Background
In March, 2010, the Patient
Protection and Affordable Care Act (PPACA) was signed into law as a
part of the health care reform initiative. Included with the law was
a new rule that limits the eligibility of over-the-counter (OTC)
drugs and medications for reimbursement through a Health Care FSA, a
Health Reimbursement Arrangement (HRA) and a Health Savings Account
(HSA).
We have prepared some
Frequently Asked Questions
to help explain this change in regulations.
When does the change take effect?
The law is effective on January 1, 2011, which
means that any OTC drug or medication purchase made in 2011 will
require a doctor's prescription before it can be reimbursed from one
of the covered health care accounts. The prescription date must be
prior to the date of the purchase of the OTC drug or medication.
What does this mean for
your account?
If you would like
to be reimbursed for expenses you incur for OTC drugs or
medications, you must obtain a prescription from a medical doctor
listing the item(s) you are to take. Once you have obtained
the prescription, you must submit this to ASIFlex who will keep this
on file for the lesser of one year or the duration noted on the
script.
The date
on the prescription must be prior to the purchase date of the OTC
item(s).
What about OTC supplies?
The
legislation only placed the requirement for a prescription on OTC
drugs and medications. OTC supplies such as contact lens
solution, bandages, hearing aid batteries, and eligible diagnostic
devices do not require a prescription. Additionally, the
legislation explicitly stated that OTC diabetes supplies will not
require a prescription.
What
am I supposed to ask for from my doctor?
You just need
to let your medical doctor know that you are enrolled in a pre-tax
spending program, and that in order for the OTC medications you take
to be eligible for reimbursement through the program, federal law
now requires that you have a prescription on file. He or she
should write the prescription for the OTC medication exactly as he
or she would with an actual prescription drug, meaning that the
prescription will need to be on a prescription pad, and the
prescription can include multiple items.
Do I need to
show my pharmacist the prescription?
No.
The prescription simply needs to be submitted to ASIFlex in order
for certain OTC drugs and medications to be eligible for
reimbursement through your spending account.
I
have a letter from my doctor that says I need certain OTC drugs.
Will this be sufficient?
No.
The regulations governing the eligibility of OTC drugs and
medications state that you must obtain a prescription that is valid
in the state in which you purchase the OTC items in order for
these items to
qualify.
| OTC Items That
DO NOT REQUIRE a Prescription |
OTC Items
that NOW REQUIRE a Prescription |
Bandages
Blood pressure monitors
Condoms
Contact lenses
Crutches
Diabetic monitors, test kits, strips and supplies
Hearing aids and hearing aid batteries
Insulin
Reading glasses
|
Acid controllers
Allergy and sinus medicine
Anti-diarrheal medications
Anti-gas products
Cough, cold and flu
Digestive aids
Feminine anti-fungal
Laxatives
Motion sickness
Pain relievers
Smoking deterrents
Stomach remedies
|