How do I know which over-the-counter medicines and drugs are eligible for reimbursement?

Medicines and drugs are classified as eligible, ineligible, or dual purpose expenses. Dual purpose means that the items may or may not be eligible, depending on whether the expense is based on medical necessity, or if it's a personal or cosmetic expense.

When determining whether an expense is eligible for reimbursement, consider the "but for" test.

But for this condition, would the person purchase or use the item anyway?

Example: But for the baby's rash, would the parents purchase the diaper rash ointment anyway?

Answer: No. The purchase is made only because the baby has diaper rash. The expense is eligible.

Example: But for the dental problem, would the individual brush his teeth anyway?

Answer: Yes. Individuals will continue to brush their teeth whether or not they have a dental problem. Toothbrushes are not eligible.

A list of eligible, ineligible and dual purpose over-the-counter expenses can be found on Discovery's web site.

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