Over-the-counter medicines and drugs frequently asked questions
April 11, 2014
How did the rules change for reimbursing the cost of over-the-counter medicines and drugs from health flexible spending arrangements (health FSAs) and health reimbursement arrangements (HRAs)?
Section 9003 of the Patient Protection and Affordable Care Act (PPACA) established a new uniform standard for medical expenses. Effective January 1, 2011, distributions from health FSAs and HRAs are not allowed to reimburse the cost of over-the-counter medicines or drugs only if they are purchased with a prescription. This rule does not apply to reimbursements for the cost of insulin, which will continue to be permitted, even if purchased without a prescription.
How did the rules change for distributions from health savings accounts (HSAs) and Archer Medical Savings Accounts (Archer MSAs) that are used to reimburse the cost of over-the-counter medicines and drugs?
Only prescribed medicines or drugs (including over-the-counter medicines and drugs that are prescribed) and insulin (even if purchased without a prescription) will be considered qualifying medical expenses and subject to preferred tax treatment.
When did the changes become effective?
The changes became effective for purchases of over-the-counter medicines and drugs without a prescription after Dec. 3, 2010. The changes did not affect purchases of over-the-counter medicines and drugs in 2010, even if they were reimbursed after Dec. 31, 2010.
How does this change affect over-the-counter medical devices and supplies?
The rule does not apply to items for medical care that are not medicines or drugs. Thus, equipment such as crutches, supplies such as bandages, and diagnostic devices such as blood sugar test kits will still qualify for reimbursement by a health FSA or HRA if purchased after December 31, 2010, and a distribution from an HSA or Archer MSA for the cost of such items will still be tax-free, regardless of whether the items are purchased using a prescription.
I use health FSA funds for my co-pays and deductibles. Am I still able to reimburse those expenses with health FSA funds after Dec. 31, 2010?
Yes. Co-pays and deductibles continue to be reimbursable from a health FSA after December 31, 2010. Similarly, funds from an HRA can continue to be used for these expenses and a distribution from an HSA or Archer MSA for these purposes will be tax-free.
The ACA removed over-the-counter medicines and drugs from the list of reimbursable qualified medical items if purchased without a prescription. If you have an HSA, Archer MSA, health FSA, or HRA, how does the change in the law affect reporting on Form W-2? Do the reimbursements for items that are not qualified medical expenses need to be included as taxable wages on employees’ Forms W-2?
If you have an HSA or an Archer MSA, distributions for expenses that are not qualifying medical expenses (including over-the-counter medicines and drugs purchased without a prescription) will be included in your gross income and subject to an additional tax of 20%. The income tax and additional tax are reported on Form 8889 for an HSA distribution and on Form 8853 for an Archer MSA distribution. You complete these forms and attach them to your Form 1040 when you file your income tax return. Distributions from an HSA or an Archer MSA are not included as taxable wages and do not affect your Form W-2.
Lifetime and annual limits under the Affordable Care Act
Preventive services for adults covered under the Affordable Care Act
Preventive services for children covered under the Affordable Care Act