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What Documentation Do I Need for HSA/FSA Reimbursement?

A
Written by Anchor Ebanks
Updated today

Quick Answer: You need two things: your Letter of Medical Necessity (LMN) from Crates and your itemized receipt from the purchase. Some admins may also request an Explanation of Benefits (EOB) or additional details.


The Two Essential Documents

1. Letter of Medical Necessity (LMN)

This is the document from Crates that connects your purchase to a medical need. It includes: - Your name and health information - Your diagnosed condition(s) - The specific product being recommended - Medical necessity statement from a licensed healthcare provider (MD, DO, PA, NP) - Provider signature and date

Access your LMN anytime from your Crates Health dashboard.

2. Itemized Receipt

Your receipt should clearly show: - Retailer/provider name (e.g., "Equinox," "Amazon," "Thorne") - Date of purchase - Product or service description (itemized - not just a total amount) - Amount paid

Digital receipts work! Email confirmations, order confirmations, and screenshots are all acceptable.

What Different Admins May Request

Depending on your HSA/FSA admin, you may need additional documentation:

Administrator

What They Typically Want

HealthEquity

LMN + receipt. Generally doesn't require additional documentation for HSA distributions.

Optum

LMN + itemized receipt. May request more detail for larger claims.

WEX

LMN + detailed itemized receipt. Can be strict on documentation.

Navia

LMN + detailed receipt. Known for stricter review - include as much detail as possible.

Fidelity

LMN + receipt. HSA distributions are generally self-certified.

FSAFEDS

LMN + detailed receipt. Federal FSA requires itemized documentation.

Bank of America

LMN + receipt.

HSA Bank

LMN + receipt.

What Receipts Are NOT Acceptable

Most admins will not accept: - ❌ Credit card statements (shows amount but not what was purchased) - ❌ Canceled checks - ❌ Balance-forward statements - ❌ Handwritten notes without business details - ❌ Receipts that only show a total without item descriptions

Need an Itemized Bill?

Some admins (like Inspira) require more detail than a standard receipt — sometimes called an itemized bill or Explanation of Benefits (EOB).

If your admin requests this, contact us. We can help provide additional documentation that includes: - Detailed product/service description - Eligibility classification - Your account details

HSA vs. FSA Documentation: A Key Difference

HSA Documentation

With an HSA, your admin typically does not require you to submit documentation upfront. You can take a distribution and self-certify that it was for a qualified medical expense. However, you must keep your itemized receipts and LMN in case the IRS audits you, which they have the right to do up to 10 years after a transaction.

Think of it this way: your HSA admin trusts you, but the IRS may check.

FSA Documentation

With an FSA, your admin is required to substantiate (verify) your claims. This means they WILL ask for itemized receipts and supporting documentation before releasing funds. This is why FSA reimbursements may take a bit longer.

How Long Should I Keep Records?

Keep all documentation — LMNs, itemized receipts, claim submissions — indefinitely or at least 10 years. The IRS can audit you up to 10 years after a transaction. Crates stores your LMNs and receipts on your dashboard for easy access.

Pro tip: Take photos or scan paper receipts and save them digitally. Paper receipts fade over time.


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