Health Care Reform-1/1/11 Flex change

[Green Tea]

As of the new year, over the counter meds will no longer be Flexible Benefits eligible.

 

[Christine]

As of the new year, over the counter meds will no longer be Flexible Benefits eligible.

Unless prescribed by a doctor...

So if your doc writes something out that you need Zyrtec, then you can submit that and claim it.

 

[Piecey]

Unless prescribed by a doctor...

So if your doc writes something out that you need Zyrtec, then you can submit that and claim it.

I think most doctors would do that, too. I know if I asked my pediatrician would write me something saying they told me to give him Tylenol and Motrin for his fever.
It just seems like another hurdle to make people jump through.

I don't usually use ours for OTC drugs but I like that it's there in case I have money left to claim.

 

[Christine]

I think most doctors would do that, too. I know if I asked my pediatrician would write me something saying they told me to give him Tylenol and Motrin for his fever.
It just seems like another hurdle to make people jump through.

I don't usually use ours for OTC drugs but I like that it's there in case I have money left to claim.

Me too. I rarely use the flex plan for OTC stuff because I have enough regular stuff to claim for a few people!! But it is a nice backup and I know lots of people who claim every expense.

I know that for federal employees there has been talk of cutting the $5,000 limit on the medical flex plan to $2500. Now that bums me out. When I left the private sector I worked for a company that let me claim $10,000 through the flex plan. When I went to work for the federal government, that dropped to $5,000. Now, $2,500? It's hardly worth it.

 

[Piecey]

Ah. This is our first year doing the flex through DH (he's a federal employee, too) and so far I've loved the way they do it! I love that our insurance company forwards our OOP costs to them and it just gets direct deposited automatically.
The last two years we've done it through my employer because I'm the one who handles it. We still have $760 in last years account I'm trying to come up with receipts for (I know they're out there I just need to find them!!).

We only did $1,000 this year, though. Since our deductible is $700 and maternity is covered at 100% we didn't think we'd need much more than that in general.

I don't think I'd like the $2500 thing either!! That isn't even enough to pay for braces and glasses for an entire family, much less enough to cover deductibles, co-pays and prescriptions!

 

[pansmermaidzlagoon]

we rarely use ours for OTC (only to use up year end), so not that big of a deal for us. We don't even use that much OTC for it to matter that much.

have a DD in braces - now if they took that away, we might have a problem!!

 

[wvjules]

So if I sprain my ankle and want to take some Ibuproferin I need to go see my doctor for him to write me a note saying that I can take it?

 

[PatsMom]

They had to put something in to try to make the health care reforms look revenue neutral. This effectively increases taxes without calling it a tax increase since you will be able to shelter less income.

Doesn't affect me at all since I do not work for an employer who offers a plan. And since my husband is a retiree and our insurance is through his pension plan, we can't even pay our $900+ monthly premium with pre-tax dollars, which effectively increases our cost of insurance.

But I do feel bad for those who are used to being able to deduct who will now have to go to an extra step.

 

[SaraJayne]

So if I sprain my ankle and want to take some Ibuproferin I need to go see my doctor for him to write me a note saying that I can take it?

No. Only if you want to use flex $$ to buy it.

Seriously, how much money do people spend on OTC meds that they can't/don't want to pay OOP??

This change in a non-issue for me.

 

[Piecey]

So if I sprain my ankle and want to take some Ibuproferin I need to go see my doctor for him to write me a note saying that I can take it?

IF you want to get the money back from your flexible spending account, yes...

 

[wvjules]

Obviously I meant if I wanted remibursed from my Flex Spending account since that is the topic. (Or I guess not so obviously. )

 

[PatsMom]

No. Only if you want to use flex $$ to buy it.

Seriously, how much money do people spend on OTC meds that they can't/don't want to pay OOP??

This change in a non-issue for me.

If I had a plan available to me I would certainly use it for OTC meds if possible. I take Omega 3 fish oil, alpha lipoic acid, calcium, vitamin D and aspirin all on doctor's advice. My husband takes the fish oil, two B vitamins, COQ10 (very expensive), aspirin, and phytoserols. When you add all those up, it gets to a pretty impressive total. My daughter takes cheap stuff - just generic ibuprofen.

I don't thinks its really a matter of can't pay OOP. Flex plans are out of pocket, they are just pre-tax. Any amount I can keep instead of paying in taxes is worth bothering about as far as I am concerned. For those that are used to using the benefit, this amounts to a small income tax increase.

 

[Mickeyluver37]

No. Only if you want to use flex $$ to buy it.

Seriously, how much money do people spend on OTC meds that they can't/don't want to pay OOP??

This change in a non-issue for me.

