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Which Products Require a Letter of Medical Necessity?

A
Written by Anchor Ebanks
Updated today

Quick Answer: Most wellness products need an LMN because the IRS considers them "dual-purpose" - they can be used for general wellness OR for treating a medical condition. The LMN proves the medical purpose. Standard medical items (prescriptions, OTC meds, glasses) don't need one.


Products That DO Require an LMN

Any product that could be used for either personal wellness or medical treatment needs documentation. These include:

Fitness & Exercise

  • Gym memberships (all gyms and studios)

  • Fitness classes (yoga, Pilates, boxing, spinning, etc.)

  • Personal training sessions

  • Home fitness equipment (Peloton, Tonal, treadmills, etc.)

Wearables & Tech

  • Fitness trackers and smartwatches (Apple Watch, Oura Ring, WHOOP, Garmin, Fitbit)

  • Sleep technology systems (Eight Sleep)

  • Health monitoring devices (when used for general wellness)

Supplements & Nutrition

  • Vitamins and supplements (ALL require LMN)

  • Probiotics

  • Electrolytes

  • Protein supplements

  • Collagen products

Recovery & Wellness

  • Massage therapy (and massage devices like Therabody)

  • Red light therapy devices

  • Saunas and sauna equipment

  • Cold plunges and cryotherapy

  • Compression therapy (Normatec)

  • TENS/EMS units (when for general wellness, not prescribed pain management)

Home Health

  • Air purifiers

  • Humidifiers

  • Standing desks

  • Ergonomic chairs

  • Mattresses (only the excess cost over a standard mattress may qualify)

  • Weighted blankets

Mental Health Tools

  • Meditation apps (Headspace, Calm)

  • Stress-reduction tools

  • Neurofeedback devices

Products That DON'T Require an LMN

These are considered standard medical expenses and are automatically eligible:

  • ✅ Prescription medications

  • ✅ Over-the-counter medications (pain relievers, allergy meds, cold medicine, antacids, sleep aids)

  • ✅ Sunscreen (SPF 15+, broad-spectrum)

  • ✅ Menstrual care products

  • ✅ First aid supplies (bandages, kits, antiseptic)

  • ✅ Contact lenses and prescription glasses

  • ✅ Hearing aids and batteries

  • ✅ Breast pumps and lactation supplies

  • ✅ COVID-19 tests, masks, and hand sanitizer

  • ✅ Dental care (cleanings, fillings, braces)

  • ✅ Doctor visits and copays

  • ✅ Physical therapy (when recommended by a licensed healthcare provider)

Why Does the IRS Require an LMN?

The IRS draws a clear line between expenses that are "primarily to alleviate or prevent a physical or mental disability or illness" versus those that are "merely beneficial to general health."

A gym membership for fun? Not eligible. But the same gym membership recommended by a licensed healthcare provider to help manage diagnosed hypertension? That's a qualified medical expense.

The LMN is what makes the difference. It's a licensed healthcare provider's documentation that the product serves a medical purpose for you specifically.

How Crates Makes This Easy

Instead of scheduling a doctor's appointment, paying a copay, and waiting weeks for a letter, Crates streamlines the process:

  1. Complete a short online health survey

  2. Our licensed healthcare providers review your profile

  3. LMNs are issued for products where medical necessity is established — many in just minutes for catalog products, or 24-48 hours for custom requests

No office visits. No waiting weeks. No extra copays. And Crates can issue LMNs for ANY eligible wellness product — you're not limited to a set catalog.


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