CurrentBlue Cross Blue Shield - South CarolinaPolicy N/A

OTC and Healthy Foods Approved Product List

Lists eligible over-the-counter (OTC) medical products and approved healthy food items for purchase; defines examples and comments about eligibility and dual-purpose exclusions. Affects program administrators, merchants, and members using OTC/healthy foods benefits.

Policy Summary

PayerBlue Cross Blue Shield - South Carolina

PolicyOTC and Healthy Foods Approved Product List

Policy CodePolicy N/A

Change TypeMinor / informational (no material changes)

Effective DateN/A

Next Review DateN/A

Key ActionUse the provided lists to determine eligible OTC products and approved healthy foods for member purchases; no prior authorization is required.

SourceLink

POLICY UPDATE CHANGES

No material clinical or coverage changes in this revision.

15+OTC categories

multipleHealthy food groups

frequentDual-purpose exclusions

CDC-basedMask criteria source

Eligible OTC Products and Healthy Foods — Coverage Criteria

Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

Coverage criteria for eligible OTC products and approved healthy foods

Items are classified as eligible OTC products or eligible OTC medicines/drugs when their primary purpose is to treat, monitor, or prevent a medical condition. Many consumer or cosmetic items are noted as dual-purpose and are ineligible unless the product's primary purpose is medical.

ALL of the following

ANY of the following
- Acupressure treatments (e.g., Sea Band) when used to treat a medical condition
- Compression hosiery for anti-embolism, ulcer care, or lymphedema (medical compression 30-40+ mmHg)
- Sterile cotton products (cotton balls, rolled cotton, applicators) — non-sterile items are dual-purpose and ineligible
- Diagnostic products (thermometers, blood pressure monitors, cholesterol testing, pulse oximeters, drug/alcohol/body fat testers) used to monitor or screen for disease

ALL of the following

ANY of the following
- First aid dressings & supplies (bandages, saline wound wash); bandages impregnated or coated with a medicated product
- Denture cleaners, adhesives, repair and maintenance products; denture pain relief products containing active drug ingredients
- Ear care devices (ear drops, syringes, ear wax removal devices) and medicated ear drops

ALL of the following

Disposable masks must have: multiple layers of non-woven material AND a nose wire
Cloth masks must have: multiple layers of tightly woven breathable fabric, a nose wire, AND block light when held to a bright light source
Masks with exhalation valves/vents, gaiters, and face shields are not eligible

ALL of the following

ANY of the following
- Acid controllers (e.g., Pepcid AC, Zantac, Prilosec)
- Allergy & sinus medications (e.g., Alavert, Benadryl, Claritin, Sudafed)
- Antibiotic topical products (e.g., Bacitracin, Neosporin)
- Oral rehydration solutions (anti-diarrheal and ORS formulations)
- First aid burn remedies that contain an antiseptic or pain reliever (100% aloe is dual-purpose and ineligible)

ALL of the following

ANY of the following
- Mobility and support items (braces, elastic bandages, hot/cold therapy, orthopedic supports, work/industrial back braces when used to prevent or treat injury)
- Home health devices and accessories that are for medical function; accessories not related to function may be dual-purpose and ineligible

ALL of the following

ANY of the following
- Hearing aid / medical batteries (single-use hearing aid batteries; multi-purpose batteries are ineligible)
- Hearing amplifiers available OTC
- Contact lens care and eyeglass repair kits; post-surgical eye protection and medicated eye drops

ALL of the following

ANY of the following
- Fruits (fresh, canned, dried, frozen) — e.g., apples, bananas, berries, dates, mangoes
- Vegetables (fresh, canned, dried, frozen) — e.g., broccoli, carrots, leafy greens, tomatoes, peppers
- Dairy and dairy substitutions — e.g., almond milk, buttermilk, cheeses

Coding and Product Specifications

Durable medical equipment examplesmixed

Wheelchairs	Wheelchairs
Crutches	Crutches
Oxygen Machines	Oxygen Machines

Hand sanitizer alcohol content

Required alcohol concentration60-95% alcohol (ethanol/ethyl alcohol, isopropanol/2-propanol) required for eligibility

Excluded formulationsProducts using benzalkonium chloride or other non-alcohol sanitizers are excluded

Excluded product formsHousehold wipes, sprays, and non-ABHR antiseptic cleansers are not eligible

Sun protection SPF threshold

Minimum SPF and spectrumSPF 15 or above and broad spectrum (UVA and UVB) required for eligibility

Primary use requirementPrimary purpose must be protection against skin cancer and premature skin aging

Dual-purpose exclusionProducts that are primarily moisturizers/cosmetic with a sunscreen are considered dual-purpose and generally ineligible

Key Definitions and Eligibility Notes

Dual-purpose items

DefinitionDual-purpose items have both medical and non-medical uses and are generally ineligible unless the product's primary purpose is medical (as noted in comments)

Examples of eligible when primarily medicalCompression hosiery for anti-embolism, ulcer care, or lymphedema; sterile cotton products; diagnostic testing devices

Examples of ineligible or conditionalWeight-loss products, non-sterile cotton, multi-purpose consumer items are considered dual-purpose and typically ineligible

Masks eligible for COVID-19 prevention

Disposable mask constructionMust have multiple layers of non-woven material and a nose wire to be eligible

Cloth mask constructionMust have multiple layers of tightly woven breathable fabric, a nose wire, and should block light when held up to a bright light source

Ineligible mask typesMasks with exhalation valves or vents, gaiters, and face shields are not eligible

OpenPayer

OTC and Healthy Foods Approved Product List

Eligible OTC Products and Healthy Foods — Coverage Criteria

Coding and Product Specifications

Availability and Provider / Merchant Actions

Key Definitions and Eligibility Notes