Another obamacare hassle

[TXgolfer]

HEALTHBEAT: A prescription for aspirin? Yup, if you pay with a flexible spending account | San Francisco Examiner

HEALTHBEAT: A prescription for aspirin? Yup, if you pay with a flexible spending account
By: LAURAN NEERGAARD
Associated Press
11/16/10 5:05 AM PST WASHINGTON — A headache awaits people who use those tax-free health spending accounts to pay for over-the-counter allergy relievers, heartburn blockers and other drugstore remedies. Starting next year, you'll need a prescription for the drugs to qualify.

The change in so-called Flexible Spending Accounts is part of the new health care law, and doctors are bracing for patient confusion and annoyance as they decide how to handle prescription requests for products that people normally use on their own.

"A huge hassle," predicts Dr. Roland Goertz, president of the American Academy of Family Physicians.

Flexible spending accounts, or FSAs, are pretax dollars that workers can set aside through their employers to pay out-of-pocket health care costs. That includes insurance copays and deductibles, treatments that an insurance plan may not cover, eyeglasses, dental work and, yes, nonprescription medications.

But the new health care law says over-the-counter drugs qualify for reimbursement through FSAs starting Jan. 1 only if the patient has a doctor's prescription. The only exception is for insulin bought without a prescription. (The new rule applies to similar Health Savings Accounts, too.)

Another change comes in 2013, when the new law will set a $2,500 cap on how much can be set aside in an FSA. Many employers currently allow up to $5,000 to be put into the accounts — reflecting that they tend to be used for pricier expenses than OTC drugs. Today's average set-aside is about $1,500, says Rose Stanley of WorldatWork, a human resources association.

For now, what do savvy patients need to know in planning for over-the-counter purchases in next year's FSA?

_The estimated 35 million FSA users must spend all their set-aside money each year or lose it. People tend to use leftover dollars by stocking up on aspirin and other drugstore staples at year's end, and the prescription requirement may put a crimp in that spree next fall.

_According to the Internal Revenue Service, the prescription requirement is only for OTC medications, not other non-drug health supplies such as contact lens solutions, bandages, crutches and blood-sugar test kits. These will merely require a receipt for reimbursement, just like today.

_Next year the health care law also eliminates preventive service copays, such as for well-child visits, mammograms and vaccinations, possibly altering how much people put into an FSA in the first place.

_Most affected by the OTC rule will be daily users of those drugs — like people who treat arthritis with ibuprofen, or gastric reflux with Prilosec OTC, or hay fever with Claritin. They will have to calculate if any extra doctor visits offset the pretax savings.

The change shouldn't cost extra if your doctor knows you've been taking OTC medicines routinely and thus has no trouble writing a prescription by phone or at your next regularly scheduled visit, says Dr. Gary Rogg, an internist with Montefiore Medical Center in New York. In that case, the change wouldn't cost anything extra.

If you've never mentioned taking a particular OTC drug, the doctor may demand an office visit, with its copay, before pulling out the prescription pad.

"If a 20-year-old wants to buy Prevacid because of heartburn, odds are it's diet-related. If it's a 60-year-old, you really are obligated to do a 'workup'" in case the pain signals something worse, Rogg says.

People who use high doses of OTC drugs might find a prescription-only version a better deal depending on their insurance copay rules, he adds, even if that's costlier for the health care system overall.

Increasing communication about OTC drug usage would be a good side effect of the rule change, says Dr. Joshua Freeman, family medicine chairman at the University of Kansas Hospital.

"If you're taking something I think is bad for you, I'm glad I found out," he says.

But Goertz says it's not clear exactly what's required for an OTC prescription. If he writes one for a 30-day supply of ibuprofen with 11 refills but the arthritis patient buys once in bulk, will the FSA provider honor that reimbursement?

And there's an added wrinkle for the millions who use special FSA debit cards to pay for purchases straight from their account. IRS guidelines say those debit cards can't be used for over-the-counter drugs under the new change, and will have to be reimbursed by turning over a copy of their receipt and prescription to their FSA provider.

