These stories illustrate how millions of Americans are handling the new requirement that they must obtain a doctor’s prescription for the purchase of OTCs before they can be reimbursed by an FSA.
If you have not already done so, please click here to share your story about the need to repeal this burdensome provision.
Kathy / Kentucky
Requiring my family to obtain a prescription before using my FSA to purchase OTC medications has created great burden for my family. In order to participate in my FSA I am required to determine ahead of time how much money to place in the account. If I do not use all of that money I lose it. My FSA runs from July through June. When I did my homework and determined how much money to put in the FSA account, I factored in the purchase of OTC medications without considering the need for a prescription. At the time of my decision this rule did not exist. Now with the implementation of this rule taking effect in January, half of the FSA period for my plan will not allow me to purchase OTC medication without a prescription. This will cause my family to leave money in the FSA which we will now lose.
Angie / Virginia
My son has a lot of medical issues related to asthma and allergy symptoms. I go through a lot of allergy and reflux medications for him, which we now buy over the counter. I recently took him to the doctor and in the rush of getting all of his PRESCRIPTION medications figured out with the doctor I forgot to ask her for a PRESCRIPTION for NON-PRESCRIPTION medicines. Our doctors are already stretched so thin, I now feel bad calling back and asking for a prescription. I also do not want to have to waste her time (and take up a precious slot on her calendar that some other SICK person could use) so that I can get a prescription so that medicine is covered by my HCRA account. It is beyond frustrating and I hope someone comes to their senses and fixes this in Congress!
Audrey / Kentucky
The new requirement means I can no longer use flex spending money for OTC medications without a doctor's visit. Going to the doctor for these things costs me money--both in the co-pay as well as time away from work. This reduces productivity in the workforce and wastes my doctor's time slotting an appointment to write me a prescription for Tylenol instead of attending to patients who have more serious medical needs. Moreover, it is an unnecessary doctor's visit, which will artificially inflate health care expenses. Please work to repeal this rule and allow OTC medications back in flex spending as they used to be--without a prescription! After all, isn't that the definition of OTC?!
Laura / Utah
It is horrible to not be able to purchase OTC medications on my flex card, specifically because I have a child who has Febrial Sezures if she gets a high fever. This is something that is very easily treatable with Tylenol or IB. Before when I knew she was getting sick, I would run to the store, and be able to by the medicine. Now, not only do I have to obtain a prescription for it, I also have to pay for it out of pocket and wait for a reimbursement. In these times, I just don't have the extra money to put away, and wait for someone to pay me back later, since it is already taken out of my paycheck. When these charges come up, I shouldn't need a prescription, and I should be able to use my flex card like I did in the past.
Mary / Missouri
I regularly use several over-the-counter drugs that I think should be covered by my flexible spending account. These include Co-Advil for my sinus headaches, NiteQuil for colds, BenGay for back aches etc. I use these medications to avoid a trip to the doctor which would be more expensive for both me and my insurance company. I try to be financially responsible and feel this is undermining my efforts.
Tabatha / Kentucky
I have sent several emails to my state’s representatives since this went into effect because of the negative impact it can have. I personally live on a very limited budget and one main reason flex spending was desirable in the beginning was because of this option to get over-the-counters. I can't afford to go to the doctor's every time I have a cold. This is ridiculous for them to take this away. When I do get sick I will have to wait until a paycheck in order to help me instead of being able to resolve or soothe immediately.
Bonnie / Connecticut
The new law makes the majority of OTC products previously covered by Flexible Spending Accounts without a doctor's prescription a burden not only on those with FSA accounts, but the physicians as well. I'm not sure how this new law saves time or money for anyone. The reason I started my FSA was to give me flexibility and a way to afford the healthcare I need without having to budget each time I get prescriptions filled or have a co-pay for an office visit. I do not tend to use my FSA much for OTC products, but it was nice to be able to buy pain relievers, cold and flu products, and first aid items. This law will hurt the very people it is suppose to be helping.
Thomas / Virginia
My wife and I have both been advised to regularly take PPI for reflux. Prilosec has been available as an OTC med for several years, and before the change to the FSA we purchased it through our FSA. Now that it is no longer available it will cost us approximately $521/ year. Sure we could get prescriptions but that would require each of us to visit the PCP and pay a co pay. Additionally the cost of Prilosec by prescription would be more as the pharmacy will impose a dispensing fee on each refill and it will not be covered under my health insurance drug plan as it is an OTC product.
