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Letter of Medical Necessity

Health insurance organizations may not routinely cover some treatments for hyperhidrosis. They may require documentation of medical necessity when particular treatments are prescribed before deciding to pay for these treatments. Physicians can download and adapt the following Sample Letter of Medical Necessity for their own use when providing documentation of your need for a particular therapy.

Sample Letter of Medical Necessity for Hyperhidrosis Treatment

[date]
[insurer name]
Attn: [name of individual]
[address]

re: [patient name]
[policy number]

Dear [insurer name]:

I am writing on behalf of [patient name] to document the medical necessity of [insert
treatment option here] for the treatment of hyperhidrosis. This letter provides information
about the patient’s medical history and diagnosis and a statement summarizing my
treatment rationale.

Hyperhidrosis, or excessive sweating, can have a devastating effect on a patient’s quality
of life, causing physical discomfort, social embarrassment, and disruption of
occupational and daily activities. This has certainly been true for [patient name], who
has been impacted by hyperhidrosis for [insert duration of symptoms here]. Specifically,
[he or she] has had difficulties with [insert quality-of-life problems here].

[discuss patient’s diagnosis, treatment history, and degree of illness]

Experts recommend a stepped approach to choosing therapy for hyperhidrosis. More-
conservative therapies have not controlled [patient name]’s symptoms, and therefore
[insert treatment option here] is the next logical choice for treating [his or her]
hyperhidrosis.

In light of this clinical information, and this patient’s condition, [insert treatment option
here] is medically necessary and warrants coverage. Please contact me at [(000) 000-
0000] if you require additional information.

Sincerely,
[physician’s name]


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