LMN Requests

A Letter of Medical Necessity (LMN) is the document that allows you to use your HSA or FSA funds for eligible purchases through Truemed. Most of the time, your LMN is issued automatically as part of the Truemed checkout process. But there are a few situations where you may need to request one differently, or where an LMN may not be possible. This article walks through each scenario.

Requesting an LMN for a new purchase

For most purchases through a Truemed partner merchant, getting an LMN is built directly into checkout. Here is how the process works:

1. Select the Truemed payment option at checkout. When you reach the payment step, choose Truemed as your payment method.

   

2. Complete the clinical intake survey. You will be prompted to answer a short health questionnaire before your payment is finalized. This survey is required to establish medical necessity.

3. Your survey is sent to a licensed provider for review. The provider reviews your responses to determine whether an LMN is appropriate for your situation.

4. Your LMN is issued after approval. If the provider approves your request, your LMN is generated and associated with your purchase. You can access it from your Truemed dashboard.

The key requirement is that the survey must be completed on or before the day of purchase. The LMN date is tied to when you complete the survey, and your HSA or FSA administrator will verify that this date aligns with your purchase date.

If you have questions about your survey results or LMN status, see LMN Status & Troubleshooting.

Requesting an LMN for a past purchase (retroactive)

We hear this question often, and we want to be upfront with you: Truemed is not able to issue an LMN for a purchase that was already made outside of Truemed checkout.

Here is why. In order for an LMN to be valid, the clinical intake survey must be completed before or on the day of purchase. This is not a policy we created arbitrarily — it is an IRS compliance requirement. The survey establishes a patient-provider relationship, and that relationship must exist at the time of the transaction. Because of this, we are not able to backdate a letter of medical necessity to a time prior to the establishment of that relationship.

If your purchase was made through the merchant’s standard checkout instead of Truemed, the survey was never completed, and there is no qualifying documentation to support an LMN for that transaction.

What you can do next:

• If this was a one-time purchase: You can reach out to the merchant to see if they can process a refund, which would allow you to repurchase using Truemed at checkout and go through the proper qualification process.
• For future purchases: To make sure your purchase is eligible, select the Truemed payment option at checkout and complete the clinical intake survey before your payment is finalized.

We know this can be frustrating, especially if you were not aware of the Truemed option at checkout. For future purchases, keep an eye out for the Truemed payment option wherever you shop.

Requesting an LMN for a non-partner or third-party merchant

Truemed issues LMNs specifically for purchases made through our partner merchant network. If a merchant is not a Truemed partner, we generally cannot issue a standard LMN for products purchased there, because we have not verified the merchant’s products for HSA/FSA eligibility.

There are a couple of exceptions: gym memberships, and some other broad categories like saunas, exercise equipment, activity trackers. If you are buying products from a merchant that is not a Truemed partner for any of the above, we may be able to issue a generic LMN for these expenses, provided that medical necessity is established through the clinical intake survey. This LMN can then be submitted to your HSA or FSA administrator along with your itemized receipts, following your plan’s submission guidelines. Your HSA/FSA administrator makes the final determination on whether the reimbursement is approved.

For all other non-partner merchants:

• We are not able to issue LMNs for services purchased outside of our partner network.
• If there is a merchant you love and want to shop through Truemed, encourage them to apply at truemed.com/partners.

If you are unsure whether your situation qualifies for an LMN, reach out to our support team and we can help you figure out the best path forward.

Renewing an expired LMN

Letters of Medical Necessity are valid for one year from the date they’re issued. After that, the LMN expires and will need to be renewed before it can be used for additional HSA/FSA-eligible purchases or payments.

Truemed will typically email you a few weeks before your LMN is set to expire with an updated survey link to request a new LMN. 

To obtain a new LMN for the product, you’ll need to:

1. Re-purchase the product.
2. Complete the post-checkout steps you followed the first time, including retaking the clinical survey.
3. Have the survey evaluated by a medical provider.

Once the provider approves your survey, you’ll receive a new LMN, valid for another year, tied to that purchase.