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1301089 tn?1290666571

Over-the-Counter Drugs? Better Get a Note From Your Doctor


New Rules Coming for Payments Out of Health Savings Accounts

Published October 15, 2010 | FoxNews.com


Under the new health care law, consumers using workplace pre-tax health savings accounts will soon need a doctor's note to pay for Tylenol and an estimated 15,000 other over-the-counter drugs.

Starting Jan. 1, employees who use flexible spending accounts (FSAs), health saving accounts (HSAs), or health reimbursement arrangements (HRAs) to pay for common medications such as pain relievers, cold medicines, antacids and allergy medications will need prescriptions. The new rules don't apply to insulin.

The new rules will also prohibit the use of FSA or HRA debit cards provided by administrative plans for over-the-counter purchases, because the IRS says there's no way to prove the drugs were prescribed.

The IRS says any money removed from HSA accounts to pay for medical expenses bought without a prescription will be included as taxable income and subject to an additional tax of 20 percent.

Robert Zirkelbach, a spokesman for America's Health Insurance Plans, the industry lobby that voiced support for the overhaul but has been accused by some of the law's proponents of trying to undermine it, said the law creates "unintended consequences."

"It creates unnecessary hassles for consumers and provides the wrong kind of incentives," Zirkelbach said, adding that the changes could make it more difficult for consumers to get medicines they need at costs they can afford.  

"This change could have the unintended consequence of increasing health care costs," he said. It might provide an incentive for consumers to go back on more expensive medications when over-the-counter medicine works just fine."

More than 10 million consumers use HSAs, according to a survey done in January by AHIP. That's up from 8 million in 2009 and 6.1 million in 2008.

According to an analysis by benefits administrator Aon Hewitt of more than 220 employers covering more than 6 million workers, 20 percent of employees, or 1.2 million, contributed to an FSA in 2010. Of those workers, the average annual contribution is $1,441.

FSAs and HSAs allow workers to reduce their taxable income to pay for qualified health care or child care expenses. Anyone with a high-deductible medical insurance plan can obtain an HSA. The IRS defined a high-deductible plan in 2010 as $1,200 a year for individuals and $2,400 for families.

FSAs, which were first authorized by Congress in 1978, are only available through employers who offer the plans. But FSAs face another new rule under the Affordable Care Act -- a limit on the pre-tax contributions to $2,500, starting Jan. 1, 2013. There is currently no limit on how much an employee can contribute to FSAs, although employers can impose one.

Lawmakers imposed the cap to help pay for provisions that will expand coverage starting in 2014. The cap is expected to raise $13 billion for other government-provided health care services offered between 2013 and 2019.


URL

http://www.foxnews.com/politics/2010/10/15/new-health-care-rules-require-doctors-note-pay-otc-drugs-fsas/
43 Responses
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973741 tn?1342342773
Oh Sara, are you trying to make my blood boil?  
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Avatar universal
Faux News Again!  I have yet to see anything put out by them that didnt have more than a smidgen of truth to it. Nope, not buying it.
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1301089 tn?1290666571
Sorry but I'm afraid it's true.  It's bad news for me as well.  My card automatically sorts out the things that aren't covered.  Why didn't anyone read this bill?????
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Avatar universal
http://www.truthabouthealthcarereform.org/current-reform-proposals-p2/
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1301089 tn?1290666571
http://www.newsmax.com/JohnBerlau/obamacare-health-care-healthcare/2010/03/23/id/353602
Newsmax
Obamacare Creates Windfall for Big Pharma
Tuesday, March 23, 2010 12:43 PM

By: John Berlau Newsmax

“They won’t be so opposed to it once they see what’s in it.” That’s the rationalization House leaders have given skittish Democrats to get them to walk the plank on Obamacare Sunday night.

But one of the first things millions of Americans will “see” is an effective 40 percent tax hike on the over-the-counter (OTC) medicines — from an antihistamine such as Claritin for allergies, pain relief medicine such as Tylenol or Excedrin, Pedialyte to prevent their kids from becoming dehydrated when they are sick, and even prenatal vitamins if they are expecting another one.

All of these items have two things in common. One is that they are classified as “over the counter" medicines and available without a doctor’s prescription.

Special: Do You Support Obama’s Healthcare Plan? Vote Here Now!

The other is that if you pay for any of these items with money in your flexible spending account (FSA) or health savings account (HSA) — and according to a guide from FSA plan administrator Benesyst, all of these are eligible expenses — you will face an effective tax increase of up to 40 percent on these items in the healthcare bill that President Obama signed today.

The bill restricts individuals with these pre-tax accounts to buying a “medicine or drug only if such medicine or drug is a prescribed” one. And ironically, this tax will raise healthcare costs substantially by creating incentives for the use of more expensive prescription drugs even when OTC drugs are just as safe and effective.

And while the tax on “Cadillac” plans for union members was delayed in the reconciliation bill until 2018, no such luck for HSA and FSA account holders, many of whom are self-employed and entrepreneurs.

These healthcare consumers and voters — and there are more than 40 million of them according to the Washington Times — will still “see” this tax hike go into effect at the beginning of 2011, the same as when I last reported on this “medicine cabinet tax” in BigGovernment.com and at the Competitive Enterprise Institute blog OpenMarket.org. And if there were a couple smart politicians, Americans would “see” this tax as soon as this week’s reconciliation debate.

Both FSAs and HSAs allow Americans to pay for medical expenses with pretax dollars.

An HSA goes along with a high-deductible insurance policy and gives individuals a tax deduction for money saved that can be used for healthcare expenses. An FSA has similar tax advantages, but contributions to it are deducted from an employee’s salary, and money in the account must be used by the end of the year.

In 2003, the Treasury Department and the Internal Revenue Service ruled that OTC medicines could be paid for by FSAs and the newly enacted HSAs. In a press release that sounded unusually compassionate for the IRS, the agency stated: “Drugs are increasingly becoming available over-the-counter without prescription. Many health plans no longer cover the cost of these drugs as over-the-counter.

“While an over-the-counter drug is less expensive than the prescription drug, the cost to many consumers increases because the price paid by the consumer for the over-the-counter drug is greater than the co-payment by the consumer when the drug was covered by insurance. This is especially an issue for individuals who remedy chronic health problems by regularly taking an over-the-counter medicine.”

Then-Treasury Secretary John Snow added in the release, “Since many prescription drugs have moved to the over-the-counter market, this action today makes paying for them a little bit easier to swallow.”

Specifically, the government ruled that since the tax code written by Congress did not specifically require that “only medicines or drugs that require a physician’s prescription be taken into account” for health expenses, OTC medicines were eligible.

The ruling made clear that although health accounts could not purchase items for general health such as toothpaste, they could be used for medicines that treat specific conditions, such as an “antacid, allergy medicine, pain reliever, and cold medicine.” Companies that administer FSAs and HSAs have developed extensive lists of a variety of OTC items that are covered.

The Benesyst guide fills two pages with an alphabetical list of eligible expenses that includes everything from analgesics to wound care.

But Section 9004 of the Senate bill the House ratified Sunday night, as well as Section 531 of the House bill that passed in November, changes the tax code so that “distribution for medicine” from HSAs and FSAs are “qualified only if for prescribed drug or insulin.”

Yes, the bills are merciful enough to allow diabetics to purchase insulin under these tax plans, but if you or your family members need Pedialyte, prenatal vitamins, or numerous other OTC health items, you will see a tax hike that could be huge.

Since HSAs and FSA contributions are exempt from both income taxes and 15.3 percent payroll tax for Social Security and Medicare, and since these together can reach more than 40 percent of an employee’s salary, the effective tax increase on these medicines could be more than 40 percent.

And this tax change will almost certainly cost the healthcare system billions more dollars in unnecessary spending both to the government and private insurance plans.

The Joint Committee on Taxation estimates that the tax hike will bring in $5 billion in revenues over 10 years — itself a drop in the bucket when compared to the bill’s new trillion-dollar entitlement — but that estimate doesn’t take into account behavioral changes as a direct result of this provision.

OTC drugs are much cheaper those available for prescription, but they could now be more expensive to individual consumers given that prescription drugs would still be eligible for favored treatment in the tax plans, and that insurance companies would be mandated to cover many of them.

Consequently, any time a consumer has the slightest headache, the financial incentive would often be to see a doctor and get a prescription rather than go to the store and get medicine off the shelf.

This could mean that billions will be wasted on the additional costs for prescription drugs in instances when OTC medicines could be just as safe and effective at treating the illness.

A 2005 study in the American Journal of Managed Care found that the Food and Drug Administration’s clearing of antihistamines such as loratadine (Claritin) for over-the-counter sale saves about $4 billion a year in healthcare costs.

