Two documents that change what your dollars and decisions do.
Done in minutes, by the cooperative's agents, attested by a real physician — the Letter of Medical Necessity that unlocks HSA/FSA dollars, and the wishes capture that becomes the first page of your CareGoals advance plan.
The Letter of Medical Necessity — and what it actually unlocks.
An LMN is a one-page document from a licensed physician naming a diagnosis or condition and certifying that a specific item or service is medically necessary for the treatment of that condition. Under IRS §213(d), an LMN can make many expenses HSA- or FSA-eligible that wouldn't otherwise be — turning a post-tax expense into a pre-tax one. For most families that's a real 22–32% savings on the cost of care they're already paying for.
From your situation, the diagnosis context, the specific expenses you're considering. Takes about a minute. No paperwork on your end.
A licensed physician — the cooperative's Medical Director — reviews the draft, edits if needed, and attests. Real signature, real NPI, real attestation chain.
The card pays the eligible expenses; the savings are real and immediate. Most members use this for companion care, respite, home modifications, eligible wellness items, and qualifying supplements.
An LMN does not change tax law; it certifies that a specific item meets the IRS §213(d) standard for medical necessity. Whether a given expense qualifies is ultimately the IRS's call, and case law in the wellness space is unsettled. We never recommend filing for items the cooperative's Medical Director is not willing to attest in writing. HSA/FSA eligibility via LMN is a real and widely-used mechanism, not a tax shelter. If you're audited, you produce the LMN.
The wishes capture — five small prompts that become a real document.
The most useful thing we can capture, in the calmest moment, is what matters to the person at the center — at the end, in pain or not, at home or not, who's there, who decides. Five small prompts, five minutes, on your timeline. The result becomes the first page of your CareGoals advance care plan — a document your family and your clinician can actually use when the moment matters.
Plain language, on your pace. Skip any you're not ready for. Save and return.
The cooperative's structural commitment: a neutral values fiduciary holds your end-of-life wishes — not your insurer (who has a conflict), not the cooperative as platform (which doesn't deserve them), not a database (which can't hold them).
On your timeline. The directives agent drafts; you and the people you love revise; the doula attests. The result is a real document — not a checkbox.
An advance directive document drafted by an AI does not, by itself, become a legally binding instrument. State-specific execution (notary, witnesses, registration) is required to make it enforceable, and we walk you through it. The CareGoals capture is the substance; the legal wrapper is the formality. Both are real; both matter.
The two documents are the same act, at different ends of life.
The LMN unlocks today's care: the money you were already going to spend, made pre-tax, returned to your kitchen. The wishes capture prepares the day decades from now: what matters most to the person you love, when they cannot speak for themselves. Both are produced by informed agents, attested by humans you trust, held by entities that work for you. Both are what the cooperative does for you, in concrete document form.
Both documents come with membership.
The LMN, the wishes capture, the agents who draft them, the humans who attest them — all are part of becoming a member-owner of the family co-op.
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