Pre-tax accounts like an FSA or HSA can be used to pay for a wide variety of products and services the IRS considers qualified medical expenses. But, your healthcare provider might recommend treatment the IRS doesn't consider eligible.

If that happens, you can submit a letter of medical necessity (LOMN) written by your healthcare provider. The letter is a document stating that the products or services they recommend are necessary for your health, and should qualify as eligible expenses.

What should the letter include?

First, ask your provider to write the letter on their official letterhead. After that, most letters of medical necessity include the following:

  • Patient name and medical history

  • Relationship to the patient, contact information, date, and signature

  • Diagnosis and duration of treatment

  • Reason why the medical treatment or item is needed

It’s very important that your healthcare provider explains why the treatment they’re recommending is medically necessary — or it might be rejected.

Does Forma have a specific template?

Not at this time. Just have your provider write the letter on their official letterhead to make it easy to verify they’re a licensed healthcare provider.

How do I submit a letter of medical necessity to Forma?

Once you have the letter from your healthcare provider, upload it as a receipt on your claim. If you’re trying to appeal a claim that has already been denied, file a new claim and attach both the receipt for the product or service and the letter.

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