Ironically, the liberals and Democrats who normally rail against big pharmaceutical companies are now creating a huge windfall the firms that make expensive prescription drugs by penalizing users of OTC medicines.

The rallying cry for opponents of Obamacare has been, “Hands off my healthcare.” In addition, they now could say, “Hands off my medicine cabinet.” And the fight could begin as soon as reconciliation.

A smart politician could introduce an amendment to strike the medicine cabinet tax, arguing that under dynamic scoring which takes into account behavioral changes of taxpayers, the tax would cost the government more.


And quite a few more:  http://www.dogpile.com/Dogpile_fctb/ws/results/Web/OTC%20drugs%20obamacare/1/0/0/Relevance/iq=true/zoom=off/user_id=38055999/tool_id=60241/_iceUrlFlag=7?_IceUrl=true





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377493 tn?1356502149
I didn't read all the comments because it's getting late and my eyes hurt..lol.  However, something in the original article struck me...you guys get over the counter medications covered?  Now there is a big "wish" for me.  We don't.  Prescription, yes (depending of course on your extended benefits insurance package, none are covered under our gov't program), but I don't know of any insurance plan that pays for over the counter.  Wow!!

Our gov't program covers any and all medical visits, hospital visits, Dr. ordered tests, etc. etc.  Dental, prescriptions, life insurance, etc. are all covered by private insurance plans.  I wonder...is that what your proposed health care plan (or Obamacare) looks like?  
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973741 tn?1342342773
I saw in the middle "Special, do you vote for Obama Health Care.  Vote here now"

Was that me?  LOL  I veto his health care bill.  Never supported it and never will.  I actually tried to read the bill in its entirity vs. the White House talking points (selling points).  

Amanda, this has to do with "flexible spending".  In America, you can set aside money from your pay check that won't be taxed for your health care needs.  You can only set aside so much but it is to pay for things that insurance doesn't cover.  I have seasonal allergies and do use over the counter allergy medicine in the Fall.  I could use my non taxed flexible spending account to pay for it.  NOW, it will be taxed making the cost of those items go up.  This is our OWN money we are spending and not insurance money.  
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Avatar universal
People seem to think that pre existing conditions, which the new healthcare reform has insisted that insurers carry, free mammography and cancer screenings, no more caps on healthcare for a lifetime, or illness, children being covered on the parents policy till the age of 26, etc.etc.etc. and disallowing the insurance company to drop someone cause they are sick,  is a bad thing. Why? cause they dont want government telling them they have to carry insurance so all can be covered, and would rather get hung up on something that wont effect 80% of the people anyway.

They want insurance companies to get their power back, wall street in their opinion has been treated badly and they think poor people should die, anyone who is non white or not heterosexual are less than human and want to protect the wealthy. Doesnt make much sense does it? Altho they will be the first in line when it comes to getting their ss and medicare cheks! Yet many of these same people call themselves christians and want to take that  passage in the bible that pretty much states I am my brothers keeper to a whole new level.


Follow the link that I posted and it will explain what FSA's are and how they work.
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973741 tn?1342342773
And by the way, insurance companies actually make out by the public using a drug that has gone OTC because before when it was prescription only, they had to pay for it.  Once we can get it ourselves at the drug or grocery store-----------  they were off the hook. They LOVE OTC!

And your govt. pays for life insurance for everyone there?  I always thought life insurance was very individual and every family had different needs.  My husband certainly needs more now that he has a stay at home wife and two kids than he did prior to marriage.  

Ha, and I also like our lower tax rate here in the US.  Oh, and I thought you said you had to buy into dental as an "extra" on your insurance.  

I know, we'll just never agree on this subject.  LOL I'm okay with that if you are!
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973741 tn?1342342773
Now Teko, I really can say with all my heart that I do not want people to die.  I think that is a bold statement to those of us who are not in favor of this bill.  I think the health care options in this country can be improved but I do not care for Obama's version of that.  
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Avatar universal
LOL, guess I should have drank the coffee before posting! lol.... No I am not singling anyone out, speaking in generalities and of course that does not cover everyone in that blanket statement. However, after listening for months on end to the politicians and their ploys to get into power and the reasoning they give, that pretty much is the jist of what they are saying.At least that is what I am hearing.  And I agree that health care reform needs more, yet it is a good beginning, certainly more than we had before, imo. I also don't think repealing it, is the answer. Personally, I am for the public option, or a system similar to what adgal in Canada has or even Australia
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1301089 tn?1290666571
Our health care system did need some revisions.  I already get mammograms, colonoscopies, bone density, etc.. at no additional charge.  These are good things.  People shouldn't be dropped because they're ill.  And I like being able to keep my kids on the insurance until age 26.  

