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Eligible OTC List 4.22.20

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Eligible OTC List 4.22.20 Eligible: Devices and Supplies Category Example Comment Acupressure Treatments Sea Band, Flents EZ Travel Wrist Band Products that treat a medical condition are eligible. Weight-loss products are dual-purpose. Breast Pumps and Breast- Breast Pump (cost or rental fee), Breast Products that directly aid lactation Feeding Supplies Pump Parts (pump valve, replacement are eligible. tubing, piston unit, diaphragms, pump body, flange, shield), Storage Bottles, Storage Items not eligible include: Bottle Bags, Gel Pads, Nursing Pads, Nipple Stands, Bottle Nipples, Cleaners, Shields, Conversion Kits, Areola Stimulator, Freezer Blocks, Bra Shields and Car Adapter Nursing Pillow and Covers, Nursing Bras and Milk Coolers. Compression Hosiery Medical Compression 30-40 and above; any Treats condition-specific medical compression of Anti-Embolism Stockings, conditions such as anti-embolism, Ulcer Care Compression or Lymphedema ulcer care or lymphedema. Contraceptives Condoms (with and without spermicide) – See also Contraceptives under Trojan, Durex, Lifestyle OTC Drugs and Medicines for products that include an active drug ingredient. Cotton Balls, Rolled Cotton, US Cotton Sterile Cotton Balls and Rolls Only Sterile cotton products are Cotton Applicators eligible. Non-sterile products are dual-purpose. Dental Repair Dentek, Temparin, DOC Recapit Temporary dental repair products are eligible. Denture Adhesives, Repair, PoliGrip, Benzodent, Plate Weld, Efferdent Denture cleaners and and Cleansers maintenance products are eligible. See also Denture Pain Relief under OTC Drugs and Medicines for products that include an active drug ingredient. Diabetes Care Ascensia Meters & Strips, One Touch Testing (meters, strips, lancets, Meters & Strips, Softclix Lancets & Device, alcohol swabs), dosing (syringes, Monoject insulin syringes; Dex 4 glucose pens, etc.), glucose are eligible. products Personal Care are ineligible or dual purpose. Diagnostic Products Braun Forehead Thermometer, Nexcare Includes devices that monitor, (Includes thermometers, Thermometer, Lifescan BP Monitor, screen or test for the presence of blood pressure monitors, Cholestrak, Azo UTI Test Strips, Quest disease, dysfunction of the body cholesterol testing, pulse Pulse Oximeter or for other medical conditions. oximeters, drug, alcohol and body fat testers) Diapers – Juvenile GoodNites, Under Jams Products marketed for juvenile Incontinence incontinence only. Regular diapers and training paints are not eligible. Downloada ble Apps with App cost could be a med ical Medical Functions for expense if used for medical tablets and smartphones purpose only (i.e. track heart rhythm). Apps that include function for general wellness are not eligible. Du rable Medical Equipment Wheel Ch airs , Crut che s, Oxygen Ma chines Can be included wh en manufacturer provides UPC, merchants can mark non-UPC tagged items as private label items. See Home Health Care for additional criteria. Ear Ca re Bi onix Oto Clea r, Select Nutrition Ear Wax Ear drops ear syringes, ear wax Candle, Provent Hearing Aid Dryer removal devices, ear candles, hearing aid cleaners and dryers. See also Ear Care under OTC Medicines and Drugs for products that include an active drug ingredient. Ene mas Bag s, Syringes, prefilled sali ne ene mas - De vices are eligible. Prefil led Fleet enemas are eligible. Eye Ca re Conta ct lens care, eyeglass repa ir kits Produ cts used to mainta in corrective lenses and frames are eligible. Post-surgical eye protection is eligible. Family Planning EP T, Answer Quick & Si mple Ovulat ion Pregnancy, ovulation and fertility Test, Clearblue Fertility Monitor kits are eligible. Dietary supplement only products are not eligible. Firs t Aid Dress ings & Band Aid, 3M Ne xc are, J&J Firs t Aid, non - If the main pu rpo se is for med ical Supplies sport tapes, Simply Saline Wound Wash care, and there is no “normal” use that is not medical, it could automatically qualify as eligible. Saline wound washes are eligible. Bandages impregnated or coated with a medicated product are eligible. Tapes and bandages indicated as "Athletic" or "Sport" are eligible unless marketed as performance enhancing. Foot Ca re Treat men ts Co rn & callus cushions & pad s, corn & Produ cts that have a primary callus remover implements; therapeutic purpose to treat specific ailments insoles, orthotic inserts, arch supports, heel are eligible; products for general cups use or comfort are dual-purpose. Glucosamine &/or Os teo -Bi -Fl ex, Co samin D, Flex-a-min Glucosamine-only or main Chondroitin Nutritional Supplements ingredient glucosamine products are eligible. Head Lice Products Nix Lice Co mb, Rid Lice Comb Co mbs, electron ic devices are eligible. Preparations are not eligible. Hea lth Care Serv ices Urgent Care or Primary Ca re servi ces provided by a licensed practitioner at an IIAS merchant Hea lth Suppo rts ACE, Futu ro, braces, elastic ban dage s, If the main pu rpo se is for med ical hot/cold therapy, orthopedic supports, rib care, and there is no “normal” use belts, back