Flexible Spending Accounts

Over-the-Counter (OTC) Reimbursement Charts

 

The following is a listing of OTC drugs by type (and name brand example).  We have separated these OTC drugs into the following categories:

 

  1. Primarily Medical Care: This chart identifies drugs that typically fall into the category of medical care.  The participant does not need a diagnosis of a specific condition and recommendation to take the OTC from a health care provider in order to receive reimbursement.

 

  1. Dual Purpose: This chart identifies drugs that typically serve a dual purpose-general health of the individual and/or to treat a specific medical condition.  Participants must have a diagnosis of a specific condition and a recommendation to take the OTC by a health care provider in order to receive reimbursement.

 

  1. General Health/Cosmetic: This chart identifies drugs that are typically for the general health of the individual and/or cosmetic drugs and toiletries.  These are typically not reimbursable under any circumstance. 

 

These lists are not intended to be exhaustive.  Other drugs not listed may fall into one the categories described below.

 

1. OTC Drugs Used Primarily for Medical Care

 

These typically reimbursable with only a proper receipt.  No recommendation from a health care provider is needed.

Type of Drug

Examples[1]

Acne Treatment

 

Allergy Prevention & Treatment

Clearasil, Proactiv Solution

 

Benadryl, Sudafed, Actifed, Chlora Trimaton, and Nasalcrom

Antacids and Acid Reducers

Gas-X, Maalox, Mylanta, Tums, AXID AR, Pepcid AC, Prilosec OTC, Tagamet HB, and Zantac 75AXID AR, Pepcid AC, Prilosec OTC, Tagamet HB, and Zantac 75;

Anticandial

Femstat 3, Gyne-Lotrimin, Mycelrx-7, Monistat 3, 7, and Vagistat-1

Antihistamines

Actidil Syrup and Capsules, Actifed, Allerest, Benadryl, Claritin, Chlor-Trimeton, Contac, Dimetane, Drixoral, Nyquil, Sudafed, Tavist-1, and Triaminic

Antidiarraheal and Laxatives

Ex-Lax, Pepto-Bismol, Immodium A.D. and Kaopectate

Anti-fungal

Lamisil AT, Lotramin AF, and Micatin,

Anti-itch Lotions and Creams (e.g., for athletes foot, jock itch, bug bites, poison ivy)

Bactine, Caldecort, Cortaid, Hydrocortisone, and Lanacort, Calamine Lotion, Benadryl Cream, Caladryl, Cortaid, Lamisil AT, Lotramin AF, and Micatin

 

 

1. OTC Drugs Used Primarily for Medical Care (con’t)

These typically reimbursable with only a proper receipt.  No recommendation from a health care provider is needed.

 

Cold Sore/Fever Blister

 

 

 

 

 

 

 

Abreva Cream

Cough Suppressants, Cough Drops

Robitussin, Vicks 44, Chloraseptic

Decongestant/ Nasal Decongestant and Cold Remedies

Advil Cold and Sinus, Afrin, Afrinol, Aleve Cold and Synus, Children’s Advil Cold,  Duration, Dristan Long Lasting, Neo-Synephrine- 12 Hour, Orrivin, Sudafed, Tavist-D,   Tylenol Cold and Flue, Thera-flu, Alka Seltzer Cold and Flu, Nyquil, Actidil Syrup and Capsules, Actifed, Allerest, Benadryl, Claritin, Chlor-Trimeton, Contac, Dimetane, Drixoral,  Sudafed, Tavist-1, and Triaminic

Dehydration in Children

Diaper Rash Ointments

Pediatlyte

Balmax and Desitin

External Analgesic

Eye Drops for Allergy/Cold Relief

Ben Gay, Flexall

Ocu Hist, Visine

Hemorrhoid Treatments

Preparation H, Hemorid, and Tronolane

Internal Analgesic/antipyretic

Advil, Aleve, Children’s Motrin, Nuprin, Excedrin, Tylenol, Bayer,

Menstrual Cycle Medications

Midol, Pamprin, and Premysyn PMS

Migraine

Advil Migraine Liqui-gels, Excedrin Migraine, Motrin Migraine Pain,

Motion Sickness Medication

Dramamine and Marizine

Nicotine Gum or Patches and Smoking Cessation Aids

Nicorette, Nicotrol, and Nicodin

Pediculicide (head lice)

Nix

Poison Ivy Protection

Ivy Block

Smoking Cessation

Commit, Nicoderm CQ, Nicorette, Nicotrol,

Toothache and teething pain relievers

Wart removal medication

Orajel

 

[1] This list is not an exhaustive list and is intended to give examples of some of the most common brand names of OTC drugs.

 

2. Dual Purpose OTC Drugs

 

Permissible with Health Care Provider’s Note Listing Diagnosis of a Medical Condition and Recommendation of OTC Drug

Anti-baldness/hair loss/ hair replacement/ such as Rogaine, but only if to replace hair loss due to a medical condition and not for balding due to age

Medicated shampoo to treat a specific medical condition like psoriasis and only the amount in excess of the cost of normal shampoo.

Dental fluoride treatments, special mouthwashes, or treatments for gingivitis

Fiber supplements such as Benefiber and Metamucil

Glucosamine/chondrotin for arthritis or other medical condition (not reimbursable if taken for overall joint health)

Herbal supplements used to treat a specific disease such as St. John’s Wort for depression

Nose strips for proper breathing or other medical conditions

Retin-A (not reimbursable if used for cosmetic purposes such as wrinkle reduction)

Snoring cessation aids and medications such as Breathe Right Spray, Snorezz

Weight loss/dietary supplements must be for a specific medical condition such as obesity

 

Type of Drug

Comments

Sunscreen

Arguably, sunscreen prevents cancer and “prevention” is one of the core elements of the definition of medical care.  However, unless the individual had or has skin cancer, there is likely no imminent probability of disease.

 

 

Chapstick

Some would argue that this is cosmetic.  However, medicated chapstick is used to treat chapped and broken lips, which is arguably a medical condition. 

 

 

 

3. OTC Drugs Primarily - Not Reimbursable

 

OTC Drugs or other products that are not for Medical Care

Deodorants

Face creams, moisturizers, eye creams, and wrinkle reducers

Hair removal treatments and waxes

Mouth washes, antiseptics and oral anesthetics

Toothpaste, Teeth Whitening kits, and powders

Vitamins taken to improve overall general health