| These items are reimbursable only with a third-party receipt (the name of the medication and the purchase date must be on the receipt). No recommendation from a health care provider is required. | |||
| Type of Drug | Examples * | ||
| Allergy Prevention & Treatment | Actifed, Benadryl, Claritin, Nasalcrom, Sudafed | ||
| Antacids and Acid Reducers | AXID AR, Gas-X, Maalox, Mylanta, Pepcid AC, Prilosec OTC, Tagamet HB, Tums, Zantac 75 | ||
| Anticandial | Fenstat 3, Gyne-Lotrimin, Mycelrx-7, Monistat 3, 7, Vagistat-1 | ||
| Antihistamines | Actidil Syrup and Capsules, Actifed, Allerest, Chlor-Trimeton, Contac, Dimetane, Drixoral, Nyquil, Sudafed, Tavist-1, Triaminic | ||
| Antidiarrheal and Laxatives | Ex-Lax, Immodium A.D., Kaopectate, Pepto-Bismol | ||
| Anti-fungal | Lamisil AT, Lotramin AF, Micatin | ||
| Anti-itch Lotions and Creams (e.g., for athletes foot, jock itch, bug bites, poison ivy) | Bactine, Benadryl Cream, Calamine Lotion, Caldecort, Caladryl, Cortaid, Hydrocortisone, Lanacort | ||
| Asthma | Primatene Mist | ||
| Cold Sore/Fever Blister | Abreva Cream, Carmex | ||
| Condoms and Other Contraceptive Devices | Trojans, Magnum, VGF Film, Delfen Contraceptive Foam | ||
| Contact Lenses Solutions | Aosept, Allergan, Bausch & Lomb, Boston, Opti-Free, Renu | ||
| Cough Suppressants | Chloraseptic, Robitussin, Vicks 44 | ||
| Decongestant/ Nasal Decongestant and Cold Remedies | Advil Cold and Sinus, Afrin, Afrinol, Aleve Cold and Sinus, Alka Seltzer Cold and Flu, Children's Advil Cold, Duration, Dristan Long Lasting, Neo-Synephrine- 12 Hour, Orrivin, Pedialyte, Sudafed, Tavist-D, Tylenol Cold and Flu, Thera-flu | ||
| Diaper Rash Ointments | Balmax, Desitin | ||
| Eye Drops for Allergy/Cold Relief | Ocu Hist | ||
| First Aid Supplies | Ace Bandages, Band-Aids, Bandage Tape, Gauze, Medical Gloves, Neosporin, Rubbing Alcohol, Thermometers, Visine | ||
| Hemorrhoid Treatments | Preparation H, Hemorid, Tronolane | ||
| Internal Analgesic/antipyretic | Advil, Aleve, Children's Motrin, Nuprin, Excedrin, Tylenol, Bayer | ||
| Incontinence Supplies | Depends | ||
| Liniments | BenGay, Tiger Balm, Flexall | ||
| Medical Monitoring | Services and Bracelets specifically for medical information | ||
| Medical Products and Devices | Blood Pressure Monitor, Cholesterol Test, Diabetic Supplies, Crutches, Glucose Tester, HIV Test Monitor, Pregnancy Testing Kits, Ovulation | ||
| Menstrual Cycle Medications | Midol, Pamprin, Premysyn PMS | ||
| Migraine | Advil Migraine Liqui-gels, Excedrin Migraine, Motrin Migraine Pain | ||
| Motion Sickness Medication | Dramamine, Marizine | ||
| Nicotine Gum/Patches and Smoking Cessation Aids | Commit, Nicoderm CQ, Nicorette, Nicotrol, Nicodin | ||
| Pediculicide (head lice) | Nix | ||
| Poison Ivy Protection | Ivy Block | ||
| Sleep Aids | Sominex, Sleepinal, Tylenol Simply Sleep, Unisom Sleep Tabs | ||
| Sunscreen and Sunblock | Coppertone, Hawaiian Tropic, Neutrogena | ||
| Toothache and Teething Pain Relievers | Orajel | ||
| Wart Removal Medications | Tinamed | ||
| * This list is not an exhaustive list and is intended to give examples of some of the most common brand names of OTC drugs. | |||
| Dual Purpose OTC Drugs. These require a third-party receipt and a note from the health care provider listing the diagnosis of the medical condition and the recommendation of the OTC Drug. | |||
| Anti-baldness/ hair loss/ hair replacement/ such as Rogaine, but only if to replace hair loss due to a medical condition (e.g. cancer treatment) and not for balding due to age | |||
| Fiber supplements such as Benefiber and Metamucil | |||
| Glucosamine/Chondrotin for arthritis or other medical condition (not reimbursable if taken for overall joint health) | |||
| Herbal supplements used to treat a specific disease such as St. John's Wort for depression | |||
| Hormone Therapy Drugs | |||
| Medicated shampoos to treat a specific medical condition like psoriasis (only the amount in excess of the cost of normal shampoo is reimbursable) | |||
| No Doz (and other sleep prevention drugs) | |||
| Nose strips for proper breathing or other medical conditions | |||
| Retin-A and other acne medicines (not reimbursable if used for cosmetic purposes such as wrinkle reduction) | |||
| Snoring cessation aids and medications such as Breathe Right Spray, Snorezz | |||
| Vitamins are not an eligible expense, unless prescribed by a physician to treat a specific medical condition. (i.e. Iron to treat, not prevent, anemia; Calcium supplements to treat, not prevent, Osteoporosis). A doctor's note detailing the specific medical condition will be required for reimbursement | |||
| Weight loss/dietary supplements must be for a specific medical condition such as obesity | |||
| OTC Items Not Reimbursable. These item are obtained for cosmetic, personal, or general health purposes and are not reimbursable. | |||
| Lip Balm that is not listed as either medicated or having an SPF for protection against the sun. Cosmetics Cotton balls Deodorants Face creams, moisturizers, eye creams, and wrinkle reducers |
Feminine hygiene products such as tampons and maxi pads Food items (i.e. Slim Fast) Hair removal treatments and waxes Mouth washes, antiseptics and oral anesthetics |
Shaving cream and razors Soap Teeth whitening kits and powders Toothpaste Vitamins taken to improve overall health |
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| 721 South Parker Suite 300 Orange, CA 92868 |
866.279.8385 fax 888.866.3312 www.CONEXIS.com |
6191 North State Hwy 161 Suite 400 Irving, TX 75038 |
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