Health Insurance Made Easy June 2026

Some health care treatments, services and products do not automatically qualify for coverage under employer-sponsored benefit plans or reimbursement through health savings accounts (HSAs), flexible spending accounts (FSAs) or health reimbursement arrangements (HRAs). In these cases, individuals may need documentation from a licensed health care provider to show that an expense is medically necessary rather than primarily for general wellness or personal use. Without proper documentation, reimbursement requests may be delayed or denied, even when the expense relates to a valid medical condition.

A letter of medical necessity (LMN) helps support eligibility. This overview explains what an LMN is, when it may be required and how to request one.

LMN Overview

An LMN is a formal document, written and signed by a licensed health care provider, that explains why a specific treatment, service or item is necessary to diagnose, treat or manage a medical condition. Plan administrators and account custodians use LMNs to determine whether an expense qualifies for coverage or reimbursement.

A typical LMN includes:

• The patient’s name and relevant medical condition
• A description of the prescribed treatment, service or item
• An explanation of why the treatment is medically necessary
• The expected duration of treatment or use
• The provider’s credentials and signature

An LMN does not guarantee coverage, but it provides the required documentation to support eligibility under a plan’s rules.

When Is an LMN Needed?

LMNs are commonly required for expenses that fall between medical care and general wellness. Many routine expenses—such as office visits, prescriptions and hospital services—are automatically eligible, while others require additional justification. You may be asked for an LMN by an FSA or HSA provider, private insurance company, or, in some cases, Medicare or Medicaid. Common examples include:

• Over-the-counter products used to treat a specific condition
• Alternative or complementary therapies, such as acupuncture or massage
• Weight management programs or medications prescribed for a diagnosed condition
• Certain mental health, behavioral or digital health services
• Durable medical equipment or items with both medical and nonmedical uses
• Dual-purpose expenses like ergonomic equipment or air purifiers

Conclusion

An LMN can be essential for securing coverage or reimbursement for certain health care expenses. Understanding when it is required and coordinating with a licensed provider can help ensure smoother claims and better compliance with plan requirements.

ICHRA Facts and Myths

Health insurance can feel confusing, especially if your employer offers a new option during open enrollment or if you enrolled in a different plan this year. One option you may be covered under or could hear about is the individual coverage health reimbursement arrangement (ICHRA). If your employer offers an ICHRA, it works differently from a traditional group health plan.

Under an ICHRA, employers solely fund an account-based group health plan through employer contributions for medical care expenses, up to a specified maximum for a coverage period. Instead of an employer selecting one group plan for everyone, an ICHRA allows eligible employees to purchase their own individual health insurance coverage. The employer then reimburses its employees, tax-free, for their premiums and certain qualifying medical expenses.

Because ICHRAs follow specific federal rules, employers cannot offer both an ICHRA and a traditional major medical group health plan to employees within the same employee class. However, they can offer different options to different employee groups. This means that if you are offered an ICHRA, it will be provided as your designated benefit arrangement rather than as one plan choice among multiple group health plans. An ICHRA replaces, not supplements, other group health plan offerings.

This article explains some common ICHRA myths and pairs them with the facts to help you understand this benefit and how it might support your health care choices.

3 Myths and Facts About ICHRAs

Consider the following three myths and facts about ICHRAs:

1. Myth: ICHRAs are only available for workers at small employers. 
   Fact: A growing number of employers of all sizes are offering ICHRAs, from small teams to larger organizations. Federal regulations allow employers to design ICHRAs for many different groups of employees, including full time, part time, hourly and salaried employees. That means whether you work for a small business or a major employer, you may be offered an ICHRA rather than traditional group insurance. In fact, interest among large employers is rising fast as health care costs grow. More large organizations are exploring ICHRAs because they can offer predictable budgeting, administrative flexibility and an easier way to accommodate employees in different states or job categories. However, an ICHRA isn’t necessarily a better fit for every employer or employee.
2. Myth: Choosing your own insurance is confusing and time-consuming.
   Fact: Research shows the opposite: Many employees appreciate having choice and control over their health care. Many people prefer selecting a plan that matches their needs rather than being offered traditional group health insurance. There are user-friendly tools that help you compare plans quickly and easily. Choosing a plan may take as little as 30 minutes with the right support, though it is important not to rush major decisions and to educate yourself about the best available options.
3. Myth: If my employer offers an ICHRA, it means more hassle and less support for me.
   Fact: The goal of an ICHRA is to give more customization and simplicity, not extra work. Employers typically use dedicated platforms that make enrollment and reimbursement straightforward. Many employers partner with administrators who help employees submit receipts, understand coverage options and navigate their ICHRA benefits. New tech tools, even mobile apps, make comparisons, enrollment and ongoing claims much easier. Over 40 ICHRA platforms now support streamlined plan selection with reliable tools used across the industry.

Conclusion

ICHRAs are designed as an option that gives you flexibility in choosing and obtaining health coverage. Instead of being offered a single, standard group plan with limited tiers, an ICHRA lets you choose an individual health insurance plan that aligns with your needs and preferences. Contact your employer if you have further questions regarding your health care options.

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