Documentation Requirements

In order to be reimbursed for OTC drugs, you will need to complete a Request for Reimbursement (claim) form and attach an itemized receipt for the drugs. If you are submitting a cash register receipt, the receipt must include:

Name and address of provider (i.e., drug store or grocery store);

  • Date of purchase;

  • Name of OTC drug.

  • If the name of the drug or medicine is not shown on the cash register receipt, you must submit a tear off portion of the box or package that includes the name of the drug and price along with the cash register receipt.

    Please note that OTC drugs NOT eligible for reimbursement include the following, unless a specific medical condition exists (physician’s recommendation for the OTC drug purchase outlining the specific medical reason must be included with your claim submission):

  • Drugs purchased for cosmetic reasons (e.g., Rogaine);

  • Weight loss drugs;

  • Drugs purchased for general good health (including dietary supplements and vitamins).

    Please remember that there is a minimum reimbursement amount of $10.00. For this reason, we recommend that you either batch receipts, or submit with other expenses to ensure that your minimum submission amount is $10.00.

    If you have any questions, please feel free to contact CSI or our claims administrator, Arcadia Benefits Group, at one of the numbers shown below.
    CSI Flexible Benefits Plan
    (616) 284-3228 or 877-274-8796, Ext. 228
    Arcadia Benefits Group)
    269 744-3431or 877-274-8796, Ext. 228

    Full Issue: No. 41 - September 12, 2003

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