Letter of Medical Necessity (LMN)

Accept HSA/FSA payments on your e-commerce store and unlock the billions of dollars sitting in HSA and FSA accounts today.
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How it works

1
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Request LMN

Customer completes intake form to begin LMN request process to enable payment with HSA/FSA.

2
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Consultation

Sika's healthcare provider consults with the customer to determine eligibility and issues a letter of medical necessity to qualifying customers.

3
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Payment with HSA/FSA

Customer pays with HSA/FSA directly on retailer's website and receives documentation to submit to their plan administrator.

Capture customers'
pre-tax spend

70 million people in the United States have HSA and FSA accounts estimated at more than $175 billion in value in 2024. Sika's Letter of Medical Necessity (LMN) service enables these customers to spend their pre-tax dollars with merchants who sell products that address medical conditions while also having non-medical uses (also called "dual-eligible items"). Sika's LMN service is an innovative approach that combines telehealth and payments to enable merchants to capture more share of customers' pre-tax wallet.

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Man holding green mug on the phone

Bring the healthcare benefits of your products to a broader audience and help customers save

Retailers whose products address medical conditions such as hypertension, obesity, diabetes, anxiety, arthritis, chronic pain, sleep disorders, depression, stress, asthma, and more can help their customers save money by paying with pre-tax HSA and FSA funds through Sika's LMN process.

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Attract new customers and grow revenue with Sika's LMN service

Sika's streamlined, trusted LMN service eases the purchase experience for customers by creating a direct connection with a healthcare provider. This lets you serve your customer when they need you the most.

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FAQs - for merchants

What is a Letter of Medical Necessity?

An LMN, or Letter of Medical Necessity, is like a doctor’s note. It’s issued by a healthcare provider to outline the medical reasons why a particular product or service is medically necessary for an individual's health, and qualifies the purchase to be HSA/FSA eligible. LMNs demonstrate that an expense is needed to diagnose, treat, or alleviate a medical symptom, rather than for general health or wellness purposes.

Why would my customer need a Letter of Medical Necessity?

Certain products are eligible for purchase with HSA/FSA funds if they treat, cure, prevent, diagnose, or alleviate a medical need. For instance, items like bandaids are always eligible as they serve a solely medical purpose. However, there are “dual-eligible” products that can be used for general health and wellness or for specific medical purposes—if recommended by a healthcare provider based on individual needs. Take iron supplements, for example; many use them to support their overall health. Yet, for someone with anemia, iron supplements become crucial. In such cases, individuals can use their HSA/FSA funds if their healthcare provider issues an LMN, recommending the supplements specifically to address their anemia.

How does this work?

Sika makes it easy for merchants to embed a practice of telehealth within their e-commerce experience. The customer will:

  1. Chat with a certified healthcare provider to evaluate if they qualify for an LMN
  2. Complete intake forms, similar to what they would at a doctor’s office
  3. Consult with our team of healthcare providers, who will determine if they are eligible

Once customers have their LMN in hand, they can return to your site and shop as usual. During checkout, they simply select the Sika payment method to utilize their HSA/FSA funds. Our checkout process manages all nuances of split tender and partial authorization, ensuring a seamless experience for both you and your customers.

How long does it take to get approved for a Letter of Medical Necessity?

Our healthcare provider team strives to provide a response within 12 business hours after customers submit their LMN intake forms.

What happens if the customer is not approved for a Letter of Medical Necessity?

Our assessment and intake forms are designed to streamline the process, ensuring that only eligible customers proceed to the Letter of Medical Necessity approval stage so we won’t waste your customer’s time. While our healthcare provider team independently makes all final eligibility determinations, it's important to note that some customers may not receive approval following their consultation. In such cases, we promptly notify the customer of the outcome and redirect them to your site to complete their purchase using traditional payment methods. We advise against customers reapplying in these instances.

FAQs - for customers

What is a Letter of Medical Necessity?

An LMN, or Letter of Medical Necessity, is like a doctor’s note. It’s issued by a healthcare provider to outline the medical reasons why a particular product or service is medically necessary for an individual's health, and qualifies your purchase to be HSA/FSA eligible. LMNs demonstrate that an expense is needed to diagnose, treat, or alleviate a medical symptom, rather than for general health or wellness purposes.

Why do I need a Letter of Medical Necessity to purchase certain products?

Certain products are eligible for purchase with HSA/FSA funds if they treat, cure, prevent, diagnose, or alleviate a medical need. For instance, items like bandaids are always eligible as they serve a solely medical purpose. However, there are “dual-eligible” products that can be used for general health and wellness or for specific medical purposes—if recommended by a healthcare provider based on your individual needs. Take iron supplements, for example; many use them to support their overall health. Yet, for someone with anemia, iron supplements become crucial. In such cases, individuals can use their HSA/FSA funds if their healthcare provider issues an LMN, recommending the supplements specifically to address their anemia.

How do I get a Letter of Medical Necessity?

You can request a Letter of Medical Necessity through Sika’s merchant partners on their website. If you’re approved, you’ll be able to check out using your HSA/FSA funds for your qualified purchase. Here’s how:

  • Chat with a certified healthcare provider to evaluate if you qualify for an LMN
  • Complete intake forms, similar to how you would at a doctor’s office
  • Consult with our team of healthcare providers, who will determine if you are eligible

Once you have your LMN in hand, you can return to the merchant’s site and shop as usual. During checkout, you’ll simply select the Sika payment method to utilize your HSA/FSA funds.

How long does it take to get approved for a Letter of Medical Necessity?

Our healthcare provider team strives to provide a response within 12 business hours after you submit your LMN intake forms.

What information will I need to provide for a Letter of Medical Necessity?

To see if you’re a candidate for a Letter of Medical Necessity, similar to other telehealth experiences, you’ll be asked to share your name, contact information, date of birth, and information about the symptoms you are experiencing and your medical history. We will also verify your phone number and ask you to upload a photo ID to verify your identity.

The information you provide in the LMN process will be kept confidential and shared only with our independent healthcare provider(s) to evaluate your eligibility for an LMN. For more information, see our privacy policy.

How long is a Letter of Medical Necessity valid?

Letters of Medical Necessity are valid for 12 months from the date they are signed.

Please note, LMNs cannot be used retroactively for purchases made prior to the date they are signed.

How do I submit my Letter of Medical Necessity to my HSA/FSA provider?

After you complete a purchase using an LMN, you will need to submit your Letter of Medical Necessity and your receipt to substantiate the purchase if you paid with your HSA/FSA or to get reimbursed if you paid with your credit/debit card. To do this:

  1. Log into your HSA/FSA account on your benefit administrator’s website
  2. Find the Reimbursement or Claims section
  3. Upload your receipt and Letter of Medical Necessity

Your administrator will process and evaluate your claim. Please note that some HSA/FSA benefits administrators may incorrectly deny reimbursement, so before purchasing a product with an LMN you should consider contacting your administrator to determine if your purchases will be covered/reimbursed. You can learn more about what is eligible at https://www.irs.gov/publications/p969.

If you are having trouble locating your itemized receipt or LMN, please contact Sika at support@sikahealth.com

Why wasn’t I approved for a Letter of Medical Necessity?

Sika’s independent healthcare provider may determine that you do not have symptoms demonstrating a medical necessity for a product or service. While you cannot use your HSA/FSA funds now, you can still use another payment method to complete your purchase. We do not recommend reapplying.

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