What is a Letter of Medical Necessity, and when do I need one?

Some expenses, sometimes referred to as “dual-purpose,” are items or services that are often purchased for general good health or other purposes, but may sometimes be recommended by doctors to treat a specific medical condition. Some examples include massage therapy, some vitamins and nutritional supplements, and weight loss treatments (note that food and food replacements are not eligible, even with a doctor’s recommendation). If your doctor has recommended an item like this to treat a specific medical condition, you’ll need to submit a Letter of Medical Necessity from your provider in order to be reimbursed for the expense. We will need a letter from the physician stating that the item or service is recommended to treat the specific medical condition. The letter should be on the physician’s letterhead with clear reference to your case. It can be brief and does not have to go into detail or great substantiation. It simply must recommend the item or service to treat a specifically diagnosed condition. Or you may provide your doctor with this Letter of Medical Necessity form to complete. We’ll keep the letter on file for a year from the date written, and as expenses are incurred, you may submit provider receipts for the item or service along with your reimbursement claim as usual. A new letter of medical necessity will need to be submitted each year or each time the treatment changes. Before making an election based on an expense that requires a letter of medical necessity, please contact us to ensure the eligibility of the expense in question, as the changes allowed to FSA elections are very limited.