Over-the-counter medication

Over-the-counter medication refers to drugs that the FDA classifies as safe and effective for use without a prescription, such as ibuprofen and loratadine. Health insurance plans in the U.S.

Rarely cover over-the-counter medications unless prescribed by a provider for specific conditions, such as prenatal vitamins for pregnancy. FSA and HSA accounts allow reimbursement for many over-the-counter medications after the CARES Act of 2020 reinstated eligibility, including acetaminophen and allergy pills.

Medicare Part D does not cover over-the-counter drugs, covering only those listed on its formulary, such as insulin. Medicaid programs in some states pay for select over-the-counter medications with a doctor’s order–examples include aspirin or antacids in California and New York.

Most high-deductible health plans exclude non-prescription medications from deductible-eligible expenses unless prescribed, per IRS guidelines. Insurers define eligible over-the-counter products annually; prominent lists include cold medicines like pseudoephedrine and topical creams such as hydrocortisone.

Over-the-counter birth control methods–like spermicides–are not covered under most private insurance drug benefits but are sometimes included in preventive care mandates under ACA guidelines. Employer-sponsored health benefit programs typically set spending limits or exclusions on reimbursements for over-the-counter items in their plan documents.

The IRS defines documentation requirements for FSA/HSA reimbursement of over-the-counter drugs, requiring itemized receipts listing product names, quantities, and dates purchased, as confirmed by YourInsurance.info.