BUT this monstrosity they've passed is turning into a nightmare of unintended consequences.  No one read it.  (Anyone remember the Tea Party cry of "Read the Bill?")   It needs to be rescinded in total and redone.  It does have SOME good things but too many special interests (AARP and Big Pharmacy) and is too heavy in regulations.  (A separate form for EACH purchase of over $600???)  It was done behind closed doors and they put WAY too much on the states.  Payoffs to Louisiana and Nebraska??  It needs to be redone from the bottom up.  And quite frankly, I can't think of anything that Government can do better than private industry.
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377493 tn?1356502149
Lol, no no no. Our Gov't doesnt pay any of that stuff.  Just basic health care.  Then a private insurance company handles things like prescription drugs, dental, life insurance, etc.  So our taxes are what takes care of all basic health care needs, then usually your employer will have (through an insurance company) a plan that we refer to as Extended benefits which covers the rest.  In some cases (such as my employer) the employer will cover 100% of the extended benefits.  In others (usually smaller companies) the employee will pay part of the premium, employer the other.

Basic healthcare (through our taxes) will pay for any and all Dr. visits, specialist visits, tests, hospitilization, etc.

Sorry, I wasn't clear on that, it was late!!  

I was wondering about the OTC medication because I can't think of a single instance in which we would have that covered.  

Yeah, we will probably always disagree on this.  But I do love the debate!!!!!  hehe.
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973741 tn?1342342773
Is your tax rate 20 to 25 percent?  Mine is lower than that and I'd rather take that 10 percent extra income and decide how to spend it.  So------------ I as in me as in I make the choices rather than these unknown folks in Washington that I really don't trust all that much doing it!  In some European countries, taxes are as high as 42%!  
'
Okay, I won't be popular.  I also don't think keeping our adult children on our policies until 26 is sending the right message.  I expect my kids to get it together and make choices to set themself up in life including getting their own insurance.  I really want to raise the bar for my kids vs. lower it.  Dependence on others including their parents just seems like a backward move when we are talking about adults here.  

Just my little old tired opinion.  LOL
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377493 tn?1356502149
Our tax rate is essentially a sliding scale...the wealthier you are the higher your tax bracket.  Ours is about 30%.  It's normal for us so I guess much is what you are used to.  That covers everything..health, schools, unemployment insurance, etc. etc.  

I actually don't know if I think it much matters how health care coverage is handled.  The reason I would not like to have your current system here is because of the fact they seem to be able to drop you for just about any reason.  Just as you hear the horror stories about our system, we hear them about yours and people being wildly in debt or having to declare bankruptcy because someone in their family got sick.  Or being born with a disease or illness so they can never get coverage.  I think that's important to remember...we always hear the worst case scenarios on either side.  What  Iike about our system is that you cannot be dropped for any reason whatsoever...nothing.  It scares me someone in my family might get sick and what could happen if we didn't have our current system.  

Frankly, our system needs some reform as well. I still always think that if gov'ts spent more time talking...for example, take what works well from your system and combine it with what works well for ours and they could probably come up with almost a perfect solution.  Maybe they should hang out on these boards....I bet we could solve it...lol!

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973741 tn?1342342773
It is so interesting because I don't know anyone personally that has been actually dropped from their insurance company.  You do hear the stories in the media, but in my own life--------- this hasn't happened to anyone I know.  Are they talking about people who cap out their benefit?  But the same thing happens with that under your system----  it just isn't spelled out for the patient the same way.  I have heard of pre existing conditions in some cases coming into play.  It wasn't that someone could not get insurance but they had to pay more.  They cost more to cover, I guess and I do know of this happening to someone.  

But I think working out some things within our system is mandatory.  I think everyone agrees on that.  But this health care legislation has such a bad feeling around it with a good chunk of our country------------  that I'd like to see it repealed and then a new plan presented.  

And yes, maybe we should send a link for med help to the White House!!
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Avatar universal
I've got a lot of problems concerning this health care debacle.  For starters, the bill was unreadable and numerous polticians that voted for it have said that they havent read it, or at least in its entirety.  (I wish I could remember who just recently said that they hire professionals to read these things....what in the hell does that even mean?)  Top that with the fact that one cannot get the straight facts on this bill.  

