Does FSA cover over-the-counter medicine?
OTC medicines like pain relievers, cold medicine, and allergy medication are FSA-eligible without a prescription, a change the 2020 CARES Act made permanent.
What flips the answer
- Covered when
The item is an OTC drug or medicine (e.g., pain reliever, allergy medication, cold medicine) or a menstrual care product.
- Not covered when
The item is a general personal-care or cosmetic product (toothpaste, shampoo, cosmetics) with no medical purpose.
Before 2020, OTC drugs required a doctor's prescription to be reimbursable from an FSA. The CARES Act, effective for expenses incurred on or after January 1, 2020, permanently removed that prescription requirement for OTC drugs and medicines.
That means common items — pain relievers, cold and flu medicine, allergy medication, antacids — are now qualified expenses with just a receipt, no prescription needed.
The same CARES Act provision also made menstrual care products (pads, tampons, cups, liners) qualified expenses for the first time. General personal-care items like cosmetics, toothpaste, and shampoo remain excluded even though they're sold over the counter, since they don't treat a medical condition.
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