Your Protocol is Approved. Here is How to Fund It.
Congratulations. Your clinical evaluation is complete, and our medical team has officially issued your Letter of Medical Necessity (LMN).
This document legally converts your prescribed wellness routine into a qualified medical expense. It allows you to use your tax-advantaged accounts (HSA/FSA) to pay for things that actually improve your health, rather than just waiting until you are sick.
Because these therapies happen outside of a traditional doctor’s office, the financial process looks a little different. Find your account type below to see your exact next steps.
Route A: I am using an HSA
(Health Savings Account)
An HSA is your personal money. You do not need anyone’s permission to spend it, but you must keep your records for the IRS.
Make the Purchase
You have two ways to pay for your prescribed wellness intervention:
- Option A: Swipe your physical HSA debit card at the merchant.
- Option B: Pay with your personal credit card (great for earning points!), then log into your HSA bank’s website and transfer the exact amount from your HSA into your personal checking account to reimburse yourself.
Get an Itemized Receipt
Always ask the merchant to email or print an itemized receipt showing the date, the business name, the exact service/item, and the amount paid.
File It Away (Do Not Upload)
You do not need to upload your LMN to your bank. Simply create a folder on your computer. Save your signed LMN PDF and your itemized receipts in that folder. You only need to produce these documents if the IRS formally audits your tax return.
Route B: I am using an FSA
(Flexible Spending Account)
An FSA is employer-sponsored money. It is managed by a strict Third-Party Administrator (like WageWorks or Optum) that requires proof of your medical need before releasing funds.
Make the Purchase
Try swiping your FSA debit card first. If it declines, this is normal. Wellness centers do not use standard hospital billing codes. Simply pay with your personal credit card.
Get an Itemized Receipt
You must get a receipt showing the date, the business name, the exact service/item, and the amount paid. A standard credit card statement will not work.
Submit Your Claim
Log into your employer’s FSA Benefits App or website. Click “Submit a Claim.”
- Upload a photo of your itemized receipt.
- Upload the PDF of your signed LMN.
The administrator will review your doctor’s note and direct deposit the reimbursement into your bank account.
What if the FSA App says “Denied”?
Do not panic. First-level checks are done by automated software that just looks for pharmacy codes. If denied, log back in and click “Appeal” or “Request Manual Review.” A human will review your doctor’s signature and approve the claim.
Route C: I am Self-Employed / A Business Owner
You are using this to lower your personal taxable income at the end of the year via a Schedule A Medical Deduction.
Make the Purchase
Pay for your prescribed intervention using your personal funds.
The QuickBooks Rule
Do not categorize a personal wellness intervention (like a gym or sauna) as a “Business Expense” (like office supplies). The IRS will reject this. If the charge hits your business account, categorize it strictly as an “Owner’s Draw” or “Shareholder Distribution.”
Send to your CPA
Create a digital folder. Save your signed LMN PDF and your itemized receipts inside. In April, email this folder to your accountant and tell them: “I have a physician-signed Letter of Medical Necessity. Please add these to my Schedule A Medical Deductions.”
Frequently Asked Questions
Yes. To remain compliant with IRS regulations, your LMN is valid for exactly 12 months from the date it was signed. We will reach out before it expires to conduct a brief follow-up evaluation and issue a renewal.
No. This document is a clinical prescription based on your specific medical evaluation and Social Security Number. It cannot be applied to joint or family memberships.
The cashier does not dictate tax law; their credit card machine just isn’t coded for medical billing. Simply smile, pay with your regular credit card, get your itemized receipt, and follow the reimbursement steps for your account above.
No. Your purchase must match the “Prescribed Protocol” on your LMN. If you were prescribed a “Cold Plunge Tub,” you cannot use those funds to buy a standard swimming pool.