Prescription required for reimbursement for many over-the-counter meds



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Posted on December 20, 2012 at 6:34 PM

Updated Thursday, Dec 20 at 8:58 PM

DALLAS – As residents begin filing a year's worth of medical bills for reimbursement, News 8 has found it's likely that claims including over-the-counter medication will be denied. 

Basic things like cough drops, which used to be covered, no longer qualify for reimbursement unless you have a doctor's prescription.

"You know, frankly, it is goofy,” said Andy Komuves, CEO of Dougherty's Pharmacy in North Dallas.

For years, the federal government allowed people to pay for over-the-counter medicine tax-free by setting money aside in something called a flexible savings account, or FSA. This rule change was part of President Obama's Affordable Health Care Act.

Experts say eliminating the tax-free status of certain over-the-counter medications helped bring in new tax revenue to pay for health care reform.

Komuves said it puts pharmacies in an odd position.

"The pharmacists are now being asked to the call the doctor and say, 'Hey, your patient is here and we need a prescription now for ibuprofen -- which doesn't require a prescription -- but to get it on their FSA card, and it's confusing to everybody,” Komuves said.

Anna Backes is a claims manager at TaxSaver, a Dallas company that administers flexible savings plans for 300 companies nationwide. She said the rule change has led to participants putting less money into their flexible savings accounts and some unnecessary confusion.

"My opinion is that it has provided a lot of extra work,” Backes said.

So how do you know what cannot be reimbursed? A good rule of thumb is anything with a "Drug Facts" box on the back now requires a doctor's prescription, even if it's over the counter.