Health Evaluations, Letters of Medical Necessity, and Saving Big: A Guide to Maximizing Your Health Spending

Listen to your health

Created by Jacqueline Caffrey, Physician Assistant

January 18th 2025

Let me set the scene: You’re staring at your HSA or FSA account balance, wondering if it’s doing enough for you. You’re using it for the obvious stuff—prescriptions, co-pays, maybe the occasional pair of new glasses—but then you hear about people paying for things like home gym equipment, fitness classes, or even supplements. And you think, How? Are they bending the rules? Do they have some kind of magic wand?

No, friend. They have a Letter of Medical Necessity (LMN).

What Is a Letter of Medical Necessity, and Why Do You Need One?

A Letter of Medical Necessity (LMN) is a document written by a healthcare provider that states that a specific item or service is essential for your health. Think of it as the golden ticket that makes traditionally non-eligible expenses suddenly eligible for reimbursement from your HSA or FSA.

With an LMN, you can save 30% or beyond on things that aren’t usually covered—because you’re using pre-tax dollars. It’s like finding a cheat code in a game, except it’s legal, and the only thing you have to do is…get evaluated.

How Do You Get an LMN Without Losing Your Mind?

Here’s where it gets even better: you don’t have to wait weeks for an in-person appointment, awkwardly explain why you need a massage chair for your “posture,” and then cross your fingers that your doctor understands the process.

This is where Flexup Wellness PLLC comes in. They’re a telehealth service based in Massachusetts (for now—but keep an eye out as they expand to other states).

With Flexup Wellness, you can:

• Get Evaluated Quickly: Fill out a health evaluation followed by a phone appointment without leaving your house.

  
  

• Pay a Small Fee: No hidden charges, no endless billing.

  
  

• Receive Your LMN: Once they’ve reviewed your health needs, you’ll get a professionally written LMN to submit to your HSA or FSA provider and keep for tax purposes.

  
  

Flexup Wellness takes the hassle out of the process, leaving you more time (and money) to focus on what matters: you.

What Can a Letter of Medical Necessity Cover?

Here’s where things get exciting. With an LMN, you can unlock savings on all kinds of things.

Here’s a list of 12 common items or services that could be reimbursable with an LMN:

1. Massage therapy for chronic pain or injury recovery.

2. Chiropractic care, acupuncture.

3. Sauna's, cold plunges (Brrrrr).

4. Weight-loss programs prescribed for obesity or related conditions.

5. Specialized footwear or orthotics for foot problems.

6. Supplements, probiotics, etc.

7. Gym memberships, home gym equipment (Peloton anybody?).

8. Nutritional counseling for conditions like diabetes or eating disorders.

9. Mental health therapies (including art or music therapy).

10. Air purifiers for severe allergies or asthma.

11. Supportive pillows, mattresses, or ergonomic chairs.

12. Medical-grade skincare treatments (think eczema or severe acne solutions).

What Doesn’t Usually Get Covered (Even with an LMN)?

It’s not a free-for-all, though. Some things are still no-go’s, even with an LMN.

Here’s a quick list of 12 items you probably can’t justify:

1. Cosmetic surgery that isn’t medically necessary.

2. Teeth whitening.

3. Motorized bikes.

4. Vitamins or supplements not prescribed for a medical condition.

5. Some over-the-counter medications without a prescription.

6. Cosmetic dental work (like veneers).

7. Hair transplants.

8. Non-prescription sunglasses.

9. Vacation expenses (unless medically prescribed travel is required).

10. Regular mattresses (specialty mattress however…).

11. Purely cosmetic dermatology treatments (like Botox for wrinkles).

12. Spa days (even though we all wish).

The Process: What to Expect When Getting an LMN

So, you’re ready to make the move. Here’s how it works, step by step:

1. Identify Your Needs

Think about the expenses you’d like to cover. Are they health-related? Can you tie them to a medical condition or goal?

2. Reach Out to Flexup Wellness PLLC

Begin a health evaluation at Flexupwellness.com. It’s fast, easy, and convenient.

3. Discuss Your Health Goals

During your consultation, explain your condition and the specific item or service you’re aiming to cover. The provider will evaluate whether it qualifies for an LMN.

4. Get Your LMN

If approved, Flexup Wellness will issue a personalized LMN tailored to your needs.

5. Submit the LMN to Your HSA/FSA Provider

Send the document to your account provider. Once approved, you can reimburse yourself for the cost of eligible items.

Why Flexup Wellness is a Game-Changer

Flexup Wellness PLLC isn’t just convenient; it’s designed to save you money and time.

Here’s why they’re worth considering:

• Affordable Service: Their fees are transparent and reasonable, ensuring the LMN doesn’t cost more than the item or service you’re trying to cover. Customers usually get up to 3 eligible items approved for the same fee!

  
  

• Quick Turnaround: No waiting weeks or months for paperwork. 1-3 business days is where it's at.

  
  

• Expert Providers: Their team knows the ins and outs of LMNs and how to make them work for you.

Final Thoughts: Stop Leaving Money on the Table

Health-related expenses can add up quickly. By leveraging tools like an LMN and working with a telehealth provider like Flexup Wellness PLLC, you can stretch your HSA or FSA dollars further than you thought possible. It’s not just about saving money; it’s about taking control of your health spending and making it work for you.

So, what are you waiting for? Stop overpaying for things that could be covered. Flexup Wellness is ready to help—and your wallet will thank you.

Disclaimer: Flexup Wellness PLLC is currently available in Massachusetts but is expanding soon. Stay tuned!