FSA / HRA FAQs

Over-the-Counter

• Are Over-the-Counter (OTC) items eligible for reimbursement from my Medical Flexible Spending Account (FSA) or Health Reimbursment Account (HRA)?


• What requirements must be met for an OTC item to be eligible for reimbursement?


• What documentation do I need to submit for reimbursement of eligible OTC items?


• What OTC items are not eligible for reimbursement?


• Some OTC items can be used either for medical purposes or for general health/cosmetic purposes. Are these dual-purpose items reimbursable?


• Can I purchase large quantities of OTC items?

Are Over-the-Counter (OTC) items eligible for reimbursement from my Medical Flexible Spending Account (FSA) or Health Reimbursement Account (HRA)?

If certain requirements are met, a Medical FSA or HRA may reimburse medicines, drugs, and medical supplies that are available without a prescription. (You should refer to your Plan Highlights to see if OTC items are eligible for reimbursement under your HRA Plan.) Note that OTC items are still not deductible for federal income tax purposes.

What requirements must be met for an OTC item to be eligible for reimbursement?

• The item must be a medicine, drug or medical supply that is used "primarily for the prevention or alleviation of a physical or mental defect or illness" and that would not be used except for a particular medical condition.
• The item must not be used for general health or cosmetic purposes.
• The item must be used by the medical FSA / HRA participant or the participant’s spouse or dependent.
• The expense must be for medical care during the timeframe indicated in your Plan Highlights.

What documentation do I need to submit for reimbursement of eligible OTC items?

Along wtih your completed and signed claim form, you need to submit an itemized receipt from the provider indicating the following:

• name of the provider;
• date of the purchase;
• word description of the item being purchased;
• your out-of-pocket cost for the service.

Receipts that do not have this information pre-printed by the provider are not acceptable. You may need to find an alternate provider who provides itemized receipts.

Your signature on the claim form certifies that the item qualifies as an eligible expense under IRS regulations, is for use by you, your spouse or your eligible dependent and is not reimbursable from any other source.

What OTC items are not eligible for reimbursement?

Items are not eligible for reimbursement if they are normally used for general health or are used even when there is not a medical condition being treated (e.g. toothpaste, mouthwash, lotion, shampoo) or are cosmetic in nature (e.g. teeth whitening products, wrinkle reducers).

Some OTC items can be used either for medical purposes or for general health/cosmetic purposes. Are these dual-purpose items reimbursable?

Dual-purpose items may be reimbursable if they are used strictly for medical purposes. Any claim for a dual-purpose item must be accompanied by the Certification of Medical Necessity form.

Can I purchase large quantities of OTC items?

Reasonable quantities of OTC items are reimbursable if purchased for either existing or imminent medical conditions. If large quantities are necessary for the treatment of an existing condition, the medical practitioner must indicate on the Certification of Medical Necessity form that the quantity being purchased is necessary for the treatment of the diagnosed medical condition.

Sample Chart - thru 12/31/2008

Sample Chart - Effective 1/1/2009