Letter Of Medical Necessity Health Care Flexible: Fill & Download for Free

In all cases - No.In some cases - Yes.Applicability is not clear from vague wording of the question without listing doctor-described medical necessity.HSAstore.com | The One-Stop-Shop for Health Savings AccountsCord blood storage is sometimes eligible with a Letter of Medical Necessity (LMN) from a physician if it is to treat an existing or imminently probable disease with a flexible spending account (FSA), health savings account (HSA) or a health reimbursement arrangement (HRA).Cord blood storage reimbursement is not eligible with a limited care flexible spending account (LCFSA) or a dependent care flexible spending account (DCFSA).

A letter of medical necessity can help you reach the maximum amount of your flexible spending account. The vitamins must be ordered to treat a specific deficiency. Analgesics also need to be used to treat a specific ailment.Eligible Health care expenses - Individuals

*bouncy, bouncy* I'd try to answer this without any credits at all being applied, because it's an interesting question.I apologize for the novel I'm about to write, because I'm sure it's going to be too long.There are several related issues here, which I'll try to sketch, and then talk about their interactions and what I think are good potential solutions for multiple expressions of ASD.The first issue is the obvious issue: how do we conceptualize autism? The question points out multiple personal conceptualizations, but I mean this in the medical or psychological sense. In order to define services, a diagnosis, prognosis, and to track autism, we have to have a model for understanding it. Much of the current debate over autism that I've been reading has had to do with how a medical model is to be applied to autism.Early models conceptualized autism as a form of mental retardation (sorry for the phrase) or some sort of pervasive lack of mental capabilities that expressed itself as impediments to social, occupational or personal functioning in ways that prevented the person from ever being able to perform self-care. This meant that people who displayed what we now think of as developmental delays or social adjustment difficulties were considered to be unfit to have an opinion on their own care. Some were institutionalized, or permanently given to some sort of caretaking agency or caretaker.Autism, as a diagnostic category in the US, appeared in the first DSM (1952), under the heading schizophrenic reaction, childhood type. The diagnostic category itself was known at that point, but the behaviors were thought to be manifestations of psychosis, and not differentiated from any other psychotic disorder (the category schizophrenia itself was quite broad in the DSM I.) The DSM II (1968) also contained autism as a form of childhood schizophrenia, and the diagnostic category classified it as the failure to develop an identity separate from the mother, and noted that it may result in mental retardation.It was not until 1980 that autism became its own diagnosis, with the DSM III and the category "infantile autism." It was explicitly distinguished from schizophrenia by a lack of delusions, hallucinations, loosening of associations, and incoherence, but was categorized by a lack of responsiveness to other people, and it was noted that speech may not be present and the child may be abnormally attracted to inanimate objects.The revised DSM III (1987) contained a general diagnostic category for autism that could be applied to adults, and is the first time "autistic disorder" appears as a general category in the DSM. The diagnostic category of includes the following diagnostic characteristics, which have since disappeared from the DSM:No or abnormal seeking of comfort at times of distress (for example, does not come for comfort even when ill, hurt or tired; seeks comfort in a stereotyped way, for example, says "cheese, cheese, cheese" whenever hurt);No mode of communication, such as: communicative babbling, facial expression, gesture, mime, or spoken language;The last, in particular, is very important--communication and the lack of verbosity has been the lynchpin on which the autism diagnosis has changed, and is the lynchpin on which the conversation about autism has to happen.(I note to my own wry amusement that the first was true of me and I was around in 1987 to be diagnosed; when I was a child, I got my hand stuck in an automatic door at the supermarket and rather than cry, I bit through the skin on my lower lip, puncturing it entirely with my teeth.)As anyone reading this no doubt knows, it is the ability to communicate from which intelligence is inferred, and the ability to take part in one's own care is inferred on intelligence. Facilitated communication did not get its start until the genesis of computing technologies, on which such things are very reliant. It was only with facilitated communication that it was made clear that a lack of verbosity means nothing for intelligence. Or, to be even more clear, once the means for letting non-verbal people with ASD communicate, it became clear that there were a fair number of what we would view as intelligent people in the category of non-verbal autistic people, which meant that the policy of warehousing non-verbal autistic people and ignoring their attempts to communicate or participate in their care was a bit of a human rights violation by the terms of the way we constitute rights (eg the ability to have input in the way one is treated or cared for.)The widening of the diagnostic category to people who can communicate did several things for the incidence of autism and how autism is conceptualized:First, and most importantly, it put an end to the idea that an autism diagnosis signaled the complete inability to engage in self-care, which meant that autistic persons could and should be offered