Pre-tax accounts are used to pay for qualified medical expenses as determined by the IRS. Certain services or products may be eligible medical expenses or ineligible personal expenses depending on their specific use.
In this case, you can submit a letter of medical necessity (LMN) written by your medical provider. This letter states that the recommended products or services are necessary for your health and should qualify as eligible expenses.
What should the letter include?
Letters of Medical Necessity should be written on official letterhead. Most letters of medical necessity include the following information:
- Patient name and medical history
- Relationship to the patient, contact information, date, and signature
- Diagnosis and duration of treatment
- Reason why the product or service is needed
Does Forma have a specific template?
Yes! You can download this template and give it to your medical provider.
How do I know if my item or service requires an LMN?
Please refer to the FSA/HSA eligibility list to confirm if an item or service requires an LMN.
How do I submit a letter of medical necessity to Forma?
Upload the completed letter as a receipt attachment on the claim submission page in Forma. If attempting to appeal a rejected claim, file a new claim and attach both the receipt for the product or service and the letter of medical necessity.
Forma requires including an LMN each time your submit a new claim. If you've already provided an unexpired LMN to Forma, please note that in the description when submitting a new claim.