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Health Care Reform Impact on Spending Accounts


Beginning January 1, 2011, legislative changes impact the reimbursement of over-the-counter (OTC) drugs and medications from any personal spending account that allows for tax code section 213(d) expenses. Only OTC drugs and medications that are prescribed* may be reimbursed under these new rules.

  • For a health savings account, the prescription* must be retained by you along with your receipts in case the IRS needs to validate the purchase(s) at a later date.
  • For other medical spending accounts (for example, flexible spending account, health reimbursement arrangement, voluntary employees beneficiary association or health care reimbursement account) that allow 213(d) expenses, a copy of the prescription* must be submitted with the claim for reimbursement.

This change impacts only OTC drugs and medicines. Other OTC medical products, such as supplies, remain reimbursable without the additional documentation requirement. OTC drugs and medications purchased without a prescription* will not be eligible for reimbursement if purchased after December 31, 2010.

While not all inclusive, below are some examples of OTC drugs and medications that, effective January 1, 2011, require a prescription* in order to be reimbursable through your medical spending account.

Acid Controllers

Allergy & Sinus




Anti-Itch & Insect Bite

Baby Rash Ointments/Creams

Cold Sore Remedies

Cough, Cold & Flu

Digestive Aids

Feminine Anti-Fungal/Anti-Itch

Hemorrhoid Preps


Motion Sickness

Pain Relievers

Respiratory Treatments

Sleep Aids & Sedatives

Stomach Remedies

Below are some examples of OTC supplies that are eligible for reimbursement through your medical spending account without a prescription.

Band Aids

Braces & Supports


Contact Lens Solution/Supplies

Denture Adhesive

Diagnostic Tests & Monitors

Elastic Bandages & Wraps

First Aid Supplies

Insulin & Diabetic Supplies

Ostomy Products

Reading Glasses

Wheelchairs, Walkers & Canes

*The required documentation for a prescribed over-the-counter drug or medicine is a prescription or a copy of the prescription or other documentation that a prescription has been issued.

If you have questions, please feel free to contact CareFirst at Toll Free: 866-758-6119.

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