Your FSA and HSA funds don’t have to be limited to traditional medical expenses. With the right approach and proper documentation, you can use these tax-advantaged dollars for a wide range of health and wellness products and services through Letters of Medical Necessity (LMNs). As we move through 2025, more companies are recognizing the value of helping customers access their healthcare dollars for preventive and alternative wellness solutions.
What is a Letter of Medical Necessity?
A Letter of Medical Necessity is a document from a licensed healthcare provider that establishes the medical need for a specific product, service, or treatment that might not typically be considered an eligible medical expense. As detailed in our comprehensive LMN guide, these letters serve as crucial documentation to justify FSA/HSA reimbursement for expenses that fall into gray areas of medical necessity.
The letter must be written by a qualified healthcare professional and should include:
- Your medical condition or diagnosis
- How the recommended product or service will treat or prevent the condition
- The duration of treatment needed
- The healthcare provider’s credentials and contact information
The LMN Process: How It Works
Getting an LMN typically follows these steps:
- Consultation: Discuss your health needs with a licensed healthcare provider
- Evaluation: The provider assesses whether the product/service would benefit your specific medical condition
- Documentation: If appropriate, the provider writes and signs the letter
- Purchase: You buy the product or service from an eligible vendor
- Reimbursement: Submit the receipt and LMN to your FSA/HSA administrator
IRS Guidelines and Legal Considerations
The IRS maintains specific guidelines about what constitutes eligible medical expenses. As highlighted in our article about IRS warnings against misleading claims, not all health-related expenses qualify for FSA/HSA reimbursement, even with an LMN.
Key IRS requirements include:
- Expenses must be primarily for medical care
- General health or wellness expenses typically don’t qualify
- The medical necessity must be genuine and documented
- Products must be used to treat or prevent a specific medical condition
Important Disclaimer: While LMNs can help justify certain expenses, they don’t guarantee FSA/HSA eligibility. The IRS requires that expenses be primarily for medical care, not general health or cosmetic purposes. Always consult with your healthcare provider and FSA/HSA administrator before making purchases. Keep detailed records and be prepared to provide additional documentation if requested during an audit.
Companies Leading the LMN Revolution
Several innovative companies that are utilizing the LMN process, making it easier for consumers to access their FSA/HSA funds for wellness products and services:
Ice Barrel – Cold Therapy Solutions
Ice Barrel provides cold plunge therapy equipment that healthcare providers may recommend for conditions including athletic recovery, inflammation reduction, mental health improvement, and circulation disorders. Their flagship Barrel 500 offers a premium cold therapy experience that transforms ice baths from a challenging endurance test into a comfortable daily wellness routine.
The company works with healthcare providers to facilitate the LMN process for qualifying customers.
Zwift – Interactive Fitness Platform
Zwift is a gamified fitness platform that transforms indoor cycling and running into an engaging virtual experience, connecting users worldwide through structured workouts, races, and social rides. With annual memberships starting at $199, Zwift partners with TrueMed to help users access FSA/HSA funds for their interactive training platform, which can be particularly valuable for cardiovascular rehabilitation, weight management programs, exercise therapy for mental health, and chronic disease management.
Plunge – Premium Cold Therapy & Heat Therapy
Plunge offers luxury cold plunge products designed to deliver the ultimate cold therapy experience with precise temperature control and elegant design that fits seamlessly into any home environment. Their All-In model provides professional-grade cold therapy that healthcare providers may recommend for sports medicine and recovery, inflammation management, metabolic health improvement, and stress reduction therapy.
Plunge also offers premium saunas crafted from aromatic Japanese cedar that reach up to 230°F, featuring remote app control, flip-up benches for flexibility, and modular design for indoor or outdoor use. The Sauna delivers full-spectrum heat therapy benefits that healthcare providers may recommend for cardiovascular health, chronic pain management, stress reduction, and muscle recovery protocols.
You can discover Plunge’s FSA and HSA letter of medical necessity process here!
Orangetheory Fitness – Heart Rate-Based Training
Orangetheory Fitness delivers science-backed, heart rate-monitored group fitness classes that maximize calorie burn and improve cardiovascular health through their signature interval training methodology. Their Healthcare Advantage program helps members use FSA/HSA funds for these evidence-based fitness programs that healthcare providers may recommend for cardiac rehabilitation programs, medically-supervised weight management, stress management through structured exercise, and chronic disease management protocols.
Top Strategies to Maximize Your LMN in 2025
As we look ahead, several trends are making LMNs more accessible and valuable:
1. Preventive Care Focus
With growing emphasis on preventive healthcare, providers are more willing to prescribe wellness interventions that prevent costly medical treatments later. Consider discussing with your healthcare provider:
- Stress management tools and techniques
- Exercise equipment for chronic condition management
- Nutritional counseling and meal planning services
- Sleep optimization devices and programs
2. Mental Health Integration
The recognition of physical wellness’s impact on mental health opens new opportunities for LMN eligibility:
- Meditation apps and mindfulness programs
- Exercise memberships for depression and anxiety management
- Massage therapy for stress-related conditions
- Light therapy devices for seasonal affective disorder
3. Technology-Enabled Wellness
Digital health platforms are making it easier to document medical necessity:
- Wearable devices for monitoring chronic conditions
- Telehealth consultations for LMN evaluations
- Apps that track health metrics for medical documentation
- Virtual reality therapy programs
4. Personalized Medicine Approach
Healthcare providers are increasingly recognizing individual variation in treatment effectiveness:
- Genetic testing for personalized nutrition plans
- Customized exercise programs based on health assessments
- Tailored supplement regimens for specific deficiencies
- Environmental modifications for health conditions
5. Legislative Developments
Keep an eye on potential changes that could expand FSA/HSA eligibility. Our coverage of the PHIT Act and major 2025 tax bill expansions shows how legislation could broaden what’s eligible for reimbursement.
Best Practices for LMN Success
To maximize your chances of successful FSA/HSA reimbursement:
- Build relationships with healthcare providers who understand preventive medicine
- Document everything – keep detailed records of your health journey
- Start early – don’t wait until December to explore LMN options
- Be specific – ensure your LMN clearly connects the product/service to your medical condition
- Stay informed – follow FSAguide for updates on eligible expenses and new opportunities
Looking Ahead: The Future of FSA/HSA Flexibility
The landscape of FSA/HSA eligible expenses continues to evolve. With growing recognition of the connection between lifestyle factors and health outcomes, we’re likely to see:
- More companies offering LMN support services
- Streamlined processes for obtaining medical documentation
- Expanded recognition of preventive care expenses
- Greater integration between healthcare providers and wellness companies
Conclusion
Letters of Medical Necessity represent a valuable tool for maximizing your FSA and HSA benefits beyond traditional medical expenses. By working with forward-thinking companies that support the LMN process and maintaining strong relationships with healthcare providers, you can access a wider range of health and wellness solutions with your tax-advantaged dollars.
Remember, the key to successful LMN use is genuine medical necessity backed by proper documentation. When done correctly, LMNs can help you invest in your long-term health while maximizing the value of your FSA and HSA funds.
For more FSA and HSA guidance, tips, and eligible expense updates, visit FSAguide.com, join our Facebook community, and follow our subreddit for the latest discussions and member experiences.
Disclaimer: This article is for informational purposes only and should not be considered medical or tax advice. Always consult with qualified healthcare providers and tax professionals for guidance specific to your situation.