Over-the Counter Medicine
Over-the-counter (OTC) medicines and products are reimbursable under a Health Care Flexible Spending Account (HCFSA) when the OTC product is used for medical purposes. Fox & Fox allows the same expenses as those allowed by the IRS. Below is a description of the three IRS-defined categories, followed by product examples for each.
Eligible OTC Medical Care Expenses
Eligible items include medicines or products that alleviate or treat injuries or illness for you and your dependents. These drugs and products are not cosmetic in nature, or merely beneficial to your general health. Claims for OTC medicines and products must include an adequate receipt accompanied by the Fox & Fox claim form. An adequate receipt states the name of the medicine or product, the date, and the amount paid. You do not need to provide a statement from a medical provider or indicate a diagnosis in order to receive reimbursement.
Dual-Purpose Products
Certain OTC products are considered dual-purpose, such as vitamins and supplements. That’s because for some individuals, the product is used to alleviate a medical condition, while others use the product for general health and wellbeing. These products may be eligible for reimbursement, but require a Letter of Medical Necessity stating your specific diagnosis or medical condition, a recommendation to take the specific OTC medicine to treat your condition, and documentation of the product and cost. Fox & Fox provides a Letter of Medical Necessity to assist you in submitting this information.
If you have a condition that requires a specialized general purpose item (i.e. special laundry detergent due to allergies) and you have a letter of medical necessity, you can claim the difference in cost between the specialized detergent and the regular detergent. You must submit a statement or printout showing how much a “comparable” non-medicated product costs.
Excluded Items
OTC products that are not medicines or that merely benefit your general health, such as vitamins, are NOT reimbursable without a letter of Medical Necessity (LMN). Reimbursement for OTC medicines still follow the existing rules regarding FSAs. The expense(s) must:
- Be incurred during your period of coverage
- Not be reimbursed through another plan
- Be substantiated by a detailed receipt
Please note that stockpiling OTC medicines or items is not allowed and that requests for quantities deemed by Fox & Fox to be stockpiling will be denied.
Eligible OTC Expenses include medicines or products that alleviate or treat injuries or illness for you and your dependents. You do not need to provide a statement from a medical provider or indicate a diagnosis in order to receive reimbursement.
Click here to see Type/Class of Drugs and Products with Examples.
Dual-Purpose OTC Medicines and Products may be reimbursed under an FSA with a licensed health care provider’s LMN stating your specific diagnosis or medical condition, a recommendation to take the specific OTC medicine to treat your condition, and documentation of the product and cost.
Click here to see Type/Class of Drugs and Products with Examples and Excluded OTC Products (non-eligible expenses)
