Physician Practice · multiple states
Care for someone who can't
manage on their own
is medical care.
If someone can't do two everyday things on their own (like bathing or dressing) for 90 days or more, or needs watching to stay safe, their care can count as medical care under IRS §213(d). A licensed physician reviews the case and signs a letter only when the rule is met. If it isn't, we tell you.
A letter documents care that already qualifies — it cannot make a personal expense medical. Eligibility depends on the diagnosis, the plan of care, and your plan's rules. See how the letter works →
Medical Director, DO
practicing hospitalist physician · multi-state licensure
Altru.care in 15 seconds
- When someone can’t manage alone Help with two daily activities for 90+ days, or constant supervision.
- Three questions, thirty seconds. A quick gut-check, not a clinical determination.
- Then send a short request. Your name, your email, and what the letter is for.
- A physician signs, or declines. Issued only when the standard is met. If not, you hear it.
- Altru.care. A signature only when the standard is met. altru.care
How LMNs work
Three steps from intake to signed letter.
Submit your intake
A minute online: who the care is for, the state and the type of care. No medical details. This is a request, not an appointment.
Start the intake ↓A physician reviews and signs
AI helps prepare a draft for review. Under the standard, a licensed physician reviews the case and signs or declines. Nothing is issued without that signature.
See how physicians review →Letter delivered
If the physician signs, you receive the signed letter by email. If the standard isn’t met, you hear that instead. Your HSA/FSA administrator makes the final call on reimbursement.
Every signature, hash-anchored →Need ongoing care, not just a letter? co-op.care is forming a worker-owned care cooperative; paid care begins once it is licensed and staffed →
Clinical services
The letter review is the one service on this page.
Open for requests
Letter of Medical Necessity
Documents care that already qualifies as medical, for a person who can’t manage on their own. A licensed physician signs or declines. A letter cannot make a personal expense medical.
Is telehealth right for this?
What telehealth can — and can’t — do.
Pick what you need. We’ll tell you honestly whether a remote physician practice is the right fit, what is open today, and where you’d be better served in person.
Before you request one
Will my expense likely qualify?
Three questions, thirty seconds. An LMN needs a genuine medical basis — if yours is missing one, we’d rather tell you now than waste your time.
Is the expense for someone with a real medical need — a diagnosed condition, a recovery, or something like memory decline that makes daily life unsafe?
Would the expense directly help treat or manage that need — home care or companion care hours, or medical equipment?
Honestly — would you be making this purchase anyway, even if the health issue didn’t exist?
A quick gut-check, not a clinical determination. A licensed physician decides whether to sign; nothing is issued without that decision.
Request a letter review
A Letter of Medical Necessity (LMN): a licensed physician reviews the case, then signs or declines.
Common questions
Will my HSA or FSA accept this letter? ∨
An LMN signed by a licensed physician in your state is the standard documentation required by HSA and FSA administrators. Eligibility depends on your specific plan and the nature of the expense. Home care that qualifies under IRS §213(d) can be paid through an HSA or FSA once an LMN documents the need — see how ComfortCard tracks HSA/FSA savings →. A licensed physician decides whether to sign; nothing is issued without that signature.
Can you issue letters in my state? ∨
Our medical director is licensed in multiple states and practices as a hospitalist. We confirm your state at intake and tell you plainly if we can’t serve it yet.
Is there a charge? ∨
Nothing is charged or sold on this page, and no payment is collected here. If that changes, the terms will be shown before anyone pays.
What is remote monitoring? ∨
Remote monitoring means devices that send vitals or weight to a clinician between visits. It is not offered here; ask your own clinician whether it fits.
What is Chronic Care Management (CCM)? ∨
CCM is a Medicare program for patients with two or more chronic conditions: monthly care coordination and medication reconciliation. It is not offered here; ask your own primary care clinician. For age-in-place tools, see careho.me →.
What is Advance Care Planning (ACP)? ∨
ACP is a structured conversation that documents your healthcare wishes: values, preferences, and instructions for your care team and family. You can start the conversation yourself on CareGoals →.