Letter of Medical Necessity


download letter of medical necessity for normalyte

Some patients with dysautonomia use oral rehydration salts (or ORS) to manage their symptoms.  Increased salt and fluid intake will assist in maintaining increased blood volume and blood pressure.  NormaLyte, an electrolyte powder, comes in several flavors (grape, orange, and green apple) and an unflavored version called "Pure".  Pure was created in partnership with Dysautonomia International. 

We are aware that patients may use NormaLyte to manage dysautonomia conditions like POTS.  We are also aware that products like this can be costly when using as prescribed (which is often 2-3 sticks a day).

Use your FSA/HSA

NormaLyte is considered a Medical Food Product approved by the FDA.  As such, you can use a FSA (Flexible Spending Account) or a HSA (Health Savings Account) to purchase and have our product shipped to you.  

Use a Letter of Medical Necessity

If you do not have a FSA/HSA with your health insurance then consider asking your doctor to fill out a letter of medical necessity.  This letter is a legal document that can be sent to your insurance provider to verify that the items you are purchasing are for the diagnosis, treatment, or prevention of a medical condition.  This will tell your insurance company that they should cover the cost of this item.  Be sure to have a copy in your patient files, and that you save a copy for yourself.

NormaLyte's Letter of Medical Necessity

We have created a template of such a letter for your doctor.  You can download NormaLyte's Letter of Medical Necessity here.  Be sure your doctor prints on their letterhead and changes the information written in red.