Save Money Using a Flexible or Health Savings Account for Certain Over The Counter Products

“Letter of Medical Necessity” Can Make Big Florajen Savings Possible

Do you rely on a Florajen Probiotic to help you with digestive or vaginal health? Or for another reason you and your doctor have determined? 

Have you set aside funds, pre-tax, in a flexible spending (FSA) or health savings account to help you save money on out-of-pocket medical expenses with tax-free dollars?

Usually, most of us think about using our flexible spending or health savings accounts for insurance copayments and deductibles, prescription medications and required medical devices. But, with a letter of medical necessity from your doctor, certain over the counter (OTC) products can also qualify as expenditures for reimbursement from your pre-tax, health-related savings accounts. 

That’s right, with the appropriate paperwork, you may be able to use your flexible spending and health savings funds for a Florajen Probiotic. This wasn’t always the case, but when the U.S. government passed the “CARES Act” (Coronavirus Aid, Relief, and Economic Security Act), it reinstated FSA reimbursement for a lot of OTC products. Eligible expenses are effective retroactively to January 1, 2020. 

While some OTC items are more easily reimbursed, you may still be able to make others, like Florajen eligible via a slightly different process. 

To be able to use your FSA funds for a Florajen Probiotic, for example, you’ll need a letter of medical necessity or doctor’s statement from your healthcare provider. This document verifies that the medication, product or service you’re asking for reimbursement for from your healthcare FSA is for the diagnosis, treatment, or prevention of a condition. In the letter or note, your healthcare provider should explain that the OTC product you’re using, such as Florajen, helps to treat, manage, or prevent a condition that you have. The letter should outline how the product plays an essential role in your care.

If you and your doctor have identified an OTC product or service that can help you better care for your digestive or vaginal health, for example, and that product is not already included in the common list of FSA-eligible OTC products, here’s what to do:

  • Ask your benefits administrator or human resources department if there is an official form you should use to get an OTC product approved as an FSA-eligible expense. 
  • If there is not a form for your doctor to complete and sign, ask him or her to write you a letter of medical necessity. This letter needs to include what medical condition the OTC products in question are being used to treat/manage/prevent, a description of the regimen (frequency, dosage), and how long you are expected to need the therapy. 
  • Submit either the appropriate and doctor-signed form or letter of medical necessity along with your receipts or invoices for products to be reimbursed.
  • Be aware that in some cases, benefits administrators may ask for additional information from your doctor. 

Key Information for Letters of Medical Necessity

Here’s an outline of the important information that should be included in your letter of medical necessity from your doctor. Letters should be provided on your healthcare provider’s official letterhead or prescription pad or you should use the official form provided for this purpose by your benefits manager or human resources department. 

  1. Provider’s official letterhead or prescription pad. Or, appropriate form.
  2. Patient/your name.
  3. Specific diagnosis/condition and the treatment/product/service being recommended/required.     
  4. Dose amount, frequency of dose, and duration of therapy (days, weeks, months, ongoing) as appropriate. (Note that letters of medical necessity typically need to be renewed/rewritten annually.)
  5. Signature of licensed medical practitioner.

Tips for success:

  • Start a conversation with your healthcare provider re. potential FSA-eligible products via email or a telehealth appointment, if possible, and get the ball rolling from the convenience of home. An in-office visit may not be required to get a letter of medical necessity and it’s great to start the process early so no one feels rushed or under pressure.
  • Create a “medical expenses” folder where you stash all potentially FSA-eligible receipts. 
  • Create a similar folder on your computer for any digital receipts or bills.
  • Make an “appointment” in your calendar for every 3-4 months to periodically file your FSA claims for reimbursement. 

Of course, caring for your digestive and vaginal health goes way beyond your wallet. To learn more about gut health, immune support and how probiotics can benefit overall health, be sure to read our other blogs.

*These statements have not been evaluated by the Food and Drug Administration. These products are not intended to diagnose, treat, cure or prevent any disease.

