Most families can pay for home care through their HSA or FSA — they just don’t know it. A physician’s Letter of Medical Necessity is what unlocks it. ComfortCard generates that letter, stores it in a digital wallet, and routes your care expenses to the right account automatically.
Or see a real member card first — no signup: Dorothy’s demo card →
The $936 figure assumes 12 months of co-op.care membership plus approximately 6 companion care hours/month, all routed through HSA at a 30% tax rate. Families using more care hours save proportionally more. The LMN (Letter of Medical Necessity) signed by a licensed physician is what makes both the membership and qualified care hours HSA/FSA-eligible under IRS section 213(d). Each plan administrator makes the final determination; this is not tax advice.
Tap where you think each everyday expense belongs. Some are HSA/FSA-eligible outright, some only become eligible with a physician’s Letter of Medical Necessity, and some never qualify. We’ll tell you the honest answer and tally the pre-tax dollars as you go.
Educational and general. Eligibility is always plan- and case-specific and decided by your plan administrator; an LMN is issued by a licensed physician only when clinically appropriate. Savings estimates assume a 30% tax rate and that the expense is approved. Not tax advice.
The front of the card is a QR anyone trusted can scan — ER physician, arriving caregiver, pharmacist, family member in another state. The back is a digital record of what matters: medications, allergies, advance directive, emergency contacts, HSA balance, care plan.
One card your family carries. One record that travels to every care setting.
Most families have HSA or FSA money sitting in an account they barely touch. Half of what they want to spend it on needs a physician’s note. The LMN changes that.
The ER physician scans the QR on his ComfortCard. They see his medication list, his anticoagulant, his allergies, his proxy contact, his advance directive — in ten seconds, before you even pick up the phone.
Most families have HSA funds sitting untouched because the things they need (therapeutic massage for chronic pain, mobility aids, certain therapies) require a doctor’s note. The card knows what’s eligible. The AI drafts the letter. A physician signs. The reimbursement clears in days.
A voice conversation paced over Sunday afternoons — hard questions, in plain English. A real physician signs the directive. No $500 attorney’s office. The signed document lives in the card, accessible via QR at any care setting.
Your mom’s prescription auto-routes through her wallet. The pharmacist sees what’s covered, what’s HSA-eligible, what was refilled, what changed last week. The Sunday-afternoon phone tag disappears. The bill routes to the right bucket.
Your adult kid in Connecticut has wallet access. She sees grandma’s care plan, today’s caregiver, the meds, what changed this week — without flying in. When she calls at six p.m., she already knows what kind of day it’s been.
Values. Preferences. The questions about the last chapter that families don’t know how to start. Voice-first, paced over weeks, not in a hospital corridor at 11 p.m. The conversation is captured. Nobody guesses what your dad would have wanted.
Dorothy Warkentine’s card is live at /card/demo — medications, allergies, emergency contacts, advance directive, care plan. This is what a caregiver, physician, or family member sees when they scan the QR.
The Letter of Medical Necessity is what converts your co-op.care membership from an after-tax expense into a pre-tax health expense. Here’s exactly how it works.
You answer a short intake through Sage, our care AI. It builds a picture of your family’s care situation — the person who needs care, their current needs, and your home situation.
A licensed physician reviews the AI-drafted assessment and signs a Letter of Medical Necessity if your situation qualifies. The LMN establishes that companion care is medically appropriate for your family under IRS 213(d).
The LMN is on file. co-op.care membership fees are now HSA/FSA-eligible. Pay with your existing HSA card or get reimbursed from FSA. Your ComfortCard wallet tracks it automatically — no forms, no guessing.
The IRS allows HSA and FSA funds to pay for medical care expenses under section 213(d). Home care qualifies — but only when a licensed physician documents that it’s medically appropriate for your specific situation. That documentation is a Letter of Medical Necessity.
