Medicine
Bronitin Mist, Bronkaid, Bronkalizer, Primatene Mist Baby Care Products
Diaper rash cream/ointment, rehydration liquids (Pedialyte), teething gel, Balmax, Desitin Cold Sore/ Fever Blister Remedies
Abreva, Anbesol, Cankaid, Carmex, Kank-A Cold and Flu Medicines
Cough & sore throat lozenges/drops, cough syrup, decongestants, homeopathic cold medicines, nasal sprays, vapor rubs Contraceptives/Family Planning
Condoms, contraceptive creams, pregnancy tests, ovulation predictor kits Dental/Denture Care
Diabetic Supplies/ Equipment
Alcohol swabs, blood glucose control solutions, monitors, strips and products; lancets and lancet devices, urine testing products. Ear Drops (ear wax removal)
Auro Ear Drops, Debrox Ear Drops, Murine Ear Drops Eye Care Products
Saline and cleaning solutions, eyeglasses, contact lenses, ear plugs Eye Drops for Allergy/cold relief /Eye Wash Products
Eye Wash products to clean out eye or remove foreign objects, Clear eye, Ocu-Hist, Murine, Visine Feminine Yeast Infection Medicine
First Aid
Bandages, Dressings, First aid kits, Medical gloves, Peroxide, Rubbing alcohol, Joint supports (ankle, knee, wrist, etc.), Ace wraps, Splints, Thermometers, Liquid adhesives, Support Hemorrhoid Relief
Home Diagnostic Test or Kits
Cholesterol, colorectal, drug, HIV, ovulation predictor, pregnancy and urine tests; thermometers Hot/Cold Packs
Medical Products, Devices, and Incontinence Supplies
Blood Pressure Monitor, Depends, Diabetic Supplies, HIV Test, Cholesterol Test, Crutches, Ovulation Kits, Pregnancy Test Motion Sickness Medicine
Bonine, Dramamine, Marizine, motion sickness wristbands Pain Relievers
Acetaminophen, Advil, Aleve, Anbesol, Aspercreme, aspirin, Ben-Gay, Cystex, Excedrin, Ibuprofen, Icy Hot, Midol, Mineral Ice, Motrin, Naproxen sodium, Pain relieving gels, Tylenol, Smoking Cessation Aids – patches and gum
Nicoderm CQ, Nicorette, Nicotine Gum, Nicotrol, Novartis Wart or Corn Removal – liquids or pads
Compound W, Curad, Dr. Scholl’s Corn Remover, Wart-Off Over-the-Counter (OTC) Medical Care Services/Items
For Dual Purpose require a Letter of Medical Necessity to review for Reimbursement

Dual Purpose OTC Items. Certain OTC products are considered dual-purpose, such as vitamins and supplements. That is because for
some individuals, the product is used to alleviate a medical condition, while others use the product for general health and well being.
These items or services may be eligible for reimbursement, but require a Letter of Medical Necessity (LMN) in writing by a physician.
The physician’s letter must cite the specific medical condition being treated and indicate that the OTC item or service
recommended will treat or alleviate the condition.
Please have the provider complete the LMN form found on our website for the handling of your request.
Product Type
Examples include, but are not limited to:
Acne Medications – pill, liquid, cream, ointment, medicated soaps Clean & Clear, Clearasil, Loma Lux Acne, Nature’s Cure
and cleansing pads
Arthritis Supplements not covered for overall joint health

Fiber Therapy/Supplements
Echinacea, Evening primrose oil, Ginkgo Biloba, Ginsana, Ginseng, Goldenseal root, Olive leaf extract, St. John’s Wort Other Supplements
Acidophilus, Amino acids (L-Lysine, L-Arginine, L-Carnitine), Cod liver oil, DHA, DHEA, EFO, Flax seed oil, Kelp, Melatonin, Omega- Sleep Induction Medicine
Simply Sleep, Sleepinal, Sominex, Unison Snoring Cessation Aids
Vitamins are not an eligible expense, unless prescribed by a
Antioxidants, Calcium to treat, not prevent, osteoporosis, physician to treat a specific medical condition, not prevent a
Chromium, Folic acid, Iron to treat, not prevent, anemia, condition
Water Retention Products
Weight Loss Supplements must be for a specific medical
Pills recommended by a physician in writing condition such as obesity

Over-the-Counter (OTC) Items or other Services
OTC Not Eligible for Reimbursement. These OTC Drugs or other products are not considered medical care and are not
reimbursable through the Health Flexible Spending Plan as they are viewed as general health items.

Product Type
Examples include, but are not limited to:
Bath Products, Cleansers, Soaps
Aveeno, Cotton Balls, Cosmetics, Dial, Dove, Softsoap Creams, Lip Balm, Lipstick, Lotions, Moisturizers
Basis, Biore, Chapstick, Eucerin, L’Oreal, Neutrogena, Nivea, Dental – Miscellaneous
Breath fresheners,, dental floss, adhesives, cleansers, gel, gum, rinses, oral cleaning systems (WaterPik); whitening products/systems, toothbrushes, toothpaste Deodorants / Anti-Perspirants
Feminine Hygiene
Always, douches, feminine lubricants and pads, tampons Hair Care Products
Conditions and shampoo (including those used for dandruff), hairspray, styling aids, hair removal treatments and waxes Medicine Dispensers
Stimulants (to stay awake)
Vitamins

Source: http://www.newsura.com/wp-content/uploads/2010/04/Eligible-Over-The-Counter-Drugs.pdf