the opportunity to have input in their own care. I should note here that if a diagnosis is categorized as leading to the inability to do so, the state has an interest in their care, and I'll talk about the political ramifications of that in the next section.Second, it allowed autism to be applied to populations previously ignored by clinicians looking at the diagnosis (hi thar.) Much as been made of the explosion of prevalence over the last few years, to which my self-interested response is "yeah, it's amazing how many people you can find with a problem when you actually look."Third, it allowed self-advocates or advocates suffering from the disorder to advocate for others in the population of autistic persons. This is incredibly important for a variety of reasons having to do with the organization of our political system and the way we view the role of medicine, and because it allowed things like pointing out the high rates of abuse perpetuated against people judged to have intellectual disabilities, as well as a robust critique of the problems with the current treatment models. To be absolutely crude, I got yer robust critique right here, therapeutic establishment. I GOT IT FOR DAYS.And finally, it allowed the current war over whether autism is seen as an abnormality (in the sense that normality is seen as a goal and a benchmark for functioning that one has an obligation to reach) or simply a fundamental difference in functioning (which may preclude reaching normalized benchmarks.) I'm a fan of the second.Causation becomes an issue here for a variety of reasons that have to do with how autism is conceptualized, the degree to which advocacy and treatment involvement can occur, and the degree to which persons with the diagnosis can get or seek accommodation.I've been active in questions on autism with a biological model for causation for a variety of reasons I've already discussed (the degree to which people with autism experience social pressure for non-conformity, the degree to which autism is treated as a moral or ethical deficit, the degree to which autism is conceptualized as a condition that makes people dangerous, etc). The other reason has to do with conceptualizing autistic persons as potentially cognizant enough to participate in their own welfare. If the cause is biological and the ability to participate is distributed among verbose and non-verbose persons with the diagnosis, the metric for cognizant enough to participate in choices can be individually applied.Or, to put it another way, it matters how autism expresses in the person, and it's not their (moral/ethical) fault that it does, nor is it their parents' fault (in the sense that there's no action they took that caused the autism--early diagnostic models faulted the mother for not bonding correctly). For the restrictions imposed by a biological paradigm (and there are definitely restrictions), the biological model offers a more clear path forward and less obsession with the moral or ethical character of the person (or, more importantly, assumptions about it.)However, autism as a diagnosis right now has some issues, since the biological model should offer stability in the expression of symptoms and what that means, and cannot do so without fracturing the diagnosis.Many people, myself included, are troubled by the implications of that fracture. I've discussed problems with the metrics before, and I'll summarize here: IQ tests don't do a good job of capture for autistic populations, functioning is not reliant on IQ, functioning summaries give the impression that anyone fitting a category has a full compliment of competencies necessary to be "normal", the metrics assume normalcy is a goal and possible, and further divide based on the assumption of IQ.As the history of the diagnosis has made clear, those cleavages unnecessarily differentiate between a group of people experiencing similar symptoms by an essentially arbitrary categorization. It is possible to have autism AND something else (and the DSM V notes this), but autism in an of itself is not inherently tied to IQ and neither is functioning definable by IQ score.Which begs the question of how functioning is to be defined--since the standard tests for noting some sort of intellectual or developmental disability aren't a good fit overall for this (and I don't think they are a good fit for measuring IQ, let alone functioning), how do we go about saying something about the differences in the expression of autism?I have a cluster of thoughts on that topic, but first I want to talk about why categorizing is something of a necessity.Medical diagnoses have a political dimension that has to be addressed if we're talking about coming to an understanding of autism. Why? Because we're talking about a population that will need accommodations, and in order to get those accommodations, there has to be a social, legal and political framework that permits those accommodations. (I'll get to people who don't feel they need accommodation, but we have to start with people who do.) There also has to be some protections built into the law for the purposes of enforcement.This is, to a great degree, tied to both the prognosis given on the disorder by experts (who are empowered to make a need-based argument about services and funding for them) and to the political climate. Autism has, for that reason, to be any of the following (and the more, the better):interesting to the polity for whatever reasonhave a good prognosis or a hopeless one (there doesn't appear to be much in the middle in terms of widespread interest and fundraising for disorders, diseases and/or biologically mediated abnormalities)have a clearly distinguishable set of traits (in my opinion, part of the reason various mental disorders get so little attention paid to them is because they're "invisible" and as such people who don't have