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Fisd employee benefits reimbursable over the counter drug information

Reimbursable Over-the-Counter Medications
Under the Section 125 Plan
AntacidsAllergy medicationAnti-diarrheal medication, laxativesBandaids, bandages, gauze pads, first aid kitsBug bite medicationCalamine lotionCough drops, throat lozenges, sinus medication, nasal sinus sprayCold medication, pain relieverCold/hot packs for injuries, crutchesContact lens solution, cleanersCarpal tunnel wrist supportsCondoms, spermicidal foamDiaper rash ointmentEye products (such as Visine or saline wash)First aid creams and ointments, liquid adhesives, topical ointmentsGlucosamine/chondroitin for arthritis or other medical condition (requires doctor’s Hemorrhoids creamsIncontinence suppliesJoint/muscle pain medicationLactose intolerance pillsMenstrual cycle products for pain and cramp reliefMotion sickness pillsNicotine gum or patches for stop-smoking purposesNasal strips for snoringOrthopedic shoe insertsOver the counter hormone therapy and treatment for menopausal symptoms (hotflashes, night sweats, etc. – requires doctor’s statement) Pedialyte for ill child’s dehydrationPregnancy test kitsPrenatal vitamins during pregnancy (requires doctor’s statement)Reading glassesRubbing alcoholSleeping aidsSt John’s Wort for depression (requires a doctor’s statement)SuppositoriesSunburn cream or ointmentSunscreenSupplements, vitamins or herbal treatments to treat medical condition (requires doctor’s Thermometers (ear or mouth)Wart remover treatmentsWeight loss drugs to treat medical condition or obesity (requires doctor’s statement) Not Reimbursable:
Chapped lip treatmentsFace creams, moisturizers, suntan lotionsMedicated shampoos and soaps (unless prescribed by a doctor)ToiletriesToothbrushes, toothpasteVitamins and supplements for maintaining general good health 1. OTC Drugs Used Primarily for Medical Care
These typically reimbursable with only a proper receipt.
No recommendation from a health care provider is needed.
Type of Drug
Examples 2
Benadryl, Sudafed, Actifed, Chlora Trimaton, and Nasalcrom Gas-X, Maalox, Mylanta, Tums, AXID AR, Pepcid AC, Prilosec OTC, Tagamet HB, and Zantac 75AXID AR, Pepcid AC, Prilosec OTC, Tagamet HB, and Zantac 75; Femstat 3, Gyne-Lotrimin, Mycelrx-7, Monistat 3, 7, and Vagistat-1 Actidil Syrup and Capsules, Actifed, Allerest, Benadryl, Claritin, Chlor-Trimeton, Contac, Dimetane, Drixoral, Nyquil, Sudafed, Tavist-1, and Triaminic Ex-Lax, Pepto-Bismol, Immodium A.D. and Kaopectate Anti-itch Lotions and Creams (e.g., for Bactine, Caldecort, Cortaid, athletes foot, jock itch, bug bites, Lotion, Benadryl Cream, Caladryl, Cortaid, Lamisil AT, Lotramin AF, and Micatin 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 Advil, Aleve, Children’s Motrin, Nuprin, Excedrin, Tylenol, Bayer 1. OTC Drugs Used Primarily for Medical Care
These typically reimbursable with only a proper receipt.
No recommendation from a health care provider is needed.
Type of Drug
Examples 2
Benadryl, Sudafed, Actifed, Chlora Trimaton, and Nasalcrom Gas-X, Maalox, Mylanta, Tums, AXID AR, Pepcid AC, Prilosec OTC, Tagamet HB, and Zantac 75AXID AR, Pepcid AC, Prilosec OTC, Tagamet HB, and Zantac 75; Femstat 3, Gyne-Lotrimin, Mycelrx-7, Monistat 3, 7, and Vagistat-1 Actidil Syrup and Capsules, Actifed, Allerest, Benadryl, Claritin, Chlor-Trimeton, Contac, Dimetane, Drixoral, Nyquil, Sudafed, Tavist-1, and Triaminic Ex-Lax, Pepto-Bismol, Immodium A.D. and Kaopectate Anti-itch Lotions and Creams (e.g., for Bactine, Caldecort, Cortaid, athletes foot, jock itch, bug bites, Lotion, Benadryl Cream, Caladryl, Cortaid, Lamisil AT, Lotramin AF, and Micatin 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 Advil, Aleve, Children’s Motrin, Nuprin, Excedrin, Tylenol, Bayer Advil Migraine Liqui-gels, Excedrin Migraine, Motrin Migraine Pain 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
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

Source: http://www.friscoisd.org/ly/hr/hrforms/ReimbOTCDrugs.pdf

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