| 1. OTC Drugs Used Primarily for Medical Care | |
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These are typically reimbursable with only a proper receipt. No recommendation from a health care provider is needed. Please note that generic brands are eligible. |
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| Type of Drug | Examples |
| Allergy Prevention & Treatment | 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 |
| 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, Hydrocortisone, and Lanacort, Calamine Lotion, Benadryl Cream, Caladryl, Cortaid, Lamisil AT, Lotramin AF, and Micatin |
| Band-aids | |
| 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 |
| Diaper Rash Ointments | Balmax and Desitin |
| Dehydration | Pedialyte |
| Eye Drops for Allergy/Cold Relief | Ocu Hist |
| Hemorrhoid Treatments | Preparation H, Hemorid, and Tronolane |
| Internal Analgesic/antipyretic | Advil, Aleve, Children’s Motrin, Nuprin, Excedrin, Tylenol, Bayer, |
| Joint Pain | Creams for joint and muscle pain such as BenGay and Flexall |
| 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 |
| Pre-Natal Vitamins | |
| Smoking Cessation | Commit, Nicoderm CQ, Nicorette, Nicotrol, |
| Toothache and teething pain relievers | Orajel |
| 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. Many plan sponsors may exclude completely to avoid having to determine whether the cost of a medicated shampoo exceeds the cost of regular 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 and other acne medicines (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 |
| Products used solely to treat acne (e.g., Clerasil) |
| No Doz (and other sleep prevention drugs) |
| Sleep-Aid |
| 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 |
| Teeth Whitening kits, and powders |
| Toothbrushes and toothpaste |
| Vitamins taken to improve overall-health |
| Wart Removal medications |
| Sunscreen |
| Chap stick |
| Visine |
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*Please note: OTC items purchased can only be used as medicines or drugs. Not for general health purposes. The purchase of these items should be proximate to the onset of the illness. FlexAmerica reserves the right to request additional documentation on questionable items that are purchased.
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| Frequently Asked Questions | |
| Can I use my debit card to buy OTC items? | Yes, but all documentation for these claims will need to be submitted |
| Do I need to send in documentation for my debit card transactions? | Yes unless it matches your RX or physician co-pay |
| Are hand written receipts allowed? | Yes, as long as they are from the provider |
| Are items I purchased before the announcement reimbursable? | Yes |
| Can a participant change their election? | No |
| Are cash register receipts acceptable documentation for OTC items? | Yes, if itemized |
| Are dietary supplements that are used to prevent/treat illnesses reimbursable? (e.g. Arthritis and Anti-Depressant) | Yes, with Dr.’s Note and in very limited circumstances |
| Can I purchase OTC items to have on hand in case of illness? | No |