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Capital Blue Cross Learning Center

Prescriptions and Letters of Medical Necessity

Some expenses are only eligible purchases from your account if you have a valid prescription and/or letter of medical necessity. For example, respiratory treatments and capital expenses all require proper documentation in order to be eligible.

The CARES Act of March 2020 allowed over-the-counter drugs and feminine hygiene products to become eligible without a prescription. Read our article on the CARES Act changes for more information.

This documentation takes the form of: 

  • Valid prescription - This means a signed written order, or an oral order reduced to writing, given by a practitioner licensed to prescribe drugs to patients in the course of the practitioner’s practice, issued for an individual patient and containing the following: the date of issue, name and address of the patient, name and quantity of the drug prescribed, directions for use, and the name and address of the prescriber. Note that drugs ordered from other countries are not covered.
  • Letter of medical necessity - This is a letter that must be signed by your doctor or eligible licensed health care provider to certify that the item or service is medically necessary.