Administrator guide · checked August 2026

Letter of Medical Necessity for FSAFEDS

FSAFEDS — the FSA program for federal employees — accepts gym membership claims, but it is stricter than most administrators: it requires an approved Letter of Medical Necessity on file BEFORE you submit claims, and an individual (not family) membership contract.

What FSAFEDS requires

  • A Letter of Medical Necessity naming the diagnosed condition and the prescribed exercise
  • The LMN must be submitted to FSAFEDS and APPROVED before your claims count
  • An individual membership contract in your name
  • Itemized documentation for each claim: dates, amounts, and the provider

The steps, in order

  1. Get the letter first, before paying for the membership period you plan to claim
  2. Submit the LMN to FSAFEDS and wait for their approval — this is the step other administrators skip
  3. Pay the gym yourself and keep itemized receipts or statements
  4. Submit claims for periods after the approved letter’s date; renew the letter annually

Source: FSAFEDS FAQ: gym membership claims. Policies change and employer plan designs vary — your administrator makes the final reimbursement decision. This page is general information, not tax or medical advice.

Need the letter itself?

A board-certified physician reviews your health profile and, when clinically appropriate, issues a signed Letter of Medical Necessity the same day — with the diagnosis, ICD-10 code, duration, NPI and license your administratorlooks for. $69, full refund if a letter isn’t issued. The eligibility check is free.

Check if I qualify →

Common questions

Can I submit gym claims to FSAFEDS before my letter is approved?

No. FSAFEDS requires the approved Letter of Medical Necessity on file first. Claims for periods before approval are the most common reason federal employees get denied.

Does a family gym membership qualify with FSAFEDS?

FSAFEDS asks for an individual membership contract. The eligible portion is the member with the qualifying diagnosis, not the whole family plan.

How do I get a compliant letter quickly?

Your own physician can write one, or a physician service like MedSlip issues a signed letter with the diagnosis, ICD-10 code, and duration — the elements FSAFEDS reviews for.

Keep reading
The complete Letter of Medical Necessity guide (2026)Is a gym membership HSA/FSA eligible?What qualifies for an LMN: the full catalog