The National Association of Chain Drug Stores has asked the IRS to reconsider, predicting customer anger if the debit card works for one kind of purchase but not another.

 

[kokonut]

Like I said, a joke. Just like the 111 waivers (so far) to companies exempting them from Obamacare.

 

[jillio]

What the heck does that have to to with Obama and the current health care revisions? A flex account is provided by employers as a feature of their health care plan and this has been in use for over 25 years.:roll:

 

[TXgolfer]

What the heck does that have to to with Obama and the current health care revisions? A flex account is provided by employers as a feature of their health care plan and this has been in use for over 25 years.:roll:

Did you bother to read the article??? It's near the top, don't even have to read the whole thing.

But the new health care law says over-the-counter drugs qualify for reimbursement through FSAs starting Jan. 1 only if the patient has a doctor's prescription. The only exception is for insulin bought without a prescription. (The new rule applies to similar Health Savings Accounts, too.)

 

[jillio]

Did you bother to read the article??? It's near the top, don't even have to read the whole thing.

Yep. Read it. And am telling you that Obama and health care reform is not responsible for this type of thing happening. It has been going on for more than 25 years. Perhaps you need to read a bit about the insurance industry and the various types of plans. The quote you provided is the way it has been with flex accounts for health care from the very beginning, and that was way before Obama was even out of high school.

 

[Banjo]

It makes sense that a prescription would be required in order to get reimbursement for over-the-counter drugs.

 

[jillio]

It makes sense that a prescription would be required in order to get reimbursement for over-the-counter drugs.

Of course it does. And it is nothing new. No insurance plan in existence overs OTC meds. And you need an RX if you want to be reimbursed for assistive devises such as canes and wheelchairs, too. Nothing new about any of it.

 

[Beowulf]

It makes sense that a prescription would be required in order to get reimbursement for over-the-counter drugs.

Exactly. As conservatives love to chant, "The only people who fear this are those who abuse the system."

 

[TXgolfer]

Yep. Read it. And am telling you that Obama and health care reform is not responsible for this type of thing happening. It has been going on for more than 25 years. Perhaps you need to read a bit about the insurance industry and the various types of plans. The quote you provided is the way it has been with flex accounts for health care from the very beginning, and that was way before Obama was even out of high school.

Not responsible????? Then why did they write it into the law?

 

[jillio]

Not responsible????? Then why did they write it into the law?

Again, let me state..."Obama care is not responsibile for an insurance company's refusal to over OTC meds without an RX. This has been happening since meds have been included in health insurance coverage, and has always been a feature of a flex account."

Tell me, does your health insurance cover OTC meds?

 

[TXgolfer]

But the new health care law says over-the-counter drugs qualify for reimbursement through FSAs starting Jan. 1 only if the patient has a doctor's prescription. The only exception is for insulin bought without a prescription. (The new rule applies to similar Health Savings Accounts, too.)

https://www.fsafeds.com/fsafeds/news.asp#OTCChanges

From CIGNA

FSA, HRA, HSA: Eligible and Ineligible Expenses

Over-the-counter medicines and drugs - (starting 1/1/2011, most will require a doctor's prescription for reimbursement) Expenses are generally reimbursable unless used for general well-being or for purely cosmetic purposes.

Starting January 1, 2011, eligible expenses that will require a doctor's prescription for reimbursement may include, but are not limited to acetaminophen, acne products, allergy products, antacid remedies, antibiotic creams/ointments, anti-fungal foot sprays/creams, aspirin, baby care products, cold remedies, (including shower vapor tabs), cough syrups and drops, medicated eye and ear drops, ibuprofen, laxatives, migraine remedies, motion sickness, nasal sprays, pain relievers, sleep aids, teething gels, and topical creams for itching, stinging, burning, pain relief, sore healing or insect bites. See Kits and Vapor units and refills.
Items that will continue to be eligible without a doctor's prescription after January 1, 2011 include, but are not limited to band aids, bandages and wraps, braces and supports, catheters, contact lens solutions and supplies, contraceptives and family planning items, denture adhesives, insulin and diabetic supplies, diagnostic tests and monitors, and first aid supplies, peroxide and rubbing alcohol.
Over-the-counter supplies - Expenses paid for bandages, ACE® wraps, hot pads, Q-tips®, cotton balls, first aid kits, gauze bandages, home test kits (e.g. diabetic, pregnancy), and snake bite and bee sting kits are reimbursable. See Kits.
Ovulation Predictor Test - Test kits to assist in identification of ovulation are covered.
Oxygen - Amounts paid for oxygen or oxygen equipment to relieve breathing problems caused by a medical condition are reimbursable.

