Administrator guide · checked August 2026

Letter of Medical Necessity for Lively

Lively’s eligibility list treats fitness programs as eligible when supported by a Letter of Medical Necessity — the letter converts the membership from a general-wellness expense into treatment for a specific diagnosed condition.

What Lively requires

  • A Letter of Medical Necessity naming the diagnosis and the fitness program
  • The provider’s signature, credentials, and a duration
  • Itemized receipts for each period you claim

The steps, in order

  1. Get the letter before the membership period you plan to claim
  2. Pay out of pocket; keep the receipts
  3. For a Lively FSA: submit the claim with the letter attached. For a Lively HSA: reimburse yourself and retain the documentation
  4. Renew the letter each year

Source: Lively: fitness programs eligibility. 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

Does Lively pre-approve letters?

For FSAs, Lively substantiates claims when you submit them. For HSAs there is usually no upfront review — you keep the letter and receipts as your audit documentation.

Can the letter cover equipment too?

Yes, when the letter names it. A treadmill or home-gym purchase follows the same rule: diagnosis, named expense, letter dated before the purchase.

What conditions typically qualify?

Commonly: obesity, high blood pressure, prediabetes or type-2 diabetes, high cholesterol, osteoarthritis, chronic back pain, depression, anxiety. A physician still has to judge that exercise is appropriate treatment for you specifically.

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