In a 2021 study by the Centers for Disease Control and Prevention, nearly 60% of U.S. adults reported using dietary supplements. And while you can easily pick them up without a prescription — that doesn’t mean they’re cheap. In 2021, people in the United States spent nearly $50 billion on vitamins and supplements. But did you know that many vitamins and supplements are also available by prescription from your doctor, which may be covered by your health insurance?

“A good way to learn more about how to save money on supplements is to ask your pharmacist,” says Alyssa Wozniak, PharmD. She’s a pharmacist and clinical assistant professor in Buffalo, New York. “They may be able to help you choose an affordable brand with reliable safety and efficacy.” Plus, if you take multiple vitamins and supplements, a pharmacist can help you choose the most efficient ones, which could potentially reduce the number you’re buying.

What’s the difference between prescription vitamins and supplements and over-the-counter (OTC) ones?

The vitamins and supplements you get over the counter at your local pharmacy are different from the ones your doctor may prescribe you. “Supplements are handled a bit differently than both prescription and over-the-counter medications,” says Wozniak. “Dietary supplements fall under the Dietary Supplement Health and Education Act of 1994, under which the U.S. Food and Drug Administration (FDA) is not authorized to approve these products for safety and effectiveness before they are marketed.”

To that end, supplement manufacturers are initially responsible for making sure their products are safe and for labeling them appropriately before marketing them, she says, in order to meet those regulations. The FDA can act after the products come to the market, however, if manufacturers do not fulfill their responsibility.

Here are the key differences between the two:

• Prescription supplements, just like prescriptions drugs, are prescribed by your doctor and can be obtained only from a pharmacy by using that prescription. They are intended to be used by just one person (you), and they must meet a set of regulations by the FDA before they can be marketed to you.
• OTC medications are drugs that do not require a prescription from a doctor and can be purchased directly from store shelves. According to Wozniak, if they conform to the recipe for an existing OTC drug, they may be marketed to you without the FDA stepping in. Those that do not will undergo a review and approval process by the FDA first.

When might my doctor prescribe me vitamins or supplements?

There are several reasons your doctor might prescribe you a vitamin or supplement.

• You need a higher concentration than what’s available over the counter. “If you receive regular blood tests from your doctor and they find you are low in certain vitamins or minerals, they may prescribe a supplement to treat this,” says Wozniak. “An example of this would be having low levels of iron or vitamin D in the blood.”
• You have a specific medical need for them. “Sometimes certain vitamins or supplements may be recommended based on a specific factor to keep you healthy,” says Wozniak. “Common examples include using vitamin D and/or calcium supplements as you age to support bone health and prevent fractures, or using folic acid or a prenatal vitamin in pregnancy to support healthy growth of the mother and baby.”
• You need them to help offset another medication’s side effects. In some cases, a prescription drug can remove certain vitamins and minerals from your body. “A doctor may recommend you take that vitamin or mineral supplement to prevent low levels from happening,” says Wozniak.

Can I ask my doctor for a prescription for a supplement I’m already taking?

If you’re already taking medications that you are paying for entirely out of pocket, you may be curious whether you can get them cheaper through your doctor and health insurance. The simple answer is yes; you can always ask.

“In certain cases, some supplements may be covered by insurance with a prescription,” says Wozniak. She adds that another major bonus of having a prescription for a vitamin or supplement is that it can help your doctor keep track of what supplements you’re taking. That information lets them:

• Check for drug interactions with your other prescriptions
• Ensure safety and efficacy of the vitamin or supplement
• Monitor the vitamins or supplements appropriately

Are prescription and OTC vitamins and supplements covered by my health insurance?

Maybe, and it depends on several factors, including what the vitamin or supplement is and what type of insurance you have. “The best way to know if a supplement may be covered by your insurance is to check the formulary document provided by your insurance company,” says Wozniak. (The formulary is a list of prescription drugs approved by your insurance company.) “If you have a prescription from the doctor, the pharmacy can also attempt to bill the supplement to your insurance.”

If your supplement isn’t covered, review your insurance company’s drug list to see what may be covered instead. You can ask your doctor or pharmacist for help with this.  “If there are no alternatives covered by the insurance, the pharmacist can work with you to find an affordable and quality over-the-counter alternative to purchase,” says Wozniak.

Can I purchase vitamins and supplements using my medical expense accounts?

If you have either a flexible spending account (FSA) or health savings account (HSA), you may be able to use the tax-free funds from those accounts to pay for certain vitamins and supplements. But only in very specific cases, says Wozniak.

“Oftentimes, vitamins or supplements cannot be purchased using HSA/FSA funds for general health,” says Wozniak. “In certain cases, they may be covered with a letter of medical necessity from a provider.” Another option may be to obtain a prescription for them and attempt to use the HSA/FSA funds for the associated prescription copayment. Examples of things you can’t use your HSA/FSA funds for, unless your doctor deems them medically necessary, include:

• Herbal supplements
• Natural medicines
• Nutritional supplements
• Vitamins

Of course, there are exceptions to the rule. For example, you may be able to use your FSA/HSA funds to pay for prenatal vitamins.