A physician-signed Letter of Medical Necessity makes any wellness service — yoga, massage, sauna, meditation, nutrition — HSA and FSA eligible. For brands that serve patients. For patients who chose wellness over surgery.
IRS Code 213(d) covers any service that treats, prevents, or mitigates a diagnosed condition. We've built clinical templates for every category below.
Hip, back, shoulder pain. Anxiety. Arthritis.
Core rehab, spinal stenosis, post-surgical recovery.
Fall prevention. Balance disorders. Parkinson's.
Arthritis, fibromyalgia, joint replacements.
Chronic tension, posture correction, chronic pain.
Parkinson's. Brain injury. Cognitive decline.
Anxiety, ADHD, mental health. Proprioception.
ADHD, PTSD, fall prevention, balance disorders.
Chronic pain. Migraine. Fibromyalgia. 40K+ studios.
Cardiovascular, depression, chronic fatigue, joint pain.
Depression, inflammation, chronic pain. Mental health.
PTSD, anxiety, migraines, fibromyalgia. Strong RCT base.
Pain, chemotherapy side effects, anxiety. 22K clinics.
Wound healing, joint pain, skin conditions. D2C devices.
Migraine, chronic fatigue, post-chemo recovery.
Incontinence, pelvic pain, post-partum. Devices + sessions.
Anxiety, hypertension, insomnia. Calm, Headspace, etc.
Anxiety, COPD management, asthma, hypertension.
Anxiety, depression, PTSD. Apps like Reflectly, Day One.
PTSD, anxiety, cancer support, trauma recovery.
Dementia, autism, stroke recovery, chronic pain.
Stress, depression, immune function. Shinrin-yoku protocols.
SAD, depression, circadian disorders. Seasonal and year-round.
IBD, diabetes, cardiovascular, cancer. Factor, Trifecta.
Type 2 diabetes reversal, metabolic disease, obesity.
IBD, IBS, SIBO, microbiome optimization. Zoe, Viome.
Any chronic disease. Anti-inflammatory protocols. Year-round.
Chronic insomnia. FDA-cleared apps. Sleepio, SomRyst.
Smart mattresses, weighted blankets for anxiety, air purifiers for asthma.
Back pain, carpal tunnel, cervical disease. Standing desks, chairs.
Asthma, COPD, severe allergies. HEPA purifiers, certified medical-grade.
HSALetter is infrastructure. Wellness brands embed the button. Patients get physician-reviewed LMNs. Josh Emdur DO is the clinical backbone for every letter across every category.
One script tag or a link. Works in Mindbody, Pike13, Shopify, or any booking/checkout flow. Setup takes 20 minutes.
We ask about their condition, current symptoms, and how the wellness service addresses them. Plain English, no medical jargon required from the patient.
Clinical language. IRS 213(d) citation. Condition-specific therapeutic rationale. The draft is different for yoga than for massage than for sauna — each template built against the clinical literature.
Every letter gets physician eyes. Not a nurse practitioner. Not an AI signature. A board-certified DO with 50-state licensure and active hospital practice reviews each submission and signs with his DEA number.
Letter delivered by email within 24 hours. Patient keeps it on file. Uses HSA card for memberships, sessions, subscriptions, devices — for 12 months.
Based on a patient spending $2,000/yr on wellness in a 24% tax bracket.
A yoga studio with 300 members. 40% conversion rate.
You have the patients. They have HSAs. We connect them. The HSALetter button is the highest-ROI thing you'll add to checkout this year.
Yoga, Pilates, CrossFit, martial arts, climbing, dance, swim. Add the button to membership checkout. Members save on annual memberships, class packs, and private sessions.
Meditation, breathwork, journaling, CBT-I sleep, fasting, gut health. A single API integration enables HSA billing for any subscription. Pure digital, national scale from day one.
Red light, TENS, CGM, ergonomic, air quality, weighted, sleep tech. The LMN is a purchase-time add-on. One letter unlocks HSA reimbursement for a $300-$800 device purchase.
The category leader raised $34M and uses nurse practitioners. We use an MD/DO with active hospital practice. The clinical authority gap matters when HSA administrators audit — and they do.
A yoga LMN for hip pain and a sauna LMN for depression cite different clinical evidence, use different diagnostic codes, and make different therapeutic arguments. Ours do. Generic forms don't survive scrutiny.
Every signed letter adds to a corpus of condition × treatment × outcome mappings. At scale this becomes a regulatory database that no new entrant can replicate. We're building it letter by letter, now.
HSALetter is designed to disappear into your checkout. Your brand stays front. We handle the clinical layer entirely.
We confirm your wellness category is covered and issue a partner key. Takes 48 hours.
One line in your site's <head>. The "Make it HSA-eligible" button appears in your checkout automatically.
Assessment, LMN generation, physician review, and delivery all happen in our flow. You don't manage anything.
$30 per issued letter, direct deposit. Dashboard shows letters issued, revenue earned, member savings.
$5.6 trillion global wellness market. $120 billion in HSA balances sitting unused. The gap is physician documentation — and that's exactly what we close.
Growing 10% annually. The largest consumer category that isn't yet systematically HSA-accessible.
Average American leaves $1,800/yr in their HSA unspent — largely because qualifying the expenses requires documentation they don't have.
Yoga, Pilates, massage, sauna, float, acupuncture. Every one is a potential partner. Most have zero HSA infrastructure today.
You manage your condition with wellness. You deserve pre-tax dollars to do it.
Every week, members share what they unlocked with their HSA letter. Anonymized. Verified by our physician team.
HSALetter gets you the physician documentation. ComfortCard puts your entire health wallet in one place — HSA balance, LMN library, family health records, and automatic eligibility checking at checkout.
If your product or service treats a condition,
your customers should be paying with pre-tax dollars.