Your Letter of Medical Necessity Template
✓ Thank You!
Your Letter of Medical Necessity (LMN) template has been sent to your email.
Check your inbox (and spam folder) for the template. You can share it with your clinician or HSA/FSA provider.
What Happens Next?
- Check your email: The LMN template should arrive within a few minutes.
- Review the template: The template includes all necessary fields for your clinician to complete.
- Share with your clinician: Ask your healthcare provider to complete and sign the template.
- Submit to your HSA/FSA: Upload the signed LMN and your MyLabInsight receipt to your plan administrator.
Important Notes
- This template is for educational purposes only and does not constitute medical, tax, or legal advice.
- HSA/FSA reimbursement is not guaranteed — approval depends on your specific plan and administrator.
- Some plans may require additional documentation, such as a Letter of Medical Necessity from your healthcare provider.
- For more detailed information, see our complete HSA/FSA guide.
Need More Help?
If you have questions about using MyLabInsight or HSA/FSA reimbursement:
- Read our HSA/FSA Guide
- Explore Features
- Check out our Pricing Plans
*Educational use only. Not medical, tax, or legal advice. Consult your healthcare provider, tax professional, and plan administrator for guidance specific to your situation.*