them or know someone who has them don't have any way to identify or invest themselves in the disorder, or to easily distinguish themselves from people who have the disorder)have a vocal series of advocates or well-connected advocatesAutism, like most other diagnoses, does not get funding, support, political advocacy and/or services without some combination of the above. This effects how autism is diagnosed and discussed in a variety of ways--for strategic reasons, it benefits some parties to discuss autism as if the diagnosis was a horrible life sentence, and others to discuss it as if it is essentially simple quirkiness.Respectively, the first makes the implicit argument that people with the diagnosis desperately need support and that it is a serious disorder that prevents any real participation in one's one life or treatment, and the second makes the implicit argument that the disorder is not ultimately limiting and/or within the normal, if somewhat on the edges of it.This is irrespective of anyone's personal experience of autism, these are just two flavors of the political arguments around autism.Part of the reason I appreciate the latest DSM detangling autism from comorbid conditions like OCD, ADHD, or other kinds of developmental disorders is because it focuses the definition of the disorder on the shared traits between groups of people with autism that expresses differently--it is an attempt to mediate the political arguments around autism (as well as the attempt to be a bit more parsimonious in the way the disorder is defined.)It also allows autism to be both a serious disorder (and helps make the case that support services are necessary) and makes room for persons with the disorder who do not need services because persistent deficits in social functioning covers a lot of ground, from things that can be covered up to things that cannot.Where the personal becomes political is where this question starts--the variety of experiences of autism and the overriding oversimplification of dialog about disability and funding (eg if it's not serious, it's not a funding priority) rightfully make people with the disorder a bit nervous--if the disorder is considered serious enough, it's possible that people with the condition will have less of a say in their own care and/or will be assumed to be incapable of participating in normal life, and the diagnosis makes the situation worse. If the disorder isn't terribly serious, people who need support services risk losing those services.I think, even though the label is a bit whiffy in terms of normal being conceptualized as good, that we're stuck with disorder in terms of a general category for describing autism--not because I think it's always a terrible, awful thing, nor because I think autism is somehow deficient of normal, but because that's how funding is structured. If autism is a disorder, it is a squeaky wheel and may get greased to the benefit of people who need services.I also think we're stuck with it because of the nature of normalcy and the role psychological services play in enforcing that--when attention is paid to our differences, pretty much the only thing psychological services can do is label them a disorder.In terms of the differences of expression, I think several concessions can or should be made to the diversity of that expression. The good news is they should be very do-able.I think, in light of the differences and comorbidities of autism, that there should be a menu of services that individuals can select, based on their needs, and that the menu should be built around a survey of the way autistic people live. People with the disorder should get to opt out (and considering the stigma associated with it, if they can they should feel welcome to do so), but otherwise should get to select on the menu based on their needs and an interview process. No matter what we do, someone is going to bottleneck the administration of services based on proving need, and so there will need to be some sort of interview process, likely along with letters of testimony from a therapist.I also think (of course, this is in my dreams), that the current state of technology and the obsessiveness of people with ASD makes them a shoo-in for certain flexibilities in the workforce (for instance, those of us with chronic insomnia would benefit from at home work with flexible hours, and a work day adjusted so that tasks have a time limit and do not require a 9-5 presence in the work place.)There are some things very wrong with the way disorders are treated, however, that would have to be dealt with--the current therapies, as they're done, are more about training social behaviors to create the appearance of normalcy and much less about helping people with the disorder handle the stress of trying to appear normal. While I would like it if there were a flexible menu of services and one could opt in or out based on needs, the mental health services offered us are just... awful...I've complained about this in other answers and I'll do it again, here. The assumption that people who are autistic have a baseline normalcy is a part of the pattern I and many others have experienced of assuming intentionality where there isn't any, and malignancy where it does not exist. We essentially need therapists with a very specific brand of training and assumptions about the way autism works. To get there, the assumption of the good of normalcy, our ability to be (not appear, be) normal, and the assumption of baseline similarity in functioning between people with and without the disorder have all got to go.What we need, when we need services, are services that focus on the unique adaptation stresses put on us in our everyday lives. Behavioral training can be a part of this, but it has to be without the assumption that we will somehow intuit the cluster of social reasoning that underlies