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Requires Letter of Medical Necessity (LOMN)
Are Calcium Supplements FSA/HSA Eligible?
Category: Medications
How to Get Approved
Only if prescribed for osteoporosis or deficiency.
The Fast Way
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Get instant approval online for $30. Skip the appointment — a licensed physician reviews your request and issues your LOMN within 24-48 hours.
24-48 hour turnaround
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Free LOMN Template
Copy this template and bring it to your doctor. They'll need to customize it with your diagnosis and sign it.
LETTER OF MEDICAL NECESSITY
Date: [DATE]
To Whom It May Concern,
I am writing to certify that Calcium Supplements is medically necessary for my patient:
Patient Name: [PATIENT NAME]
Date of Birth: [DOB]
Diagnosis: [ICD-10 CODE AND DESCRIPTION]
Medical Justification:
Only if prescribed for osteoporosis or deficiency.
I have prescribed this item as part of the patient's treatment plan, and it is not for general health or cosmetic purposes.
If you have any questions, please contact my office.
Sincerely,
[PHYSICIAN SIGNATURE]
[PHYSICIAN NAME, MD]
[PRACTICE NAME]
[NPI NUMBER]
[PHONE NUMBER]
Submit the signed letter to your FSA/HSA administrator along with your receipt.
Don't have a doctor?
Get instant approval online for $30