REFERENCES:

  1. Segers ME, Lebeer S. Towards a better understanding of Lactobacillus rhamnosus GG - host interactions. Microbial Cell Factories. 2014;13(Suppl 1):S7. doi:10.1186/1475-2859-13-S1-S7. [LINK https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4155824/ ]
  2. Sugahara H, et al. Probiotic Bifidobacterium longum alters gut luminal metabolism through modification of the gut microbial community. Scientific Reports 5, Article number: 13548 (2015) [LINK http://www.nature.com/articles/srep13548 ]
  3. Kirjavaninen et al. Aberrant composition of gut microbiota of allergic infants. FEMS Immunol Med Microbiol. 2001;32;1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1773282/
    Bjorksten et al. The intestinal microflora in allergic Estonian and Swedish infants. Clin Exp Allergy. 1999;29:342.
  4. McFarland LV. Epidemiology, risk factors and treatments for antibiotic-associated diarrhea. Dig Dis. 1998;16(5):292-307
    https://www.ncbi.nlm.nih.gov/pubmed/9892789
  5. Waigankar SS, Patel V. Role of probiotics in urogenital healthcare. Journal of Mid-Life Health. 2011;2(1):5-10. doi:10.4103/0976-7800.83253.
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3156505/
    and
    Vásquez A, Jakobsson T, Ahrné S, Forsum U, Molin G. Vaginal Lactobacillus Flora of Healthy Swedish Women. Journal of Clinical Microbiology. 2002;40(8):2746-2749. doi:10.1128/JCM.40.8.2746-2749.2002.
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC120688/
  6. Wright JJ, Paauw DP. Complications of Antibiotic Therapy. Medical Clinics of North America; July 2013, 97(4): 667–679.
    http://www.medical.theclinics.com/article/S0025-7125(13)00029-1/abstract
  7. Vanderhoof J.A., et al . Lactobacillus GG in the prevention of antibiotic-associated diarrhea in children. J Pediatr. 1999;135(5):564-568.
    https://www.ncbi.nlm.nih.gov/pubmed/10547243
  8. “ A.G. Mohamed, Hayam M. Abbas, Abeer F. Zayan and Nayra Sh. Mehanna, 2016. Bacterial Strains as Vitamins Supplements to Prepare Functional Dairy Beverages. American Journal of Food Technology, 11: 234-239. https://scialert.net/fulltextmobile/?doi=ajft.2016.234.239
  9. Probiotics, What’s the Bottom Line. National Center for Complementary and Integrative Health, National Institutes of Health website. Accessed April 2, 2017 https://www.nccih.nih.gov/health/probiotics-what-you-need-to-know
  10. Kim SE, et al. Change of Fecal Flora and Effectiveness of the Short-term VSL#3 Probiotic Treatment in Patients With Functional Constipation. Constipation Research group of Korean Society of Neurogastroenterology and Motility. J Neurogastroenterol Motil. 2015 Jan 1;21(1):111-20. doi: 10.5056/jnm14048. https://www.ncbi.nlm.nih.gov/pubmed/25537674
  11. Probiotics May Ease Constipation. Harvard Health Publications, Harvard Medical School website. Accessed April 4, 2017 http://www.health.harvard.edu/blog/probiotics-may-ease-constipation-201408217377
  12. Dimidi E, et al. The effect of probiotics on functional constipation in adults: a systematic review and meta-analysis of randomized controlled trials. The American Journal of Clinical Nutrition. August 6, 2014, doi:3945/ajcn.114.089151 https://ajcn.nutrition.org/article/S0002-9165(23)04789-5/fulltext
  13. Khalif IL, et al. Alterations in the colonic flora and intestinal permeability and evidence of immune activation in chronic constipation. Dig Liver Dis. 2005 Nov; 37(11):838-49. https://www.ncbi.nlm.nih.gov/pubmed/16169298
    and
