medicine OVER-THE-COUNTER MEDICINES AND DRUGS
AVAILABLE FOR REIMBURSEMENT*
Analgesics (all pain relievers) Enemas
Anti-inflammatories (including Ibuprofen) Laxatives
Antacids Menstrual cycle products for pain or cramps relief
Antibacterial (including creams, ointments, sprays) Muscle or Joint Pain Ointments
Antidiarrheals Nicotine Gum or Patches (for stop-smoking programs)
Antiemetics (from treating nausea and vomiting including motion sickness medications) Ocular Vasoconstrictor (such as Visine)
Antifungals (including Monistat, Gyne-Lotrimin, and any other anicandidal product) Pedialyte for Dehydration
Antihistamines (for allergies and/or cold) Sinus medications (including nasal sinus sprays)
Calamine Lotion and other bug bite medications Sleeping Aids
Cold Remedies Sunburn Ointment
Cough Suppressants and Expectorants Sunscreen
Decongestants Suppositories and Creams for Hemorrhoids
Diaper Rash Ointments

Wart Remover Treatments

*Quantities and limitations exist. Must reasonably correlate to the number of dependents.

NOT COVERED UNDER THIS PLAN
Chapstick or Lip Balm Moisturizers
Dandruff Shampoos Nasal Sprays for Snoring
Feminine Hygiene Products Nutritional Supplements
Fiber Supplements Rogaine
Fingernail or Cuticle Maintenance Products Shaving Lotions
Fluoride Toothpaste Soaps
Herbal Remedies Teeth Whitening Products
Illegal Drugs (as defined by Federal Law including medications procured from out of the Country) Vitamins

The Plan will not reimburse for any taxes or shipping charges on over-the-counter medicines and drugs. Only itemized receipts for over-the-counter medicines and drugs will be eligible for reimbursement.

Any other over-the-counter items/drugs may be considered if submitted with a Physician's recommendation, medical diagnosis, and period of treatment.