Use your HSA or FSA for more of what keeps you healthy
Get a Letter of Medical Necessity online
Your HSA or FSA may cover more then you realize. Many people us it to cover costs for fitness, nutrition counseling or massage therapy when they're medically necessary to treat a health condition. Lemonaid can help you apply for a letter of medical necessity and be prepared to conquer your health goals.
$25/year · Valid 12 months
A LMN does not guarantee that an expense will be approved. Eligibility will depend on your HSA/FSA plan.
If a provider decides a letter isn't medically appropriate, you won't be charged.
- LegitScript Certified
- Licensed U.S. medical providers
- Reviewed in 24 hours
Questions? Call 888-536-2267
Your letter in four steps
- Assessment
- Clinical review
- Documentation
- Submission
Photos are of models, not actual patients.
What is a letter of medical necessity?
A Letter of Medical Necessity (LMN) is a document from a licensed provider. It explains why an expense is medically necessary to treat your condition, so you can submit it to your HSA/FSA administrator.
An HSA or FSA lets you set aside pre-tax money for qualified medical expenses. But some costs, like fitness programs or massage, aren't automatically recognized as qualified.
One service, several needs: Lemonaid offers letters for fitness, nutrition and massage therapy, with more on the way.
Use it or lose it: about 4 in 10 health FSA holders forfeited unused money in 2024, an average of $404 among those who lost funds (EBRI, 2026). A letter may help you put that money toward care you already pay for.
What a letter can and can't do
Before you pick a service, here's the honest version. A provider decides, and your plan administrator has the final say.
| A letter can | A letter can't | |
|---|---|---|
 Your condition | Document the link between a diagnosed condition and an expense, like exercise for hypertension or nutrition counseling for diabetes. | Turn a nonmedical expense into an eligible one. Spa or relaxation massage and general wellness typically don't qualify. |
 Your claim | Give your HSA/FSA administrator the medical documentation they ask for. | Guarantee your claim. A LMN does not guarantee that an expense will be approved. Eligibility will depend on your plan and your HSA/FSA administrator. |
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Your condition
A letter can
Link a diagnosed condition to an expense, like exercise for hypertension.
A letter can't
Make spa massage or general wellness eligible.
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Your claim
A letter can
Give your administrator the documentation they ask for.
A letter can't
Guarantee your claim. A LMN does not guarantee that an expense will be approved. Eligibility will depend on your plan and your HSA/FSA administrator.
Choose your service
Choose what you want your HSA or FSA to help cover
Pick the letter that matches the care you already pay for. One price per letter, one licensed review, one secure place to keep your letter.
- LegitScript Certified
- Licensed U.S. providers
Fitness
Put pre-tax money toward exercise that treats a condition.
$25/year
- obesity
- hypertension
- type 2 diabetes
- anxiety
If regular exercise is part of treating a diagnosed condition, a letter documents that connection so your fitness costs can be considered for HSA/FSA reimbursement.
Nutrition
Put pre-tax money toward nutrition care.
$25/year
- diabetes
- high cholesterol
- disordered eating recovery
If a provider determines that nutrition counseling or a specific dietary program is necessary to manage a condition, a letter can help make that care HSA/FSA-eligible.
Massage
Massage that's part of your treatment, not a spa day.
$25/year
- chronic back or neck pain
- muscle injuries and rehabilitation
Massage therapy may qualify when it's used to treat a documented medical condition. Massage for general relaxation or wellness typically does not qualify.
Fitness equipment
- Coming soon
A letter for qualifying fitness equipment is on its way. Check back soon.
Ergonomic office equipment
- Coming soon
A letter for qualifying ergonomic office equipment is on its way. Check back soon.
Sleep apnea equipment
- Coming soon
A letter for qualifying sleep apnea equipment is on its way. Check back soon.
Conditions are examples, not a promise. A licensed provider decides what's medically necessary for you.
How it works
Four steps between you and your letter.
That's it. No office visit. No complicated paperwork.
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1. Assessment
Pick the service that you need treatment for, then answer a short health questionnaire from home.
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2. Clinical review
A licensed medical provider reviews your answers and decides if a letter is medically appropriate.
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3. Documentation
If it's medically appropriate, your letter usually arrives within 24 hours in your secure portal, ready when your administrator asks.
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4. Submission
Send the letter with your receipts to your HSA/FSA administrator.
Who reviews your letter
Real doctors and nurse practitioners, licensed in your state.
A U.S. licensed medical provider reviews every request and decides whether a Letter of Medical Necessity is medically appropriate for you. Meet some of the people behind your care.
LegitScript Certified
Our clinical team is made up of physicians, pharmacists, nurse practitioners and registered nurses whose mission is to provide great care at a price you can afford.
Meet our medical team-
Debra Tostovarsnik
Nurse Practitioner
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Nosheen Noorali
Nurse Practitioner
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Andre Tarin
Nurse Practitioner
Questions, answered
Letter of medical necessity questions, answered
The money questions, answered straight.
Does a letter of medical necessity guarantee reimbursement?
No. A LMN does not guarantee that an expense will be approved. Eligibility will depend on your plan and your HSA/FSA administrator.
How much does a letter of medical necessity cost, and how long is it valid?
A Lemonaid Letter of Medical Necessity costs $25/year for each letter. The Letter of Medical Necessity is valid for one year. After one year, it will auto-renew at the base rate of $25.
Is a gym membership HSA or FSA eligible?
A gym membership qualifies when it is used for the treatment of a specific diagnosed medical condition.
Is massage therapy HSA or FSA eligible?
Yes, massage therapy may qualify as an eligible HSA or FSA expense when it's medically necessary to treat a specific health condition. A Letter of Medical Necessity may be required to document why the treatment is needed. Eligibility depends on your medical circumstances and your plan administrator's requirements.
What if the provider says no, or my claim is rejected?
If a provider decides a letter isn't medically appropriate, you won't be charged.
We cannot guarantee approval of a claim. If your claim is rejected, contact your plan administrator to understand the reason and find out what additional documentation may be required.
How long does it take to get a letter of medical necessity?
If it's medically appropriate, your letter usually arrives within 24 hours. Lemonaid clinician, if approved, will send your letter through your secure portal. You can use this to fill out your FSA/HSA specific forms.
Don't leave your health benefits sitting on the table.
You may already be spending money on the things that help you manage your health. Start online for $25/year.
A LMN does not guarantee that an expense will be approved. Eligibility will depend on your plan and your HSA/FSA administrator.
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