    Barbara G, et al. Interactions between commensal bacteria and gut sensorimotor function in health and disease. Am J Gastroenterol.2005 Nov;100(11):2560-8. https://www.ncbi.nlm.nih.gov/pubmed/16279914
  14. Miller LE, Ouwehand AC. Probiotic supplementation decreases intestinal transit time: meta-analysis of randomized controlled trials. World J Gastroenterol. 2013 Aug 7; 19(29):4718-25. https://www.ncbi.nlm.nih.gov/pubmed/23922468
  15. Cha BK, et al. The effect of a multispecies probiotic mixture on the symptoms and fecal microbiota in diarrhea-dominant irritable bowel syndrome: a randomized, double-blind, placebo-controlled trial. J Clin Gastroenterol. 2012;46:220–227. doi: 10.1097/MCG.0b013e31823712b1.
    and
    Whorwell PJ, Altringer L, Morel J, et al. Efficacy of an encapsulated probiotic Bifidobacterium infantis 35624 in women with irritable bowel syndrome. Am J Gastroenterol. 2006;101:1581–1590. doi: 10.1111/j.1572-0241.2006.00734.x.
  16. MedlinePlus, U.S. National Library of Medicine website. Accessed April 4, 2017 https://medlineplus.gov/diarrhea.html
  17. Using Probiotics for Diarrhea. WebMD website. Accessed April 4, 2017 http://www.webmd.com/digestive-disorders/probiotics-diarrhea#1
  18. McFarland LV. Meta-analysis of probiotics for the prevention of traveler's diarrhea. Travel Med Infect Dis. 2007 Mar;5(2):97-105.
    https://www.ncbi.nlm.nih.gov/pubmed/17298915
    and
    Traveler’s Diarrhea. Centers for Disease Control and Prevention website. Accessed March 31, 2017. https://wwwnc.cdc.gov/travel/yellowbook/2016/the-pre-travel-consultation/travelers-diarrhea
  19. How to Prevent Diarrhea While You Take Antibiotics. Cleveland Clinic website. Accessed April 4, 2017 https://health.clevelandclinic.org/how-to-prevent-diarrhea-while-you-take-antibiotics
  20. Infectious diarrhea: Can probiotics help against diarrhea? PubMed Health, U.S. National Library of Medicine website. Accessed April 4, 2017. https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0088733/
  21. Based on market survey conducted by American Lifeline December 2016.
  22. Could Probiotics Help Alleviate your Functional Gastrointestinal Symptoms? International Foundation for Functional Gastrointestional Disorders website. Accessed April 4, 2017. https://www.iffgd.org/diet-treatments/could-probiotics-help-your-symptoms.html
  23. Kim HJ, et al. A randomized controlled trial of a probiotic, VSL#3, on gut transit and symptoms in diarrhoea-predominant irritable bowel syndrome. Aliment Pharmacol Ther (2003)17: 895–904. https://www.ncbi.nlm.nih.gov/pubmed/12656692
  24. Kim HJ, et al. A randomized controlled trial of a probiotic combination VSL# 3 and placebo in irritable bowel syndrome with bloating. Neurogastroenterol Motil (2005)17: 687–696. https://www.ncbi.nlm.nih.gov/pubmed/16185307
  25. Supplements for IBS: What Works? WebMD website. Accessed April 4, 2017 http://www.webmd.com/ibs/features/supplements-for-ibs-what-works#1
  26. Bloating 101: Why You Feel Bloated. WebMD website. Accessed April 4, 2017 http://www.webmd.com/digestive-disorders/diarrhea-10/bloated-bloating
  27. Health benefits of taking probiotics. Harvard Health Publications, Harvard Medical School website. Accessed March 31, 2017. http://www.health.harvard.edu/vitamins-and-supplements/health-benefits-of-taking-probiotics
  28. Survey of full-time U.S. pharmacists who stock Florajen, by DMD Healthcare Research, December 2015.