braces, etc. that is not medical, it could automatically qualify as eligible. Athletic tape – typically used on existing injuries or as prevention against further injury, similar to a brace or wrap; not a performance enhancement product will be eligible. Work/industrial back braces belts used to prevent or treat back injury will be eligible. Items eligible if not marketed solely for performance enhancements. Hea ri ng Ai d/M edical Du racell, Ene rgizer Hearing Aid Bat teries Mu lti-pu rpo se batte ries not Batteries eligible. Home Health Care (limited Elevated toilets, commodes, limb/joint Bathroom safety, nutritional segments) protectors, medical/nutritional IV products, foods/liquids, positioning & shower grab bar, bath transfer benches, support (backrests, pillows, etc.), shower stools, urinals/bedpans, traction, patient room supplies, physical specialized braces & supports, ostomy, therapy, aids for daily living. mastectomy products, urological, respiratory General rule applies that these (excluding general air filters), products may be used as part of electrotherapy, mobility (canes, walkers, the aging process which is not rollators, wheelchairs), wound care, considered a medical condition; incontinence, diagnostics (stethoscopes, however equipment that assists thermometers, blood pressure monitors, daily functions like mobility qualify drug and alcohol tests), medication even if impairment is due to dosers/organizers and medical alerts aging. Accessories not related to (jewelry, alarms, etc.) are eligible the actual function of equipment, such as cup holders, totes and baskets, are dual-purpose. See Dual-Purpose Home Health Care section. Hot & C old The rapy ACE Hot /Co ld Co mpress , Ca ra Ice Bag, Fr eezer or instant cold pa cks , Bed Buddy Back Wrap, Kaz Heating Pad, microwave or instant hot ThermaCare Heat Wrap packs/pads, ice bags and electric heating pads are eligible. See also Pain Relief Oral and Topical for Medicated pads. In con tinence Prote ction Att end s, Depend, Prevail, Good Nite s, Skin care, clean sing products and UnderJams diapers/training pants are dual- purpose. Lip Balms – Sun Care Banana Boat SP F 50, Bull frog Water Armor Primary use must be for SPF30 protection against skin cancer and premature skin aging with indication of UVA and UVB protection (broad spectrum) and 15 and above (15+). Products that are primarily moisturizers/cosmetic with a sunscreen are dual-purpose. Men strual Care Produ cts: Kote x, Always, Sta yfree, Tampax Expen ses ass oci at ed with Feminine Protection menstruation or other genital-tract secretions. (Tampon, Pads, Liner, Cup, Sponge, Disposable or Non-disposable Underwear for Menstruation, or other similar products). Mou th Gua rds Dente k, Night Guard Night mouth guards are eligible. Mouth guards used in sports to prevent mouth injury and reduce the risks of concussions will be eligible if not marketed solely for performance enhancements. Na sal Moistu ri zers & Ne ilmed Neti Pot & solutions, Oc ean Saline Produ cts that are saline and Washes Spray, Simply Saline primarily for moisturizing but may contain added aloe, menthol or eucalyptus, etc. are eligible. Na sal Stri ps & Sno re Relief Brea the Right To treat sleep apnea or improper breathing. Excludes strips marketed solely for performance enhancements. Pren atal Vita mins Stua rt Prenat al, Natu re's Boun ty Pren atal Vitamins Rea ding Glass es and Foster Gr ant Reading Glasses, Apex Eye Acc ess ories used to maint ain Maintenance Accessories Glass Repair Kit, BL Sight Saver Lens corrective lenses and frames are Cloths eligible. Chains, cases, etc. are not eligible. Sun Protection (SPF 15 & Cop perto ne SPF15+, Banana Boat SPF Primary use must be for above and Broad 15+, Cerave SPF 30, No-Add Sport Stick protection against skin cancer Spectrum”) SPF50 and premature skin aging with indication of UVA and UVB protection (broad spectrum) and 15 and above (15+). Products that are primarily moisturizers/cosmetic with a sun screen are dual-purpose. TENS Ho med ics Rap id+Relief, Icy Hot Smart TENS units and supplies are Relief, Zewa Spa Buddy eligible. Wart Removers – Cryo Co mpound W Freeze Off , Dr Scholl’s Products Freeze Away, Wartner Vacc inations Flu Shot s, Pneu mon ia, Shing les Vaccinations OTC Medicines and Drugs (Included in Eligible Product List): Tabl e Ca tego ry Exam pl e Comme nt Acid Cont rollers Pep ci d AC, Zanta c, Pri losec Acne Me dicat ions Clea rasil , OXY Allergy & Sinus Al avert, Ben adryl, Claritin, Sudafed Antibiot ic Products Bacitracin, Neo spo rin, triple an tibiot ic ointment Anti-Diarr heal Imod ium, Kaope cta te Anti-Gas Gas-X, Phazyme Dietary Supplement gas products/enzymes are dual- purpose. Antifung al (F oot) La misil , Lotrimin Anti-It ch & In sect Bi te Ca ladryl, Lana cane, Sarna, hydrocortisone Remedies Antipa rasitic Treat ments Nix, Rid, li ce treat ments Antisep tics & wound Rub bing alcohol, peroxide, Ep som salt, cleansers Betadine, Hibiclens Baby Electrolytes and Pedialyte, Enfalyte Baby Electrolytes and dehydration dehydration. Baby Rash Ointments & De sitin, Avee no Baby Includes petroleum jelly Creams merchandised and marketed for baby rash.
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