Cpa125.com

SAMPLE OVER THE COUNTER MEDICINES
Used Primarily for Medical Care
These are typically reimbursable with proper claim substantiation. No recommendation from a
health care provider is needed.
Type of Drug
Examples*
Allergy Prevention & Treatment
Benadryl, Sudafed, Actifed, Chlora Trimaton, and
Nasalcrom
Antacids and Acid Reducer
Gas-X, Maalox, Mylanta, Tums, AXID AR, Pepcid AC,
Prilosec OTC, Tagamet HB, and Zantac 75 AXID AR
Anticandial
Femstat 3, Gyne-Lotrimin, Mycelrx-7, Monistat 3, 7 and
Vagistat-1
Antihistamines
Actidil Syrup and Capsules, Actifed, Allerest, Benadryl,
Claritin, Chlor-Trimeton, Contac, Dimetane, Drixoral,
Nyquil, Sudafed, Tavist-1, and Triaminic
Antidiarraheal and Laxatives
Ex-Lax, Pepto-Bismol, Immodium A.D. and Kaopectate
Anti-fungal
Lamisil AT, Lotramin AF, and Micatin
Anti-itch Lotions and Creams (e.g., for athletes foot,
Bactine, Calecort, Cortaid, Hydrocortisone, and
jock itch, bug bites, poison ivy)
Lanacort, Calamine Lotion, Benadryl Cream, Caladryl,
Cortaid, Lamisil AT, Lotramin AF and Micatin
Cold Sore/Fever Blister
Abreva Cream
Cough Suppressants
Robitussin, Vicks 44, Chloraseptic
Decongestant/Nasal Decongestant and Cold Remedies Advil Cold and Sinus, Afrin, Afrinol, Aleve Cold and
Sinus, Children’s Advil Cold, Duration, Dristan Long
Lasting, Neo-Synephrine-12 Hour, Orrivin, Sudafed,
Tavist-D, Tylenol Cold and Flu, Thera-flu, Alka Seltzer
Cold and Flu, Nyquil, Actidil Syrup and Capsules,
Actifed, Allerest, Benadryl, Claritin, Chlor-Trimetron,
Contac, Dimetane, Drixoral, Sudafed, Tavist –1, and
Triaminic
Diaper Rash Ointments
Balmax and Desitin
Eye Drops for Al1ergy/Cold Relief
Hemorrhoid Treatments
Preparation H, Hemorid, and Tronolane
Internal Analgesic/antipyretic
Advil, Aleve, Children’s Motrin, Nuprin, Excedrin,
Tylenol, Bayer
Menstrual Cycle Medications
Midol, Pamprin and Premysyn PMS
Migraine
Advil Migraine Liqui-gels, Excedrin Migraine, Motrin
Migraine Pain
Motion Sickess Medications
Dramamine and Marizine
Smoking Cessation Aids
Commit, Nicoderm CQ, Nicorette, Nicotrol
Pediculicide (head lice)
Poison Ivy Protection
Ivy Block
Smoking Cessation
Commit, Nicoderm CQ, Nicorette
Toothache and teething pain relievers
DUAL PURPOSE MEDICINES
Permissible Only With Doctors Verification Listing Diagnosis of a Medical Condition and
Recommendation for Medication
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
Glucosamine/chondrotin for arthritis and other medical conditions (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, Norezz.
Weight loss/dietary supplements must be for a specific medical condition such as obesity.
OVER THE COUNTER MEDICAL PRODUCTS AND DEVICES
Permissible Products for Medical Care with Proper Claim Substantiation
Product or Device
Medical Care, Dual Purpose or
Comments
General Well Being
1. Crutches
Medical Care
Crutches are primarily used
when there is a leg or foot injury
2.Bandages such as Band-aids,
Likely Medical Care
Band-aids and gauze are
gauze, ace bandages
arguably used to prevent
infection where there is an
imminent probability of
infection. Ace bandages and
other similar products are
typically used to support bone
and/or joint injuries.
3. Condoms and other
Likely Medical Care
These prevent disease and
contraceptive devices
pregnancy where there is
imminent probability of either.
IRS has informally indicated
that these should be
reimbursable.
This is not an exhaustive list and is intended to give examples of some of the most common brand
names of OTC drugs. Excerpts taken from the The Employers Council on Flexible Compensation list
of example OTC Drugs
OVER THE COUNTER MEDICATIONS NOT REIMBURSABLE
Medicine or Other Products That Are Not For Medical Care
Deodorants.
Face creams, moisturizers, eye creams, and wrinkle reducers.
Hair removal treatments and waxes.
Mouth washes, antiseptics and oral anesthetics.
Teeth Whitening kits, and powders. Toothpaste/toothbrushes (even if recommended for Gingivitis).
Vitamins taken to improve overall-health.

Source: http://www.cpa125.com/OVER%20THE%20COUNTER%20MEDICINES.pdf