What is an LMN? And how does it work?

What is a Letter of Medical Necessity (LMN)?

An LMN is a written document from a medical provider that states that a certain product is recommended to treat a specific medical condition, and enables the use of FSA funds to pay for it. An LMN is required to show that an otherwise personal expense is being purchased for medical care.

Why do I need an LMN for certain products?

Under IRS rules, some products are only eligible for FSA reimbursement when a licensed healthcare provider certifies that they are medically necessary. Some items can be used for both medical and personal purposes, and an LMN helps prove that the item is intended for medical use and is recommended by a medical practitioner to treat a specific condition.

How do I know that products requiring an LMN on FSAstore.com are eligible? 

We have handpicked products that are recognized as eligible if they are purchased primarily for a medical purpose with an LMN to diagnose, treat, mitigate, or prevent a medical condition. Always be sure to check with your plan administrator to determine what is allowable under your particular plan.

How do I obtain an LMN for products featured on FSAstore.com? 

Your eligibility for the LMN is determined during the checkout process with a third party merchant. If your medical condition is validated through the required health questionnaire during checkout, you will be able to complete your purchase using FSA funds. If you are denied during the health questionnaire, you can still proceed with the purchase using a credit or debit card, but the item will not be eligible for FSA reimbursement.

Can I pre-qualify for an LMN before deciding to make a purchase? 

No, you cannot pre-qualify for an LMN. For products featured on our site, follow the steps above when making a purchase.

What information must be included in an LMN?

LMN content will vary, but it should include key components such as: name, credentials and signature of the medical provider; the medical condition and diagnosis; the recommended medical treatment or intervention; and why the recommended treatment is necessary for the condition.

Are there expenses that an LMN cannot cover?

Yes, not just any product would become FSA eligible with an LMN. A product that is strictly cosmetic and aimed at approving appearance will not qualify, nor will products that are not legal under federal law. The IRS also has additional requirements for items like food and beverages to be reimbursable with an FSA. For some items, like mattresses, only the excess cost over the cost of a standard mattress may qualify for reimbursement. Be sure to check with your plan administrator as to what may be allowable under your particular plan.

For how long is an LMN valid?

Typically an LMN is valid for as long as the treatment is recommended by the healthcare provider, but many administrators may not allow an LMN to be valid for a period longer than 12 months. If treatment extends beyond the stated time period, you may need to submit a new LMN covering the new time period. Be sure to check with your plan administrator as to the requirements of your plan.

Will my FSA administrator automatically approve the LMN for reimbursement?

No, your FSA administrator will review the LMN to determine if the product or service is being purchased for a medical reason. If the LMN is approved, the product or service will be eligible for reimbursement. If it's denied, you can appeal the decision or pay out-of-pocket.

What if my LMN is denied after I purchase?

If your LMN is denied by your FSA administrator, you won’t be able to use your FSA funds for that purchase. You can appeal the denial with your administrator or pay for the item out of pocket. If you decide to cancel or return the purchased item or service, you must contact the company from which you made the purchase and follow their return policy. FSA Store® are not affiliated with third-party companies’ return policies.

What should I do with my LMN after I make a purchase?

Always be sure to save your LMN document somewhere you can easily access it. You may need to submit this to your benefits administrator when requested.