Q: What is a Letter of Medical Necessity (LMN)?
A: A letter of medical necessity is a document that outlines not only a patient’s medical condition and the treatment required for that condition, but also why the treatment is medically necessary for a given person. It is used to support the use of several tax-advantaged accounts such as health savings accounts (HSAs), flexible spending accounts (FSAs), and health reimbursement arrangements (HRAs) by allowing individuals to pay for certain eligible expenses that may not be typically covered in most instances.
Q: What should be included in a Letter of Medical Necessity (LMN)?
A: To establish the eligibility of your claim as a qualified expense, you may be required to provide a letter to confirm that a treatment is medically necessary. An acceptable letter of medical necessity might include the following information:
- Patient’s name and date of birth
- Medical condition being treated
- Description of doctor recommended treatment/item
- Explanation of why the treatment/item is necessary
- Expected outcome of the treatment/item
- Alternate treatments/items the patient has tried that have failed
- Explanation of if the treatment is experimental or cosmetic
- Contact information for the treating physician
- Include qualifications of the provider
- Physician signature
Q: Can I use a Letter of Medical Necessity (LMN) to pay for any medical expense?
A: No, a letter of medical necessity can only be used to pay for medical expenses that are also considered eligible under the tax-advantaged account that you are requesting reimbursement or payment from. For example, a letter of medical necessity can be used to pay for certain bonding procedures for teeth if required to medically restore your teeth if it is eligible under the account as a medical procedure, but would not be covered if you received tooth bonding for cosmetic purposes. In order to determine which expenses may be eligible, it’s important you review your plan details and IRS guidelines.
Q: Who can provide me with a Letter of Medical Necessity (LMN)?
A: A letter of medical necessity should be provided by a licensed healthcare provider who is directly treating the patient’s medical condition. This could be a physician, nurse practitioner, or other healthcare provider so long as they are licensed. The healthcare must be able to provide a detailed explanation containing the elements above and in letter format. Lively’s LMN form can be accessed from your account dashboard or here.Updated: