{"product_id":"hsa-fsa-eligibility-application","title":"HSA\/FSA Eligibility Application","description":"\u003cp data-start=\"216\" data-end=\"403\"\u003eThis application fee provides access to a third-party medical eligibility review through our chosen platform to determine whether an EMPULSE services or Burn training protocol may qualify for HSA\/FSA reimbursement.\u003c\/p\u003e\n\u003cp data-start=\"405\" data-end=\"569\"\u003eAfter checkout, you will receive a secure link to complete a confidential health intake. A licensed provider will review your information and determine eligibility.\u003c\/p\u003e\n\u003cp data-start=\"571\" data-end=\"584\"\u003eHow it works:\u003c\/p\u003e\n\u003col data-start=\"586\" data-end=\"933\"\u003e\n\u003cli data-start=\"586\" data-end=\"616\"\u003e\n\u003cp data-start=\"589\" data-end=\"616\"\u003ePurchase this application\u003c\/p\u003e\n\u003c\/li\u003e\n\u003cli data-start=\"617\" data-end=\"688\"\u003e\n\u003cp data-start=\"620\" data-end=\"688\"\u003eComplete the medical intake using the link provided after checkout\u003c\/p\u003e\n\u003c\/li\u003e\n\u003cli data-start=\"689\" data-end=\"774\"\u003e\n\u003cp data-start=\"692\" data-end=\"774\"\u003eA licensed provider reviews your information (typically within one business day)\u003c\/p\u003e\n\u003c\/li\u003e\n\u003cli data-start=\"775\" data-end=\"845\"\u003e\n\u003cp data-start=\"778\" data-end=\"845\"\u003eIf approved, you will receive a Letter of Medical Necessity (LMN)\u003c\/p\u003e\n\u003c\/li\u003e\n\u003cli data-start=\"846\" data-end=\"933\"\u003e\n\u003cp data-start=\"849\" data-end=\"933\"\u003eOnce approved, you may purchase Burn services and submit for HSA\/FSA reimbursement\u003c\/p\u003e\n\u003c\/li\u003e\n\u003c\/ol\u003e\n\u003cp data-start=\"935\" data-end=\"957\"\u003eImportant information:\u003c\/p\u003e\n\u003cp data-start=\"959\" data-end=\"1291\"\u003eThis application does not guarantee approval.\u003cbr data-start=\"1004\" data-end=\"1007\"\u003eThis is not a purchase of training sessions, memberships, or services.\u003cbr data-start=\"1077\" data-end=\"1080\"\u003eEmpulse and Burn do not provide medical advice or determine eligibility.\u003cbr data-start=\"1142\" data-end=\"1145\"\u003eAll eligibility decisions are made by a licensed provider through the platform.\u003cbr data-start=\"1219\" data-end=\"1222\"\u003eThe application fee is non-refundable regardless of approval outcome.\u003c\/p\u003e\n\u003cp data-start=\"1293\" data-end=\"1402\"\u003eIf you are not approved, you may still choose to purchase Burn services as an out-of-pocket wellness program.\u003c\/p\u003e\n\u003cp data-start=\"1404\" data-end=\"1430\"\u003eWhy this step comes first:\u003c\/p\u003e\n\u003cp data-start=\"1432\" data-end=\"1609\"\u003eMany HSA\/FSA administrators require medical eligibility to be established before services are purchased. Completing this screening first helps prevent non-reimbursable expenses.\u003c\/p\u003e\n\u003cp data-start=\"1611\" data-end=\"1639\"\u003eWhat happens after approval:\u003c\/p\u003e\n\u003cp data-start=\"1641\" data-end=\"1808\"\u003eIf approved, you will be cleared to purchase Empulse and Burn services and may submit your receipt and Letter of Medical Necessity to your HSA\/FSA administrator for reimbursement.\u003c\/p\u003e","brand":"EMPULSE","offers":[{"title":"Default Title","offer_id":47749264113905,"sku":null,"price":20.0,"currency_code":"USD","in_stock":true}],"thumbnail_url":"\/\/cdn.shopify.com\/s\/files\/1\/0715\/1724\/1585\/files\/Screenshot2026-01-29at6.12.35PM.png?v=1769728372","url":"https:\/\/www.getempulsive.com\/products\/hsa-fsa-eligibility-application","provider":"EMPULSE","version":"1.0","type":"link"}