▦ Avows · Doctor's letter service
Need a doctor's letter?
We'll handle it.
Your gym membership, massage gun, supplement, or therapy session is HSA-eligible — but only with a Letter of Medical Necessity from a doctor. Most people skip the paperwork and lose the reimbursement. We get the letter, you get the reimbursement.
$39 flat · 48-hour turnaround · refund if denied
Or reply directly from your inbox to lmn@avows.app — we'll send you a secure intake form.
How it works
Tell us what you need. Email us your item or service plus the condition you'd like the LMN to cover. Takes ~30 seconds.
We pair you with a licensed clinician. A US-licensed MD, DO, NP, or RN reviews your case via secure intake form (typically a 5-10 minute self-report — no video call required for most conditions). The clinician matched to your case is licensed in your state.
You get the LMN within 48 hours. Delivered as a signed PDF you can attach to any HSA/FSA reimbursement claim. Save it to your Avows vault and reuse it across receipts for the same condition (LMNs are typically valid for 12 months).
What we cover
The six condition categories below are our standard offerings. If your situation doesn't fit, email us anyway — most things can be addressed.
Pricing
per Letter of Medical Necessity
- One signed PDF, valid for 12 months
- 48-hour turnaround (most cases same-day)
- Refund if denied — guaranteed
- US-licensed MD, DO, NP, or RN
- HIPAA-compliant intake
- No subscription, no upsell, no follow-on
Is it worth it?
For typical items, the LMN pays for itself many times over. The math:
| Item | Cost | Tax savings | Net after LMN |
|---|---|---|---|
| Theragun Pro | $300 | ~$100 | +$61 |
| Annual gym membership | $1,000 | ~$330 | +$291 |
| Personal training (1 yr) | $5,000 | ~$1,650 | +$1,611 |
| Therapy ($150/wk × 1 yr) | $7,800 | ~$2,570 | +$2,531 |
Tax savings assume ~33% combined federal/FICA/state rate. Actual savings vary by bracket and state.
FAQ
Why pay you instead of asking my own doctor?
You absolutely can — many doctors will write an LMN for free or for a $25-50 paperwork fee. Avows even has a free in-app email template for that. We exist for the people whose doctor won't, who don't have a regular doctor, or who don't want to spend a 15-minute appointment slot on it.
Is this a real doctor visit?
Yes. The LMN is signed by a US-licensed MD, DO, NP, or RN who reviews your intake form. For most conditions, no video call is required — telehealth standards allow asynchronous review for paperwork like this. If your situation needs a synchronous visit, we'll let you know upfront before charging.
What if my plan administrator denies the claim?
Full refund of the $39. Send us the denial letter (most plans email a one-page reason) and we'll process the refund within 3 business days. Plan administrators occasionally reject LMN-backed claims even when the IRS rules support them — the refund covers you for that risk.
How long is the LMN good for?
Standard LMNs are valid for 12 months. You can use the same LMN across multiple receipts during that window — buy a foam roller in April, a massage chair in October, both covered by one $39 letter. After 12 months, ask your doctor to renew (or order another from us).
What does Avows do with my data?
The intake form sends information to our partner physician's HIPAA-compliant practice. Avows itself doesn't store medical details — we only see your email and what you ordered. We don't sell, share, or use your data for anything else. Avows runs entirely in your browser; we have no servers to leak.
Do you offer letters in bulk / for multiple people?
Not yet at consumer scale, but reach out — we're talking with HSA administrators and corporate benefits teams about partnership pricing.
This is not medical or tax advice. A Letter of Medical Necessity is a clinical document signed by a licensed physician based on the information you provide. We do not guarantee that any given LMN will be accepted by your specific HSA/FSA plan administrator — plans have varying levels of strictness. The refund-if-denied guarantee covers you against that variance. Avows is a tool company; the physician partnership is operated under standard telehealth licensing.
About Avows: The HSA/FSA receipt vault that runs in your browser — yours forever, private by design. We built this concierge service because the in-app "email your doctor" template doesn't help if you don't have a doctor. Avows main site →