Is Levels CGM (Continuous Glucose Monitor) FSA/HSA Eligible?

LETTER OF MEDICAL NECESSITY Date: [DATE] To Whom It May Concern, I am writing to certify that Levels CGM (Continuous Glucose Monitor) is medically necessary for my patient: Patient Name: [PATIENT NAME] Date of Birth: [DOB] Diagnosis: [ICD-10 CODE AND DESCRIPTION] Medical Justification: Without diabetes diagnosis, requires documentation for metabolic health monitoring, pre-diabetes, or weight management treatment plan. With diabetes - often covered without LOMN. I have prescribed this item as part of the patient's treatment plan, and it is not for general health or cosmetic purposes. If you have any questions, please contact my office. Sincerely, [PHYSICIAN SIGNATURE] [PHYSICIAN NAME, MD] [PRACTICE NAME] [NPI NUMBER] [PHONE NUMBER]