John / Alabama
Simply said, the new OTC rule is stupid and punishes those that are trying to be responsible. With this rule it is not even cost effective to try obtaining OTC meds with FSA as you are force to visit a doctor and pay that cost also. I just tried to use a prescription to obtain an over the counter med for my son - a simple bottle of childrens Motrin that his doctor recommended for him while he had a fever. I had the Dr provide an Rx for the Motrin, but when I tried to use the Rx at the pharmacy, they were confused about how to charge it to the FSA card.
Dianna / California
I recently took my son to the Dentist for a cleaning. As a result of the cleaning, the dentist recommended that I purchase over-the-counter Tylenol for gum sensitivity. I had to beg and plead for a prescription for over the counter medication. I had to educate him first about the new flex laws, which he thought was completely ridiculous. The whole point of over-the-counter medication is that you can purchase it without a doctor's note. Anyway, I got the prescription and that same day I purchased the over the counter medication. I then completed the flex paperwork. Only to be rejected because I did not complete the paperwork correctly. Apparently I needed to go through the pharmacist. It makes absolutely no sense and I've spent more time fighting over $19 in the last few days than I think it's actually worth.
Lisa / Nebraska
My spouse uses OTC allergy medicine which is just as effective for him as an allergy medication obtained with a prescription. Prior to 2011, we were able to use our FSA debit card to obtain this OTC medication. With the new regulation, we had to pay for a doctor visit just to be able to submit this for reimbursement. In doing so, we are still not able to use our FSA debit card, but must pay cash, submit a paper claim form along with the prescription, and wait for a check to be issued to us. Not only is this inconvenient for us, it is costing us more money to visit the doctor, is wasting the doctor's time, is costing our health plan more for an 'unnecessary' visit to the doctor, and is costing the FSA plan administrator more to process the paper claim. We would appreciate being able to go back to getting OTC meds as we have in the past saving all of us much needed time and money.
Sarah / North Carolina
As a constant sinus sufferer I use Claritin on a regular basis. This is part of my flex spending budget as the meds are pricey. My sinus issues have been address by doctors and are not severe. I will now have to pay a doctors visit just to get an Rx. I purchased a supply before the end of December so it will be several months before I will have to actually get this from the doctor.
Donna / Pennsylvania
I am taking ibuprofen and acetaminophen for Fibromyalgia. Previously, I could purchase these meds with my Flexible spending card. I had to cut my savings significantly this year since I cannot purchase them the way I did before.
Patricia / South Carolina
I have gone without my prilosec and my allergy medications because I have to schedule a doctor’s appointment in order to use my flex card to purchase them. Now in addition to paying for my medications I will have to pay for the doctor visit and my health insurance will also have to kick in for the visit. I spend $1,050.00 per year on just these two OTC medications a year, not to mention the basic OTC pain relievers and things like Mucinex-D which is by itself about $30.00 a box and my family will go through at least two of those each winter and spring. There is no excuse for me to have to obtain a prescription for these items before they can be purchased through my flex card.
N / North Carolina
This new rule has made it more difficult for me to get the OTC medicines I need for my family. My family uses a lot of OTC medicine. I used to be able to use my flexible spending card to buy the OTC medicines I needed, whenever I needed them. Now when I need the OTC medicine, I have to pay out of my pocket, and it is more difficult to come up with the money I need when I need it. In addition, many doctors don't want to be bothered taking their time to write prescriptions for OTC medicine.
Kim / Nevada
Many of the "once prescription" medications I need are now OTC. I call my doctor and informed him I now needed a "prescription" written for the OTC meds. He was unaware of this new law and could only say something to the effect of OH GREAT! I don't think he meant that positively. I'm still waiting for the prescription from him. I take other things like ibuprofen for my bad back daily with no reimbursement. This will probably end up costing me out of pocket about $600 year.
Brigid / Arizona
I am so frustrated with the new OTC prescription requirement. I feel irritated that I can no longer purchase something as simple as Zyrtec with my HC FSA card. My son suffers with allergies and we have to schedule a doctor’s appointment and pay a co-payment in order to use my FSA money. Not to mention, we have to then submit the documentation with an itemized receipt for reimbursement. This is really a nuisance. My son is a senior in High school and we have a busy household. I wish that our lawmakers would consider changing this rule.
Heidi / Washington
We have had to stop using some OTC medications as they are not being paid for under our flex account. This has created hardships for my family. We cannot afford to buy some basic medications without the flex account and we cannot afford to go to the doctor all the time.
FSAs encourage over-purchasing of health care.
FACT:
An FSA participant is spending his or her own income when electing to deposit money into an FSA. A consumer is unlikely to waste those set-aside funds on unnecessary expenditures.