FSA, HRA, HSA: Eligible and Ineligible Expenses

Starting January 1, 2011, you will not be able to use these spending accounts to pay for most over-the-counter drugs and medicines unless you have a doctor's prescription. You will not need a prescription for insulin and diabetic supplies

 

[jillio]

This is utterly ridiculous. Nothing has changed. NO OTC DRUGS ARE COVERED UNDER ANY HEALTH CARE PLAN CURRENTLY IN EXISTENCE WITHOUT A PHYSICIANS PRESCIPTION. AND MANY PLANS DON'T COVER ANY MEDS AT ALL, OTC OR RX.

To insist that Obama is somehow responsible for a practice that has been going on for over 25 years and continues to this day is absurd.

Good sign that hatred for an individual has become a greater focus that imparting accurate information to friends and colleagues. Shameful.

I ask again, does your health care plan cover OTC drugs?

Here's another one. Check with your own physician. Doctors have been writing prescriptions for aspirin for many years, especially when they are dealing with a heart patient as a preventive measure. As most health care policies don't cover preventive treatment, they will write an RX to help the patient get insurance coverage.

Before you can say the health care reform has changed anything you need to know how it functions to begin with.

 

[Banjo]

This is utterly ridiculous. Nothing has changed. NO OTC DRUGS ARE COVERED UNDER ANY HEALTH CARE PLAN CURRENTLY IN EXISTENCE WITHOUT A PHYSICIANS PRESCIPTION. AND MANY PLANS DON'T COVER ANY MEDS AT ALL, OTC OR RX.

To insist that Obama is somehow responsible for a practice that has been going on for over 25 years and continues to this day is absurd.

Good sign that hatred for an individual has become a greater focus that imparting accurate information to friends and colleagues. Shameful.

I ask again, does your health care plan cover OTC drugs?

I have never heard of an insurance agency covering the costs of OTC drugs. I thought it was common knowledge that you cannot get reimbursed for it?

 

[jillio]

I have never heard of an insurance agency covering the costs of OTC drugs. I thought it was common knowledge that you cannot get reimbursed for it?

So did I. Obviously, there are still a few out there that don't know how their insurance or the health system works.

 

[Banjo]

So did I. Obviously, there are still a few out there that don't know how their insurance or the health system works.

Yeah, I happen to have a flexible spending account but I have never used it for OTC drugs.

 

[jillio]

Yeah, I happen to have a flexible spending account but I have never used it for OTC drugs.

I have a flex account, too. And I have never even considered filing OTC drugs on the expense form, because I know that it will be immediately kicked out.

 

[Banjo]

I have a flex account, too. And I have never even considered filing OTC drugs on the expense form, because I know that it will be immediately kicked out.

Yeah, I have used it for hearing aids, eyeglasses, etc in the past. They were a big help.

 

[jillio]

Yeah, I have used it for hearing aids, eyeglasses, etc in the past. They were a big help.

I have used it for my son's HA and I use it for my eyeglasses every year or so. I would not be able to get my prescription changed when I need to without it. But, you also get an RX for corrective eye wear and for HAs. See, nothing new in this article.

 

[Banjo]

I have used it for my son's HA and I use it for my eyeglasses every year or so. I would not be able to get my prescription changed when I need to without it. But, you also get an RX for corrective eye wear and for HAs. See, nothing new in this article.

Good times, eh?

 

[jillio]

Good times, eh?

You bet!