Eligibility

Flex-Ed: Shedding light on the letter of medical necessity

Every year, as we approach open enrollment (and it's we receive a lot of the same questions. And discussing the letter of medical necessity (LMN) is always at the top of the list. So, since this a column about the basics of flexible spending account use, we're happy to cover it again. Because it's important, and can impact how you shop for FSA-eligible products and services.

If you've spent some time looking through our Eligibility List, you probably noticed a classification of qualifying medical products and services as "requiring a letter of medical necessity."

In short, an LMN is like a doctor's note. Having an LMN can help any product or service that falls outside the IRS's definition of "medical care" (but can assist the treatment of a condition) get approved for FSA reimbursement.

Defining "medical care"

For a product or service to be FSA-eligible, it must treat, cure, diagnose or prevent a disease or illness. Or it has to affect a function of the body. So a product like a first-aid kit is a no-brainer, as it can be used in a huge variety of medical situations.

However, there are many treatment methods and products available that fall outside IRS guidelines that could be made eligible with some additional documentation from your doctor.

Here's an example: If your doctor suggests massage therapy to treat an injury, it's not FSA-eligible on its own. However, if you get an LMN from your doctor that outlines how the treatment method is essential to your recovery, your benefits administrator may accept it as an FSA-eligible expense.

How to submit a letter of medical necessity

If you and your doctor have identified a medical product or service that can aid the treatment of an injury or medical condition and it falls outside FSA eligibility, here's what you need to do:

  • Check with your benefits administrator to see if there is an official form to fill out for the expense to be approved.
  • If your doctor is writing a letter on his/her own, the letter must outline: what medical condition is being treated, a description of the treatment (frequency, dosage), and how long the expense will be needed to treat the condition.
  • A receipt or invoice must be submitted with the LMN for the full price to be reimbursed.

In some cases, benefits administrators may ask for additional information from your doctor, most likely for products/services that also have non-medical uses.

Beyond its direct medical use, most expenses are non-reimbursable if the individual would have purchased it anyway. In other words, this product can't be something you would purchase even if you didn't have the condition. It needs to be directly related to this course of treatment, and the specific use needs to be confirmed by a doctor.

One example is yoga. If you're already paying for yoga classes unrelated to a medical condition, your payments are not FSA-eligible, and these costs won't be covered retroactively. But if a physician recommends yoga to help a specific condition, they might submit an LMN on your behalf, to allow you to use tax-free funds to cover the costs of classes for a set period of time, until the doctor determines your treatment is complete.

With any luck, you shouldn't have any difficulties getting reimbursed for your expense as long as you keep an open line of communication with your benefits administrator and ensure that your physician is as detailed as possible.

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New to FSAs? Need a refresher course in all things flex spending? Our weekly Flex-Ed column gives you a weekly dose of FSA Living 101, offering tips for making the most of your tax-free funds. Look for it every Thursday, exclusively on the FSAstore.com Learning Center.

Eligibility

How does kinesiology tape work?

Whether you've begun fitness training or just getting back into the gym after a long hiatus, you may have noticed the colorful tape worn by professional and amateur athletes alike popping up all over the place. But it's not a fashion statement - it's kinesiology tape! Let's dive in to find out how this FSA eligible item works and how it can treat common pain conditions.

What is kinesiology?

Kinesiology has become an increasingly popular field of complementary health or natural medicine that refers to the study of the body's mechanics of biomechanical, physiological and psychological mechanisms of movement. One of the fundamental premises of kinesiology is that the body has innate healing energy and is always in the state of active healing, but in certain cases, the mechanics of body positioning and adjustments can promote this healing process further.

A "kinesiologist" is not currently a licensed professional designation in the U.S., but those with training in this area typically have specialties in the fields of physical rehabilitation, human motor performance and ergonomics. Ultimately, the vast majority of individuals who consider themselves as kinesiologists are those who are specialists in "exercise physiology," or the study of physiological responses to physical exercise and the rehabilitative efforts to help the body achieve peak performance.

What is kinesiology tape?

One of the most common kinesiology products is kinesiology tape, which is designed to aid the healing process of sore muscles and joints by providing support and stability to these areas without restricting the patient's range of motion. According to KinesioTaping.com, through the use of soft tissue manipulation, experts can utilize kinesiology tape in specific taping techniques to allow muscles and ligaments to be stabilized to prevent further damage or re-injury. This strategy has become increasingly popular in the treatment of pain, rehabilitation, stabilization before athletic competition and much more.

Kinesiology taping falls under a wide umbrella of proven physiotherapy techniques, including joint mobilization/manipulation, minimal energy techniques (METs), muscle stretching, neurodynamics and soft tissue rehabilitation. Before working with kinesiology tape, seek out the assistance of a personal trainer or physiologist to ensure that you are using the tape correctly to treat a specific pain or muscle issue, suggests Mayo Clinic.

If you're interested in learning more about kinesiology taping, KT Tape™ is a good place to start! KT Tape™ is one of the most popular kinesiology tapes on the market, and the company has a huge range of instructional videos on their YouTube channel to help you learn more about kinesiology taping and gain the skills necessary to apply the tape on your own. To browse our selection of kinesiology tapes and thousands of other FSA eligible products, be sure to visit FSAstore.com!

KT TAPE Original, Pre-cut, 20 Strip

Get targeted pain relief that stays in place through multiple workouts for up to 3 days.

KT Tape Pro Jumbo Black Tape, Uncut

Enjoy the flexibility of being able to measure to your exact needs with KT Tape.