that social interaction.Frankly, I think it would be good if some of us who are considered higher functioning took up practicing therapy for others of us, since the assumption that we're more or less normal and can be goaded into expressing that normalcy appears to be insidious to people without the disorder.Which brings me to my final point--in all my years of being who I am, I have never come to the point where I felt fundamentally with the crowd. What I can see of the crowd suggests to me that the way I think, reason, feel, know, organize, perceive and react is fundamentally different, if it sometimes has the same results, as people around me. Where I most object to the label disorder, though I acknowledge the political realities that make it necessary, is where it posits a fundamental baseline similarity for everyone.This doesn't mean I don't have moments where I think "ah-ha, okay, I got that one," but it does mean that such moments are the product of considerable effort on my part because they are not, nor will they ever be, "natural" for me--there will always be some context loss.The label disorder makes the assumption that there is an order, it is fundamental, natural, and necessary, and that whatever is disordered is in a fundamentally temporary position relative to what it should be.And maybe this is where loud, obnoxious, social justice warriors for autism come in--the thing itself is not a temporary position relative to where it should be, it is an entirely different life and experience that cannot be made into something it isn't.I have had extraordinary success compared to many people with autism--I can hold a job, I can finish (several) degrees, I can make friends (if not often), I can have relationships with other people (if carefully). If there were such thing as a success story for autism, I'd probably be one (especially considering the complete lack of services and accommodation I received).But no matter how hard I pull at those bootstraps, I will almost always miss something rather fundamental. In all those thousands of hours thinking about human behavior, trying to empathize, trying to understand, actively working to mimic people who don't have autism, or watching movies to learn social cues, or reading books where the thoughts of the characters are revealed to understand the way other people might think, or listening to conversations in public to trace the way they're made, I have never, ever managed to be normal.It's not happening.I have, through painstaking effort, created a public persona with just enough social graces to get through the day without making too much of a mess. At some point, I'll make the mistake of writing non-fiction, or asking the wrong question, or forget a part of the litany of behaviors I practice, and expose someone to my autism and the extraordinary efforts I go through to deal with them.I am fortunate to be able to mask the symptoms, but they will never, ever go away. As I age, they're getting worse--harder to suppress, harder to mask, harder to hide, harder to pretend around.The problem is not my autism, which is essentially neutral in my life. It doesn't make me immoral, unethical, any more likely to commit crime, any more likely to be mean to others, or anything other than awkward and unable to deal with certain kinds of environments.My problem is the way non-normalcy is treated. What I'd most like to see changed about the way autism is understood is this: I don't need to feel any shame about not being normal.All the disgusted, shocked, irritated, surprised or otherwise unpleasant responses in the world will happen to me. I will lose my shit at some point because a routine is broken, or because I can't find something I need, or because I'm at a conference and overstimulated, or because someone has just assumed I'll be totally okay finding a place in a city I've never been to by myself, or that whatever they just gave me for directions will be fine.What I don't need is to be made to feel like less because of it. This is, of course, a fine balancing act--because we're not supposed to be upset in public (because we get upset about things that make no sense to others), I've learned to suppress or delay my freak out. I've learned to try to be pleasant to people, to "understand" when they invade my personal space, or talk very loudly, or just have to have the meetup at a bar and then are an hour or two late.I accommodate other people with an extraordinary investment of time, energy and willpower. To the extent that it's possible, I'd like to see those differences normalized--so that it's not longer shaming to have to avoid the bar, or to be distressed when someone changes my routines too much and I freak out.I'd like autism conceptualized as a difference, not a deficit, that other people have to work with me to accommodate, instead of making the burden mine all the time.I want to make them have to think about me, and not to just be the one thinking about them. And when autism is simply a difference that some people have, I can spend a little less energy accommodating them and start demanding that they accommodate me a bit.I'd like, in essence, for my autism to be considered equivalent to my queerness--both concern a particular way of being that only presents in a small faction of the population, and both are not malignant, not bad, not unnatural, not shameful, but rather simply a part of differences of expression of phenotypes in a population.From listening to people with autism talk, I think many of us would benefit from help coping with the stress of adjustment instead of just being told to keep adjusting--and I wonder how many of us would be better adjusted if we were helped with that stress, instead of accused of being difficult, malignant or deviant.Source material:Diagnostic Criteria for Autistic Disorder through the yearsFacts About ASDs