Could I be eligible for FSA/HSA reimbursement for my Simple Life App subscription?

Overview

If you’re in the US, you may be able to use your Flexible Spending Account (FSA) or Health Savings Account (HSA) funds to cover your Simple Life App subscription, so long as your doctor determines that weight management through Simple Life is medically necessary to treat, manage, or prevent a health condition.

Simple Life cannot decide eligibility or guarantee reimbursement. Your doctor must confirm medical necessity in writing, and your FSA/HSA provider must approve your claim.

This document provides general information to users to assist them in determining their FSA/HSA eligibility. Nothing mentioned herein shall be construed as medical advice. 

Key takeaways

• You may qualify for reimbursement if your doctor determines weight management through Simple Life is medically necessary.
• Common qualifying conditions include obesity, type 2 diabetes, high blood pressure, and other obesity-related conditions — or preventive risk factors like family history.
• Your doctor must complete and sign a Letter of Medical Necessity.
• Your FSA/HSA provider makes the final decision on reimbursement.

When Simple Life may qualify

Doctors may determine that a structured, digital weight management program like Simple Life is medically necessary for patients with:

• Obesity or overweight (including those at risk of developing obesity-related conditions)
• Type 2 diabetes or prediabetes
• High blood pressure (hypertension)
• High cholesterol or hyperlipidemia
• Metabolic syndrome
• Osteoarthritis or joint pain linked to weight
• Polycystic ovary syndrome (PCOS)
• Obstructive sleep apnea
• Low back pain associated with excess weight

Your doctor could also recommend Simple Life as a preventive measure if you have:

• A family history of obesity, diabetes, or heart disease
• Prediabetes, impaired fasting glucose, or other early risk markers
• Overweight status with risk factors for chronic disease

In preventive cases, the doctor’s rationale typically connects your current risk factors, like your family history, elevated BMI, or early lab changes (e.g. increases in your A1c, cholesterol levels, or blood pressure) with the goal of preventing a future diagnosis.

Who decides eligibility?

• Your doctor determines whether weight management through Simple Life is medically necessary and provides a signed Letter of Medical Necessity (we have a ready-to-use template).
• Your FSA or HSA provider decides whether that documentation meets their plan requirements and either approves or denies your reimbursement claim.

Simple Life can provide guidance and templates, but cannot make medical or reimbursement determinations.

Some example clinical conditions and rationale (for reference purposes only) 

Condition	ICD-10 Code	Typical medical rationale
Obesity (unspecified)	E66.9	Structured weight management through Simple Life is medically necessary to achieve clinically significant weight loss and reduce obesity-related risks such as cardiovascular disease, type 2 diabetes, and metabolic dysfunction.
Overweight	E66.3	Weight reduction through a structured lifestyle program is medically necessary to prevent progression to obesity and mitigate elevated risk of diabetes and heart disease.
Type 2 diabetes	E11.9	A structured lifestyle program supporting weight loss and improved dietary habits is medically necessary to enhance glycemic control and reduce insulin resistance.
Prediabetes	R73.03	Weight management and improved nutrition are medically necessary to prevent progression to type 2 diabetes.
Hypertension	I10	Weight reduction and improved dietary patterns are medically necessary to lower blood pressure and reduce cardiovascular risk.
Hyperlipidemia	E78.__	Lifestyle modification through structured weight management is medically necessary to lower LDL cholesterol and triglycerides and improve overall lipid profile.
Metabolic syndrome	E88.81	Weight management and behaviour change support are medically necessary to address multiple metabolic risk factors and improve insulin sensitivity.
Polycystic ovary syndrome (PCOS)	E28.2	Weight reduction through lifestyle change is medically necessary to restore hormonal balance and improve metabolic and reproductive outcomes.
Osteoarthritis	M19.90	Weight loss is medically necessary to reduce joint stress, pain, and inflammation in weight-bearing joints.
Family history of diabetes	Z83.3	Preventive weight management is medically necessary to mitigate elevated hereditary risk of developing type 2 diabetes.
Family history of heart disease	Z82.49	Structured weight management is medically necessary to reduce inherited cardiovascular risk and prevent onset of obesity-related complications.

What to include in the Letter of Medical Necessity

The medical rationale section is the most important part of your doctor’s letter. It should:

• Clearly state your diagnosis or risk factor(s)
• Explain why weight management through Simple Life is recommended for your condition or prevention plan
• Outline expected health benefits, such as improved blood pressure, glucose control, or reduced joint stress

For example:

“Participation in a structured weight management program through the Simple Life App is medically necessary to support weight reduction and improve glycemic control in a patient with prediabetes and a family history of type 2 diabetes.”