Kisd.org

1. OTC Drugs Used Primarily for Medical Care
These typically reimbursable with only a proper receipt. No recommendation from a
health care provider is needed.

Type of Drug
Examples*
Benadryl, Sudafed, Actifed,Chlora Trimaton , and Nasalcrom Gas-X, Maalox, Mylanta, Tums, AXID AR, Pepcid AC, Prilosec OTC, Tagamet HB, and Zantac 75AXID AR, Pepcid AC, Prilosec OTC, Tagamet HB, and Zantac 75 Femstat 3, Gyne-Lotrimin, Mycelrx-7, Monistat 3, 7, and Vagistat-1 Actidil Syrup and Capsules, Actifed, Allerest, Benadryl, Claritin, Chlor-Trimeton, Contac, Dimetane, Drixoral, Nyquil, Sudafed, Tavist-1, and Triaminic Ex-Lax, Pepto-Bismol, Immodium A.D. and Kaopectate Anti-itch Lotions and Creams (e.g., for athletes Bactine, Caldecort, Cortaid, Hydrocortisone, and Lanacort, Calamine Lotion, Benadryl Cream, Caladryl, Cortaid, Lamisil AT, Lotramin AF, and Micatin Decongestant/Nasal Decongestant and Cold Advil Cold and Sinus, Afrin, Afrinol, Aleve Cold and Synus, Children’s Advil Cold, Duration, Dristan Long Lasting, Neo-Synephrine-12 Hour, Orrivin, Sudafed, Tavist-D, Tylenol Cold and Flu, Thera-Flu, AlkaSeltzer Cold and Flu, Nyquil, Actidil Syrup and Capsules, Actifed, Allerest, Benadryl, Claritin, Chlor-Trimeton,Contac, Dimetane, Drixoral, Sudafed, Tavist-1, and Triaminic Advil, Aleve, Children’s Motrin, Nuprin, Excedrin, Tylenol, Bayer Advil Migraine Liqui-gels, Excedrin Migraine, Motrin Migraine Pain * This list is not an exhaustive list and is intended to give examples of some of the most common brand names of OTC drugs. Nicotine Gum or Patches and Smoking Cessation Commit, Nicoderm CQ, Nicorette, Nicotrol
2. Dual Purpose OTC Drugs
Permissible with Health Care Provider’s Note Listing Diagnosis of a Medical Condition
and Recommendation of OTC Drug

Anti-baldness/hair loss/hair replacement/such as Rogaine, but only if to replace hair loss due to a medical condition and not for balding due to age Medicated shampoo to treat a specific medical condition like psoriasis and only the amount in excess of the cost of normal shampoo. Many plan sponsors may exclude completely to avoid having to determine whether the cost of a medicated shampoo exceeds the cost of regular shampoo. Dental fluoride treatments, special mouthwashes, or treatments for gingivitis Fiber supplements such as Benefiber and Metamucil Glucosamine/chondrotin for arthritis or other medical condition (not reimbursable if taken for overall joint health) Herbal supplements used to treat a specific disease such as St. John’s Wort for depression Nose strips for proper breathing or other medical conditions Retin-A and other acne medicines (not reimbursable if used for cosmetic purposes such as wrinkle reduction) Snoring cessation aids and medications such as Breathe Right Spray, Snorezz Weight loss/dietary supplements must be for a specific medical condition such as obesity
3. OTC Drugs Primarily Not Reimbursable
OTC Drugs or other products that are not for Medical Care

Deodorants Face creams, moisturizers, eye creams, and wrinkle reducers Hair removal treatments and waxes Mouth washes, antiseptics and oral anesthetics Teeth Whitening kits, and powders Toothpaste Vitamins taken to improve overall-health

Source: http://www.kisd.org/hr/files/OTC%20Drugs%20Used%20Medical%20Care.pdf

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