  29. Jiang, W., Ni, B., Liu, Z. et al. The Role of Probiotics in the Prevention and Treatment of Atopic Dermatitis in Children: An Updated Systematic Review and Meta-Analysis of Randomized Controlled Trials. Pediatr Drugs 22, 535–549 (2020). https://doi.org/10.1007/s40272-020-00410-6
  30. Tan‐Lim, CSC, Esteban‐Ipac, NAR, Mantaring, JBV, et al. Comparative effectiveness of probiotic strains for the treatment of pediatric atopic dermatitis: A systematic review and network meta‐analysis. Pediatr Allergy Immunol. 2021; 32: 124– 136. https://doi.org/10.1111/pai.13305
  31. M. Alexander Otto. “Yeast Infection Four Times as Likely with Penicillin Use.” Clinician Reviews, 13 Dec. 2016, https://www.mdedge.com/clinicianreviews/article/77427/infectious-diseases/yeast-infection-four-times-likely-penicillin-use?sso=true.
  32. Navarro-López V, Ramírez-Boscá A, Ramón-Vidal D, et al. Effect of Oral Administration of a Mixture of Probiotic Strains on SCORAD Index and Use of Topical Steroids in Young Patients With Moderate Atopic Dermatitis: A Randomized Clinical Trial. JAMA Dermatol. 2018;154(1):37–43. doi:10.1001/jamadermatol.2017.3647
  33. Yan F, Polk DB. Probiotics and immune health. Curr Opin Gastroenterol. 2011 Oct;27(6):496-501. doi: 10.1097/MOG.0b013e32834baa4d. PMID: 21897224; PMCID: PMC4006993. https://pubmed.ncbi.nlm.nih.gov/21897224/
  34. Hanifin JM, Reed ML; Eczema Prevalence and Impact Working Group. A population-based survey of eczema prevalence in the United States. Dermatitis. 2007 Jun;18(2):82-91. doi: 10.2310/6620.2007.06034. PMID: 17498413.
  35. Eczema Prevalence, Quality of Life and Economic Impact.” National Eczema Association, 16 Mar. 2021, https://nationaleczema.org/research/eczema-facts/.
  36. Elizabeth Campbell and Allen Sayler. “Medical Foods – Insights Into FDA's Interpretation and Enforcement.” Food Safety RSS, Food Safety, 6 Mar. 2018, https://www.food-safety.com/articles/5701-medical-foods-insighte28099s-into-fdae28099s-interpretation-and-enforcement.
  37. Simpson EL, Guttman-Yassky E, Margolis DJ, et al. Association of Inadequately Controlled Disease and Disease Severity With Patient-Reported Disease Burden in Adults With Atopic Dermatitis. JAMA Dermatol. 2018;154(8):903-912.
  38. Wei W, Anderson P, Gadkari A, et al. Extent and consequences of inadequate disease control among adults with a history of moderate to severe atopic dermatitis. J Dermatol. 2018;45(2):150-157.
  39. Study finds 1,000 species of bacteria on healthy human. Los Angeles Times website. https://www.latimes.com/archives/la-xpm-2009-may-29-sci-skin-bacteria29-story.html. Accessed April 13, 2021.
  40. Segers ME, Lebeer S. Towards a better understanding of Lactobacillus rhamnosus GG – host interactions. Microbial Cell Factories. 2014;13(Suppl 1):S7. doi:10.1186/1475-2859-13-S1-S7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4155824/.
  41. Hill D, Sugrue I, Tobin C, Hill C, Stanton C, Ross RP. The Lactobacillus casei Group: History and Health Related Applications. Front Microbiol. 2018;9:2107. Published 2018 Sep 10. doi:10.3389/fmicb.2018.02107
  42. Chyn Boon Wong, Toshitaka Odamaki, Jin-zhong Xiao, Beneficial effects of Bifidobacterium longum subsp. longum BB536 on human health: Modulation of gut microbiome as the principal action, Journal of Functional Foods, Volume 54, 2019, Pages 506-519, ISSN 1756-4646, https://doi.org/10.1016/j.jff.2019.02.002.
  43. Sugahara H, et al. Probiotic Bifidobacterium longum alters gut luminal metabolism through modification of the gut microbial community. Scientific Reports 5, Article number: 13548 (2015) http://www.nature.com/articles/srep13548