Making the most of your Flex Spending Account (FSA): The OTC hurdle
February 16, 2015
Effective Jan. 1, 2011, distributions from health FSAs and HRAs will be allowed to reimburse the cost of over-the-counter medicines or drugs only if they are purchased with a prescription.
This change to the FSA/HRA rules was a real downer.
I use quite a lot of OTC stuff for my chronic pain and it’s not cheap. Thermacare heating pads, for example, are great and last 8-12 hours but a pack of two or three costs anywhere from $10-26. A week of back or shoulder pain could cost $75 just to keep heat on, and it’s rare for the pain to be confined to a single area. Usually it’s one half of the body, right or left side.
To a more astute person, there is an obvious solution so I confess, I totally missed the obvious here.
OTC medications aren’t allowable unless you have a prescription for them. I read that as: if the pharmacy didn’t fill it as a prescription then it wasn’t eligible. I was wrong.
I’ve been doing this with my massages for the chronic pain, but it didn’t occur to me til recently that the same thing would work for the numerous OTC items I’ve had to buy for prenatal and pregnancy related conditions: the letter of medical necessity!
If it’s for any kind of treatment that your doctor is aware of, or if your doctor is happy to fulfill such requests, then all you’ve got to do is ask for a letter stating that these items are being used for treatment.
Make it really easy for your doctor to fill in a form letter by providing the list of OTC meds and send a copy of that letter in with your receipts.
We’ve spent a significant amount on OTC meds and supplies during this pregnancy, it was awesome claiming it back.
Go forth, my friends, and save your effective tax rate in OTC FSA costs!
My doc back in Chicago always offered to write a prescription for vitamins and such if I needed it for FSA claims. I never took advantage of that offering since the amount one could withhold for FSA was lowered, too, and I could burn through that amount just in co-pays for stuff like physical therapy, talk therapy, etc.
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Well that is nice that your doc offered!
Yeah? Well, I tried that after the university switched to a different FSA supplier (word choice??) whose rules were tighter than the old provider’s.
I wear contact lenses and MUST, to protect my eyes in Arizona’s extreme sunlight, wear polarized sunglasses, which cost a-plenty. Under the old FSA, a good pair of sunglasses was covered. Under the new: nope. Not unless a doctor says, in writing, that you have to have it.
So I indeed did ask my ophthalmologist (M.D.) write a statement to the effect that non-prescription sunglasses were medically necessary because of the contacts.
Denied.
Am I the only one who sees a certain craziness in requiring doctors to write prescriptions for nonprescription drugs?? The whole idea of prescriptions is to control certain drugs, making it impossible for you to buy them over the counter. Making you get a prescription for a bottle of Dr. Who’s Snake Oil Bitters is ridiculous and will add significantly to already overloaded doctors’ workload.
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I think the lesson of your experience is that while the rules are absurd, your med practitioners are jerks.
Also I shall emphasize: “or if your doctor is happy to fulfill such requests,” for obvious reasons.
Gee, that’s unkind.
Polarized sunglasses are not an option when you’re wearing contacts in an Arizona summer, when the sun glares off the pavement enough to make your eyes water and, more to the point, to increase your chances of macular degeneration as you age.
I couldn’t afford to buy them, so had to stop using contacts and go back to glasses, through which I can’t see well enough to read street signs clearly — in fact I was using contact lenses for a real reason. I don’t think the doctor was being a jerk to try to make the FSA administrators understand the sunglasses were medically necessary…just as a bottle of OTC vitamins may be for you.
Sorry to have offended. It was nice to have been your virtual friend.
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We must have crossed wires – I thought by “Denied” you meant that your doctor had denied your legitimate request to write a letter of medical necessity, when you truly did need them? In which case I thought it was a fair assessment that he was being a jerk refusing to do something that would take a minute and presumably save you a fair penny? I’m now confused as this note seems to suggest that he did.
And I was emphasizing the statement about the doctor agreeing for other people who might take my note to mean all doctors will be reasonable and agree to write a letter but it seemed from your experience that may not be a fair expectation after all. That wasn’t a jab at you… If that’s how it was read?
[…] Our last nurse loaded us up with all the supplies we could ask for but the projected 4-6 weeks of recovery meant we still had to get refills of everything. Damn good thing I figured out the FSA thing. […]