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Medicare Prescription Plan

Over-the-Counter Medicines & Products

Over-the-counter (OTC) medicines and products are reimbursable when the OTC product is used for medical purposes.

Eligible items include medicines or products that alleviate or treat injuries or illness for you and your dependents. These drugs and products are not cosmetic in nature, or merely beneficial to your general health.

OTC products that are not medicines or that merely benefit your general health may NOT be reimbursable, such as vitamins without a Letter of Medical Necessity (LMN). Please check with your health care provider for more details.



Eligible OTC Expenses

Type/Class of Drug or Product Examples
Allergy Prevention and Treatment Actifed, Allerest, Benadryl, Chlor-Trimeton, Claritin, Contac, NasalCrom, Sudafed
Analgesics/Antipyretics Aspirin, Advil, Aleve, Ibuprofen, Naprosyn, Tylenol, Midol, Pamprin, Premysyn PMS
Antacids and Acid Reducers AXID AR, Gas-X, Maalox, Mylanta, Tums, Pepcid AC, Prilosec OTC, Tagamet HB, Zantac 75 
Anti-arthritics Glucosamine, Chondroitin 
Antibiotics (topical) Bacitracin, Neosporin, Triple antibiotic ointment 
Anticandial (yeast) Femstat 3, Gynelotrimin, Mycelex-7, Monistat 3, Vagistat-1 
Antidiarrheal and Laxatives Ex-Lax, Immodium AD, Kaopectate, Pepto-Bismol 
Antifungal Lamisil AT, Lotramin AF, Micatin 
Antihistamines Actifed, Allerest, Benadryl, Claritin, Chlor-Trimeton, Contac, Drixoral, Sudafed, Tavist, Triaminic 
Anti-itch Lotions and Creams Bactine, Benadryl, Caldecort, Caladryl, Calamine, Cortaid, Hydrocortisone, Lanacort, Lamisil AT, Lotramin AF 
Asthma Medicines Bronitin Mist, Bronkaid, Bronkolixer, Primatene 
Cold Sore/Fever Blister Abreva Cream, Herpecin 
Cold, Flu, Decongestant and Sinus Remedies Actifed, Advil Cold and Sinus, Afrin, Alka Seltzer Cold and Flu, Afrinol, Aleve Cold and Sinus, Children's Advil Cold, Contac, Dayquil, Dimetane, Dristan Long-Lasting, Drixoral, Neo-Synephrine 12-Hour, Nyquil, Otrivin, Pediacare, Sudafed, Tavist-D, Thera-flu, Triaminic, Tylenol Cold and Flu, Cough Drops, Nasal Sprays, Throat Lozenges 
Contact Lens Supplies Cleaning and soaking solutions, Lens storage cases 
Contraceptive / Family Planning Ovulation predictor kits, Pregnancy tests, Spermicides, Condoms 
Cough Suppressants or Expectorants Robitussin, Vicks 44, Chloraseptic, Mucinex, Cough drops,Throat lozenges 
Dehydration Pedialyte 
Dental/Denture Care Orajel, Anbesol,Poligrip 
Diaper Rash Aquaphor, Balmax, Desitin 
Ear Care Ear drops, Ear wax removal 
Eye Care Eye drops, Reading glasses, Eye patches 
First Aid / Medical Supplies Antiseptics, Witch Hazel, Peroxide, Bandages, First aid kits, Cold/hot packs for injuries, Joint supports (ankle, elbow, knee, wrist), Rubbing alcohol, Ace wraps, Splints, Thermometers, Liquid adhesives 
Foot Care Arch and insole supports, Callous removers, Athlete's Foot products (see anti-fungal), Bunion, blister and corn treatments 
Hemorrhoidal Preparations Preparation H, Hemorrhoid, Tronolane 
Home Diagnostic Tests or Kits Blood pressure (monitor and related equipment), Cholesterol,Diabetic equipment and supplies, Colorectal screenings, HIV test, Pregnancy tests 
Lactose Intolerance DairyCare, Dairy Relief, Lactaid, Lacteeze, Lactrase 
Menstrual Cycle Midol, Pamprin, Premysyn PMS 
Migraine Relief Advil Migraine, Motrin Migraine, Excedrin 
Motion Sickness Dramamine, Marizine 
NSAIDS Advil, Aleve, Ibuprofen, Motrin, Naprosyn, Naproxen 
Pediculicide Nix, Rid 
Pre-natal Vitamins  
Skin Care Sunburn relief, Aloe Vera 
Sleeping Aids  
Smoking Cessation Commit, Nicoderm CQ, Nicorette, Nicotrol 
Sunscreen/Sunblock Note: Lotions and cosmetics that contain ingredients to protect you from the sun and/or list a SPF are not eligible 
Teething/Toothaches Orajel, Anbesol 
Topical Steroids Hydrocortisone 
Wart Removal Compound W, Dr. Scholl's Clear Away, Wart-Off 

For more information visit: www.fsafeds.com

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