Keeping the professionals mentioned above in mind, who are these professionals?  Where did we find them?  Who do they really work for?  How are they getting paid and who is paying them?  What kind of a "professional" are they...as in, where is their expertise?  I am pretty sure I can find a "professional" anywhere that will be glad to take my money and be more than happy to tell me anything I want them too.  (I probably shouldnt be so cynical when it comes to politics, but the last 20 years or so has done me in with politics.)

Any site I have gone to seems biased one way or the other.  Things Ive seen have made me think of the old addage, "if it seems to good to be true.....".  

By all means, health care has needed a revamping for a long time. (I am having a hard time finding any government program that isnt in the need for a tune up) As per usual, we wait till things are completely out of control before we address the issue, then we spend too much time finding "finding" facts that support our side of the story.  Then we spend all kinds of time and money trying to convince one another that this bill is the cure all, and a modern day necessity, while the opposition runs around spending money to fight the thing.

AT the end of the day, its all political posturing and politicians breaking their own arms in order to pat themselves on the back.  I dont think it really has anything to do with 'we the people" as much as it does with political comraderie.
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649848 tn?1534633700
I think you know that I have never been a lover of the health care reform bill; however, I have known people who have been dropped from their insurance policies, because of illnesses; I know of others who are unable to obtain insurance because of pre-existing conditions.........We have members in this group, to whom these things have happened, plus I have friends who can't get insurance........... not right.

Those are the parts of the health care bill that need to be left intact -- the rest needs to culled to the fullest extent.  They included provisions, such as the OTC issue to raise taxes to pay the huge price tag for the bill...........

I agree that by the time a child reaches 26 yrs old, they should have learned the facts of life and be able to make their own decisions regarding health care/insurance.  If a person is old enough/responsible enough to vote, s/he should be responsible enough to handle their own health care/insurance.  

There were enough of these young people who voted for Obama's "change" - let them deal with it, like the rest of us have to.  

Maybe the voting age should be raised to 26?  


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973741 tn?1342342773
Ha, this would not go over well with our party to the left who count on those young minds for a chunk of votes!

I agree that there are things that need to be fixed and pre existing conditions is one of them along with the security of knowing your insurance company won't drop you when you need them the most.  I doubt too many disagree with that.  
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1035252 tn?1427227833
Well now that's not fair! After all, I'm only 25! ;)

But don't you think that the young vote is vital? I think that older people very often dismiss younger people because we don't have experience, or life-gained wisdom...but, truthfully, not to be harsh...we're really the ones that matter because sooner than later...the oldest votes (not including anyone here!) will be, quite literally, dead and gone...and our opinions are the ones that are going to shape the future. Really need to stop ignoring the younger voters, IMO. And by that I  mean....targeting us JUST to get our votes is not the right way...how about actually respecting the future of America enough to DISCUSS HONESTLY the issues and help us come into the political scene?


at any rate, making OTC medications require a prescription is beyond ridiculous. that's the point of "OTC".....I can't believe how completely a$$-backwards this bill makes things.
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973741 tn?1342342773
I was JOKING!  I think college campuses have the reputation of being pretty liberal so Democrats would WANT them to vote but that was just part of my little funny which you didn't think was too funny.  . /And any comment made about their not being being able to vote had to do with thinking they still need mommy and daddy to cover their expenses at age 26.   If they are not adult enough to do that . . . are they adult enough to vote.  More of the joke that isn't funny.  sorry.  And see, you are 25, living as a grown up with a husband and children . . .  you act like an adult and your government should treat you as such.  Okay, hope I made that all better.  (smile).  
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Avatar universal
I think the age of 26 was put in there for the purpose of young people going thru college. A whole lot of them still do pay their own way by working in order to do it. Not everyone has a mom or a dad that puts them thru school. I think the age is good for college students.
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1035252 tn?1427227833
LOL Kay I wasn't offended please don't think I was! I was just being cheeky :)
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306867 tn?1299249709
I think it's pretty sad that people complain about having to pay for over the counter meds (actually they don't have to pay, just get a doctors note). So many people in this country can't afford life saving prescription medication. I had health insurance my whole life and they never paid for over the counter meds, so what's the big deal about this now.  I mean really.............you have people out there that worked their whole lives that will die this year because they can't get the treatment they need.  Some people should really be counting their blessings.
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