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FSA/HSA – Letter of Medical Necessity Request

See below for more information on FSH/HSA letters of medical necessity:

FSA/HSA – Letter of Medical Necessity Request

We’re happy to assist with your request for a Letter of Medical Necessity to support your FSA/HSA submission.

To get started, please complete the template linked below:

Once submitted, your provider will review your request and prepare your Letter of Medical Necessity. You will receive a copy via email once it has been completed.