Obviously neither you or any of your family members have allergies. Many of these medications that were once prescription are now over the counter, and insurance companies are rejecting the new drugs like Xyzal because they won't allow you to just switch to a new drug because your old medicine is now OTC.

We do not have an FSA, but we do have a high deductible insurance plan with an HSA, and this will definitely affect us. This is the first I've heard that we can get a Dr. to write a prescription for an OTC med and still use the card, so that's good to know. Since we buy monthly meds, I wonder if this is something that can be prescribed with "refills" so I don't have to have the Dr. call it in every month.

 

[Tony-NJ]

Obviously neither you or any of your family members have allergies. Many of these medications that were once prescription are now over the counter, and insurance companies are rejecting the new drugs like Xyzal because they won't allow you to just switch to a new drug because your old medicine is now OTC.

We do not have an FSA, but we do have a high deductible insurance plan with an HSA, and this will definitely affect us. This is the first I've heard that we can get a Dr. to write a prescription for an OTC med and still use the card, so that's good to know. Since we buy monthly meds, I wonder if this is something that can be prescribed with "refills" so I don't have to have the Dr. call it in every month.

exactly. I use it every month fopr OTC stuff, not only allergy med's. I loved the fact that I can buy pepcid and other stuff if need be. I'm sure my Dr would write that I need the allergy meds.

And yes this is a way of raising some more tax money

 

[Lisa loves Pooh]

There's lots of expensive OTC meds that one can take without going to the doctor.

So to save a few pennies in the budget--they eliminated the flex accounts from that option and many docs don't write scripts without an office visit. Very unfortunate.

Not to mention those silly OTC tests for UTI's and HPT's--not that they replace an office visit. They ain't cheap!

 

[SaraJayne]

Obviously neither you or any of your family members have allergies. Many of these medications that were once prescription are now over the counter, and insurance companies are rejecting the new drugs like Xyzal because they won't allow you to just switch to a new drug because your old medicine is now OTC.

You're right ~ we don't. Other than the occasional purchase of ibuprofen or Tylenol for the kids, we rarely buy OTC meds.

And we also have a high deductible plan with a HSA.

 

[sbell111]

Come on Tony, no new taxes for anyone under $250,000. We're getting the change, but where is the hope?

I'm tired of getting points for responding to posts like this one, so I reported it, instead.

To the actual thread topic of needing a prescription in order for an expense to be covered under a flex account, this is necessary to ensure that the meds go to someone covered by the plan. As such, it's a smart change.

 

[laurie31]

We were told by DD's doctor to give her Zyrtec, and DH's doctor told him to take Niacin for his cholesterol, but nothing was written since they are OTC. I guess sometime this year (when we're at the doctor for something else) we'll need to get scripts for those.

What about contact solution? All 4 of us wear contacts. I usually spend about $100 when I go stock up on solution. Will I need a script from our opthamologst now?

 

[PatsMom]

To the actual thread topic of needing a prescription in order for an expense to be covered under a flex account, this is necessary to ensure that the meds go to someone covered by the plan. As such, it's a smart change.

I really have to disagree with it being a smart change. Getting a prescription for my daughter's ibuprofen doesn't mean she is the one taking it. It just means I get to pay my $20 co-pay for an office visit to get the scrip. Or take time out of the day to call and request a scrip. Also, we are increasing the workload on the doctor's offices. So if a large practice hires a new administrative person to deal with OTC prescription request call ins, who do you suppose is going to pay?

I honestly believe the change is part of making the health bill "revenue neutral" and has nothing to do with wanting to make sure that the drugs end up where they were intended to be. Most people would not commit fraud by buying drugs for others and then submitting the receipts for reimbursement. Even if it is pre-tax money, it is not free money. It is money that is deducted from your paycheck that you reclaim.

 

[Lisa loves Pooh]

To the actual thread topic of needing a prescription in order for an expense to be covered under a flex account, this is necessary to ensure that the meds go to someone covered by the plan. As such, it's a smart change.

Valid point--

However, it is also an added expense. I don't have any docs that will write a script over the phone without you being seen. So if I had a cold and need some mucinex to help--I'd have to call and make an appt, go in, spend my co-pay--then get a prescription to go buy something OTC.

The whole reason stuff is made OTC to begin with is to prevent unnecessary medical visits (or so I thought).

(Just using that as an example b/c that was my most recent need--icky mucinex...but it does the job well and in the end, no need to visit a doctor.)

Even my OB, whom I obviously see regularly--will only do limited scripts over the phone...and those are for things that aren't OTC anyway.

To me it seems to be more of a headache and creates more red tape than it takes away.

Perhaps there is more abuse than I am aware of, but I can't say that any time I had a FSA or HSA that I was inclined to buy some OTC meds under the table for anyone other than my covered family. Is it really that much of a problem?