Asthma Medicine: HSA Eligibility

Asthma Medicine: requires a prescription to be eligible with a Health Savings Account (HSA)

Asthma medicine is eligible for reimbursement with a prescription with a flexible spending account (FSA), health savings account (HSA) or a health reimbursement arrangement (HRA). Asthma medicine is not eligible for reimbursement with a limited care flexible spending account (LCFSA) or a dependent care flexible spending account (DCFSA).

What is asthma?

Asthma is a medical condition that refers to a narrowing of the airways in the lungs that is caused by inflammation in the respiratory system. This chronic lung disease is associated with a variety of symptoms, including shortness of breath, coughing and occasional wheezing from strenuous and regular activity. Nearly 25 million people are affected with asthma in the U.S., and while it can affect all ages, asthma typically develops during childhood and affects more than seven million children. There is no known cure for asthma and the condition can worsen or improve over time, but its status can be managed effectively through the use of prescription and over-the-counter asthma medicines that can allow asthma sufferers to life active, healthy lives free from interruption from their symptoms (National Heart, Lung, and Blood Institute).

How do asthma medicines work?

Asthma medicines encompass a wide range of potential medications and treatments, but many are designed to treat symptoms based on the severity of the condition itself. These medicines fall into two primary categories via WebMD:

  • Quick-Relief Medications: In the event of an asthma attack and a tightening of the airways, quick-relief medications are primarily used to quickly open tight airways and alleviate the coughing, wheezing and chest tightness that comes with obstructed airways caused by asthma attacks. Inhalers, also known as bronchodilators that relax the muscles in the airways, are the most common medicines, including Albuterol, Levalbuterol, Metaproterenol and Terbutaline. However, if asthma attacks persist over a long period of time, physicians may prescribe oral steroids like prednisone (which are not quick-relief) but are used to treat and prevent the flare-ups of asthma attacks for three to 10 days following a major episode.
  • Controller Medications: These medicines take a long-term approach to treating asthma and its symptoms, which are taken regularly to improve asthma sufferers' quality of life and limit the prevalence of asthma attacks. Additionally, this limits an individual's susceptibility to asthma triggers like allergens and other environmental hazards. These medications include corticosteroids, immunomodulators, leukotriene modifiers and long-acting beta-agonists, the most popular of which include common products like Flovent, Advair, Singulair, Symbicort and Pulmicort.

Why do asthma medicines require a prescription for reimbursement?

As a result of the passage of the Patient Protection and Affordable Care Act (PPACA), as of January 1, 2011, OTC items containing an active medical ingredient require a prescription for reimbursement with an FSA, HSA or HRA. To reimburse the cost of OTC medicines and drugs under FSAs, HSAs and other consumer spending accounts, account holders must submit a prescription for each product.

However, not every OTC product falls under this distinction and thousands of products continue to remain eligible without a prescription including bandages, first aid supplies, most sunscreens, diagnostic products, products for infant care and so much more. For more information on a specific product, be sure to consult our Eligibility List.

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Specifically Not Covered

Not eligible without a prescription.

Legal Information / Regulations

Prescription Required. Information Letter (IL) 2009-0209; Notice 2010-59.