Effective September 3, 2003, the IRS has determined that only expenses for 'medical care' can be reimbursed. This includes expenses such as aspirin, allergy & sinus medication, antacids, cold medicines and pain relievers. The guidelines further clarify that expenses "merely beneficial to health" such as vitamins and other nutritional aids are not eligible for reimbursement through Flexible Spending Accounts (FSA).
Claim substantiation rules have not changed. Members must provide documentation that validates the expense, including type of drug, date of service and amount of purchase. The following is a listing of items expected to be eligible.

Over-the-Counter Medical Expense Reimbursement
Through Healthcare FSAs
IRS Rev. Rul. 2003 - 102, September 3, 2003

The below list is not intended to be all-inclusive, but is rather to answer frequently asked questions. Contact Aetna FSA Member Services at 1-888-238-6226 with any questions.

I. Reimbursable Expenses relating to Medical Care

Medical Care Subject to Reimbursement
Cold medicines, such as tablets, syrups, drops and lozenges
Analgesics, such as Fever and Pain Reducers like Aspirin, Tylenol, Ibuprofen
Antacids and Heartburn Relief, such as Alka-Seltzer, Mylanta, and Milk of Magnesia
Stomach & Digestive Relief, such as Pepto-Bismol, Imodium, Colace, Lactaid
Eye care, such as contacts, saline solution, and lubricant eye drops
Motion Sickness, such as Dramamine, patches, bracelets
First Aid, such as heat wraps, compresses, bandages, tape, gauze dressing, adhesive pads, band aids, and pain relieving creams
Joint Support Bandages and Hosiery, such as knee supports, elbow supports
Arthritis Pain Relieving Creams
Antibiotic ointments
Anti-itch and hydrocortisone creams
Allergy Relief, such as oral medications, nasal sprays, and patches
Athlete's Foot treatment, such as nail and foot anti-fungal creams
Wart removal medication
Diabetes, such as glucose monitor and related equipment
Blood pressure monitor and related equipment
Cholesterol test equipment
Vaporizers and humidifiers
Urinary Pain Relief
Smoking Cessation Relief, such as patches, gum
Feminine care relating to treatment of vaginal infections
Tooth & Mouth Pain Relief, such as Orajel, Anbesol
Shampoo treatments relating to treatment of psoriasis, lice
Eye patches
Incontinence Products, such as Depends and Serenity pads

II. Not Reimbursable Expenses relating primarily to Good Health

Merely Beneficial to Good Health
Not Eligible for Reimbursement

(These are considered eligible for reimbursement as they relate primarily to medical care.)
Personal Hygiene, such as deodorant, soap, body powder, shaving cream and razors, feminine care and sanitary products
Cosmetics, such as makeup, lipstick, Q-tips, cotton balls, baby oil  
Skin care, such as sun block, skin and body moisturizing lotion, lip balm, acne  
Hair care, such as hair color, shampoo, conditioner, brushes, and hair loss products like Rogaine  
Routine dental care, such as toothpaste, toothbrushes, dental floss, mouthwashes (including anti-bacterial mouthwash and fluoride rinses), breath strips, teeth whitening  
Denture care, such as denture cleansers and denture adhesive creams  
Nail care & personal grooming, such as scissors, nail files  
Family Planning, such as pregnancy tests, condoms  
Vitamins Vitamins prescribed at the direction of a doctor. A physician statement is required.
Nutritional and Dietary Supplements, such as bars, milkshakes, power drinks, Pedialyte Supplements prescribed at the direction of a doctor. A physician statement is required.
Weight Reduction aids, such as Slimfast, appetite suppressants Weight reduction products prescribed at the direction of a doctor. A physician statement is required.
Sleep aids, such as oral medications, snoring strips Sleep aids prescribed at the direction of a doctor. A physician statement is required.