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Microsoft word - gp53065 otc drugs listing .doc

Principal Life
Over-The-Counter (OTC)
Des Moines, IA 50392-0002 Insurance Company
Drug List Guideline
The IRS defines eligible Over-The-Counter Drugs as pain relievers, antacids, cold remedies and allergy medications. In an effort to help define each of the categories we have established a list of examples. (This is not an all-inclusive list.)
This material is intended solely for information and education. It is not to be used as the basis for legal or tax
advice. For advice on your situation, you must seek out and rely on the counsel of your own attorneys or tax
advisors.

OTC Drugs Used Primarily for Medical Care. These are reimbursable with only a third party receipt. A
recommendation from a health care provider is not required.

Pain Relievers:
Type of Drug
Examples (common brands, not a comprehensive list)
Advil, Aleve, Motrin, Bayer, Excedrin, Tylenol, Nuprin BenGay, Tiger Balm, Flexall, Absorbine Junior Advil Migraine, Excedrin Migraine, Motrin Migraine anti-itch lotions and creams (e.g. for athletes foot, Bactine, Cortaid, Hydrocortisone, Calamine Lotion, Benadryl Cream, Lanacort, Lamisil AT, Micatin
Allergy Medications:
Type of Drug
Examples (common brands, not a comprehensive list)
Benadryl, Sudafed, Actifed, Claritin, Chlor-Trimeton Actidil, Actifed, Allerest, Benadryl, Claritin, Chlor-Trimeton, Contac, Dimetapp, Drixoral Cold Remedies:
Type of Drug
Examples (common brands, not a comprehensive list)
Advil Cold and Sinus, Afrin, Aleve Cold, Children’s Advil decongestant/nasal decongestant/cold remedies Cold, Duration, Dristan, Neo-Synephrine, Nyquil, Tylenol Cold and Flu, Allerest, Alka Seltzer
Antacids:
Type of Drug
Examples (common brands, not a comprehensive list)
Gas-X, Maalox, Mylanta, Tums, Rolaids, Pepsid AC, Ex-Lax, Pepto-Bismol, Imodium A.D., Kaopectate
Miscellaneous Items:
Type of Drug
Examples (common brands, not a comprehensive list)
Trojans, VGF Film, Delfen Contraceptive Foam Bausch & Lomb, Boston, Opti-free, Allergan, Renu Thermometers, Medical Gloves, Rubbing Alcohol HIV Test, Cholesterol Test, Diabetic Supplies Clear Blue Easy, EPT, Clear Plan, First Response Nicotine Gum, Nicorette, Nicoderm CQ, Nicotrol Dual Purpose OTC Drugs. These require a third party receipt and a note from a health care provider listing the
diagnosis of the medical condition and the recommendation of the OTC drug.
• 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 • hormone therapy drugs • Retin-A • sleep-aids • vitamins are not an eligible expense, unless prescribed by a physician to treat a specific medical condition. (i.e. iron to treat, not prevent, anemia; calcium supplements to treat, not prevent, osteoporosis). A doctor's note detailing the specific medical condition will be required for reimbursement. • weight loss/dietary supplements must be for a specific medical condition such as obesity • incontinence supplies such as Depends • blood pressure monitor, glucose tester • crutches OTC Items Not Reimbursable. These OTC Drugs or other products are not considered medical care and are not
reimbursable through the plan.
• chapstick or lip balm • cosmetics • cotton balls • deodorants • face creams, moisturizers, eye creams, and wrinkle reducers • feminine hygiene products such as tampons and maxi pads • food items (i.e. Slim Fast) • hair removal treatments and waxes • mouth washes, antiseptics and oral anesthetics • shaving cream and razors • soap • teeth whitening kits, and powders • toothpaste • vitamins taken to improve overall-health • shampoo • electric toothbrush or Waterpik If you have any questions about items listed or not listed please call 877-372-4730, option 2 to speak with a Reimbursement Specialist.

Source: http://hr.co.polk.ia.us/FSA%20OTC%20Drugs%20Listing.pdf

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