Here’s how it works in practice: you complete a free care assessment through Sage. A licensed physician reviews your situation — not a template, but your actual care needs. If it qualifies, the physician writes and signs a letter stating that companion care is medically appropriate for your family. That letter is your authorization to pay for care with pre-tax dollars. It lives in your ComfortCard wallet, ready to show your HSA administrator.
A Boulder family pays $59/month for co-op.care membership and $780/month for 20 caregiver hours. After the LMN, their care expenses are HSA-eligible. At a 30% tax rate, that’s $252 back every month — or $3,024 per year in pre-tax savings. The membership that seemed like $59/month effectively costs $41/month. The care that cost $780 effectively costs $546. The LMN pays for itself in the first week.
The LMN is drafted by AI from your Sage assessment, reviewed by a licensed physician, and signed before it reaches you. Physicians are on fixed retainer arrangements — not paid per-letter — so the incentive is clinical accuracy, not volume.
LMN is drafted from your Sage context and care situation. Not a template — a real first pass tailored to your family.
Clinical logic verified. Obvious misreads flagged. The draft is queued for physician review only if it clears.
Outlier patterns, duplicate requests, and suspicious flows are held back from the physician queue entirely.
Each review requires real time-on-page metrics before a signature can be written. No rubber-stamping. No per-letter incentives.
Physician compensation follows the Personal Services Safe Harbor (42 CFR §1001.952(d)): written agreements, FMV compensation, no volume- or value-based tie. Physician signatures are earned by clinical review time, not triggered by member demand. We’d rather decline a request than write something that won’t hold up.
ComfortCard is the digital wallet and identity layer built into your co-op.care membership. Actual caregiver hours are priced separately — real human time deserves real human pay.
No service can promise that. Each plan administrator makes the final determination based on IRS rules, your plan document, and the documentation provided. A physician-signed LMN in IRS 213(d) format gives you the strongest evidence to submit. If a physician review finds an LMN is not appropriate for your situation, we’ll tell you why — we’d rather decline than write something that won’t hold up.
Physicians are on fixed retainer agreements, not paid per-letter. AI drafts the LMN from your Sage assessment, runs clinical sanity and fraud checks, then queues it for physician review. Each review requires real time-on-page metrics before a signature can be written. The arrangement follows the Personal Services Safe Harbor (42 CFR §1001.952(d)): written agreements, FMV compensation, no volume- or value-based tie.
Medications and dosages, allergies, blood type, emergency contacts, healthcare proxy designation, advance directive status, MOST form (Colorado), current care plan, and a link to your HSA/FSA wallet. Everything a stranger trusted to help you would need to know. Accessible via the QR code to anyone you’ve granted access, with different permission levels for different people.
The digital card, Sage AI, LMN generation, and advance directive conversations are available nationally. The physician network operates via 50-state telehealth licensure. Home care delivery through co-op.care is currently available in Boulder, CO; additional geographies based on member density.
Never. Business model is subscription plus explicit-consent attestation. We don’t sell your inputs, your care graph, or your identity to advertisers, data brokers, pharmaceutical companies, or model trainers. Zero invisible data pipes.
ComfortCard is the membership layer for co-op.care, a Colorado Limited Cooperative Association. Members hold patron-member shares carrying governance rights (one member, one vote) and the right to patronage dividends if the cooperative generates surplus. Caregivers are also member-owners in their own voting class. This is Colorado cooperative law, not a metaphor — and it’s why caregiver turnover in cooperatives runs at 14% versus the industry’s 77%.
ComfortCard is the digital wallet and identity layer. co-op.care is where the real-world care happens — the worker-owned caregiver network, the home care hours, the companion care coordination. Membership in one is membership in the other. If you’re looking to start care today, go to co-op.care directly.
ComfortCard is the membership. co-op.care is where care happens. If you’re looking to coordinate care, match with a caregiver, or start an assessment today — that’s at co-op.care.
Leave your email and we’ll send you the link to start a free care assessment — the step that determines whether your family qualifies for an LMN and what expenses it covers.
Or go directly: Start free assessment →