Private beta

Unlock pre-tax dollars for the care that actually helps.

A licensed physician reviews your situation and, when clinically appropriate, issues an IRS §213(d) Letter of Medical Necessity so your HSA, FSA, or HRA can cover it.

Flat price. Typical turnaround under 24 hours. No membership required.

See a sample letter & your savings →

We cannot promise your plan administrator will approve any specific expense — eligibility depends on IRS rules and your plan's terms. We provide physician review and documentation; the purchasing decision remains yours.

$199
Flat fee, per letter
< 24 hrs
Typical turnaround
50 states
Physician coverage
§213(d)
IRS-aligned format

How it works

Short intake. Physician review. A signed letter in your inbox. That's it.

01

Tell us what you need

Describe the expense and the condition it supports. Upload any prior diagnoses, provider notes, or product links.

02

A physician reviews

A licensed clinician reads your intake, checks the clinical logic, and decides whether a letter is appropriate. No rubber-stamping.

03

Signed letter, fast

If appropriate, you get a PDF letter formatted to IRS §213(d) standards, with the physician's license number, signed and timestamped.

04

Submit to your plan

Upload the letter to your HSA or FSA plan's reimbursement portal along with receipts. Your plan administrator makes the final determination.

See the letter before you buy it.

This is a representative sample — clearly watermarked, with names and details fabricated for illustration. Yours is written from your own intake, in the voice of the physician who signs it. Move the slider to see what those pre-tax dollars are actually worth.

J. Rivera, DO
Internal Medicine · Telehealth
Licensed in 50 states
NPI 1······789
License #SAMPLE
May 12, 2026

Re: Letter of Medical Necessity

Patient: Sample Patient · DOB 0·/0·/19·· · Requested item: Continuous glucose monitor (CGM) & supplies

To whom it may concern:

I am the treating physician for the above patient. Based on my clinical evaluation, the item described below is medically necessary for the diagnosis, treatment, or mitigation of a documented condition, and is recommended as part of this patient’s care plan.

Diagnosis

Type 2 diabetes mellitus with documented glycemic variability (ICD-10 E11.x). Most recent A1c outside target range despite adherence to current regimen.

Clinical reasoning

  • Continuous glucose data is required to identify post-prandial excursions and nocturnal hypoglycemia not captured by fingerstick testing.
  • Real-time monitoring is expected to improve time-in-range and reduce avoidable acute events.
  • Conservative measures alone have not achieved adequate control.

Requested intervention & duration

CGM device and consumable sensors, 12-month authorization, to be reassessed at the next visit. In my professional judgment this expense qualifies as medical care under IRS §213(d).

J. Rivera
J. Rivera, DO — signed & timestamped
Electronic signature on file · license # and NPI appear on the issued letter
ILLUSTRATIVE SAMPLE ONLY. Not a real patient, diagnosis, or physician signature. Issuance of any letter depends on individual clinical review; not all requests qualify. This sample does not guarantee plan approval.

What the letter unlocks

A $199 letter doesn’t save you $199 — it makes an otherwise after-tax expense pre-tax. Here’s the math on your spend.

$2,400
22%
30%
37%
45%
Pre-tax dollars unlocked / yr
$720
That’s $521 in your pocket after the one-time $199 letter — in year one.
Letter pays for itself in
2.8 months
Effective return
3.6×
Get on the waitlist →

Estimate only. Savings = eligible spend × your tax rate, assuming the expense is approved by your plan administrator. The $199 letter fee is itself often HSA/FSA-eligible. This is not tax advice.

What often qualifies

Examples where an LMN is frequently appropriate. Your clinical picture determines the outcome.

Home & equipmentStairlifts, grab bars, smart-home safety—when prescribed to address a documented condition.
Nutrition & weightRegistered dietitian visits, medical weight management—when tied to diagnosis.
Movement & recoveryPT adjuncts, massage, specialized equipment—when clinically indicated.
Mental & behavioralTherapy adjuncts, coaching programs—when tied to a diagnosed condition.
Prevention & monitoringCGMs, wearables, remote monitoring—when ordered as part of care.
Home caregiversNon-medical caregiver services—when a physician documents medical necessity for the care setting.

A good LMN is written like a chart note, not a brochure.

We write in the voice of the physician who signs it — diagnosis, clinical reasoning, requested intervention, expected benefit, duration. No template-speak. No marketing claims. Plan administrators can tell the difference.

Every letter is stored privately for your records and never resold.

Common questions

Will my HSA/FSA always approve this?

No service can promise that. Each plan administrator makes the final determination based on IRS rules, your plan document, and the documentation provided. A physician-signed LMN in §213(d) format gives you the strongest evidence to submit.

Who signs the letters?

A licensed clinician under the appropriate state license. No ghost-signing. The signing physician's name and license number appear on every letter.

What if I'm denied a letter?

If clinical review finds an LMN is not appropriate, we'll tell you why and refund the fee. We'd rather decline than write something that won't hold up.

Do I need a prior diagnosis?

Usually yes — documentation of a diagnosed condition makes a substantially stronger letter. If you don't have one, we'll tell you up front what kind of evidence your plan will likely expect.

How long are letters valid?

Most LMNs cover a 12-month window and can be re-issued when your situation changes. Some plans require annual renewal regardless — check your plan document.

Is this medical advice?

The letter itself reflects a physician's clinical judgment. It's not a substitute for a care relationship with your regular provider. The physician is not prescribing any drug and is not taking over your primary care.

Get on the waitlist

We're opening seats in small cohorts so we can review each letter carefully. Join the list and we'll invite you when a slot is available.

No spam. No selling your data.