How to get your itemized receipt and letter of medical necessity for HSA/FSA reimbursement

Last updated: October 27, 2025

When you purchase eligible products using Flex's HSA/FSA payment option, we automatically send you two important documents for reimbursement: an itemized receipt and a letter of medical necessity. These emails come from notifications@withflex.com.

If you can't find your documents

If you didn't receive these documents or can't locate them, here are the most common reasons and solutions:

Check your spam folder

Our emails sometimes get filtered into spam folders, especially by email providers like AOL, iCloud, and Yahoo. Be sure to check your junk/spam folder for emails from notifications@withflex.com.

Wrong email address

If you entered an incorrect email address during checkout, you won't receive the documents. Common issues include:

  • Typos in your email address

  • Using Apple's private relay email system

  • Using a different email than expected

If this happened, contact our support team at support@withflex.com with your correct email address, and we can help locate your order and resend the documents.

You didn't use Flex checkout

If you simply entered your HSA/FSA card information during regular checkout without selecting "Flex | Pay with HSA/FSA" and completing our medical consultation, we won't have a record of your transaction and cannot provide documentation.

Requesting documents to be resent

If you need your documents resent, contact us at support@withflex.com and include:

  • Your name

  • The email address used during checkout

  • Your order number (if available)

We can quickly reissue both documents to your email address.

Email address corrections

If you need documents sent to a different email address than what was used during checkout, we'll need to verify your identity first. Please provide a copy of your valid ID (driver's license works) before we can update your email and send the documents to a new address.

Auto-substantiated products

Some products are marked as "auto-substantiated" by the IRS, meaning they don't require a letter of medical necessity. For these items, you'll only receive an itemized receipt, as no additional medical documentation is needed for HSA/FSA reimbursement.

What documents you'll receive

For HSA/FSA reimbursement, we recommend submitting both documents to cover all bases:

  • Itemized receipt: Shows the purchase details and amount

  • Letter of medical necessity: Provides medical justification for the purchase

Your HSA/FSA administrator may not require both documents, but having them ensures you're fully covered for reimbursement.