Sample Letter of Medical Necessity November 17 2018, 0 Comments

Persons using AudreySpirit garments who have a Flexible Spending Account (FSA) or other health savings benefit account may be eligible for reimbursement of most of our garments' cost.

You may also discover programs which help with the cost of these garments, one example is Kansas Special Health Care Needs (SHCN) Program Pays for AudreySpirit Garments. Do let me know about your success or challenges so we can share tips with other families!


Below, I've copied a sample letter of medical necessity for your medical provider to customize for your particular need. Additional resources can be found at the end of this post. Check with your professional tax preparer for any questions related to your specific circumstances. 

Children, teens, and adults have used AudreySpirit therapeutic garments during treatments for:

  • cystic fibrosis,
  • cancer (chemotherapy, radiation therapy and stem cell transplants),
  • autoimmune diseases,
  • traumatic injuries, 
  • open heart surgery to ease dressing, ease incision care and to comfortably hide all those medical lines used during the cardiac rehabilitation period
  • spinal surgery
  • and many other medical disabilities

SAMPLE Letter of Medical Necessity

To whom it may concern,

(Patient) is an (year old) (male / female) admitted to the hospital/receiving home health care/preparing for a hospital admission/surgical procedure for (diagnosis (es)). Their care requires continuous infusion through a (peripheral intravenous catheter / central venous catheter / nasogastric tube / gastrostomy tube / other). Each time (his/her) clothes are changed, (he/she) needs to use the restroom, or a physician/nurse practitioner has to do a complete exam, there is the potential need to disconnect the continuous infusion. (NOTE: if this is in preparation for a surgical intervention, you may wish to mention post-operative needs, such as the anticipation of discomfort dressing, supporting self-care for wound access/ongoing monitoring equipment e.g. cardiac rehabilitation). 

I am writing a letter of medical necessity for
AudreySpirit  therapeutic garments. Unlike personal clothing worn by patients in medical settings, lines/tubing do not need to be disconnected by a registered nurse for clothing changes. Manipulation of medical circuits/lines can become a source of serious complications for this patient. Also noteworthy is that these garments open discreetly allowing doctors, nurses and home caregivers access to body areas but also preserve modesty giving patients control over how much of their body is exposed during therapies, examinations and self-care.

Thank you for considering this request.

Physician/Clinical Provider

ADDITIONAL RESOURCES of interest to you/your professional tax preparer

1. A sample letter of medical necessity from a benefit account administrators, Neusynergy

2. Excerpt below from IRS Publication 502

Personal Use Items

You can't include in medical expenses the cost of an item ordinarily used for personal, living, or family purposes unless it is used primarily to prevent or alleviate a physical or mental disability or illness. For example, the cost of a toothbrush and toothpaste is a nondeductible personal expense.

In order to accommodate an individual with a physical disability, you may have to purchase an item ordinarily used as a personal, living, or family item in a special form. You can include the excess of the cost of the item in a special form over the cost of the item in normal form as a medical expense. See Braille Books and Magazines under What Medical Expenses Are Includible, earlier.