Letter of Medical Necessity

Use your HSA or FSA funds to pay for Nervana

Download Your Letter

This Letter of Medical Necessity (LMN) can be submitted to your HSA or FSA administrator to request reimbursement for your Nervana subscription.

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What is a Letter of Medical Necessity?

A Letter of Medical Necessity (LMN) is a document that explains why a particular treatment, product, or service is medically necessary for a patient. HSA and FSA administrators often require this documentation to approve reimbursement for health-related expenses.

How to Use This Letter

Download the Letter of Medical Necessity PDF
Have your healthcare provider review and sign the letter
Submit the signed letter along with your Nervana receipt to your HSA/FSA administrator
Keep copies of all documents for your records

Note: Approval of HSA/FSA reimbursement is at the discretion of your plan administrator. We recommend contacting them directly to confirm their specific requirements before submitting your claim.