Dr. B Letter of Medical Necessity vs Burst: Which to Use
Dr. B's $19 consultation gets you a fitness letter, then the claim is yours. Burst is $35 for everything, within 24 hours or 2 expedited, filed for you.
5 minute read
Short answer
Dr. B charges $19 for an online consultation, per their page. If you qualify, a licensed provider emails you a Letter of Medical Necessity. It covers fitness expenses like gym memberships, classes, and personal training, plus nutrition counseling and massage. That's the lowest published price we've found for a letter alone in those categories. After the letter, you're on your own. Dr. B's page doesn't say it files your claim. Their guidance is that you submit the letter and receipt to your administrator yourself. Nothing on their pages describes an appeal or a refund if the claim is denied.
Burst is $35 once for everything, and $0 if you don't get paid back. Add the claim, the appeal, and the $19 you lose if your plan says no, and it costs you less than a $19 letter. It's the only all-in-one option. No letter, no charge. Claim denied, money back.
Here's what you get with Burst:
Shop anywhere and pay the way you already pay.
A clinician-reviewed letter within 24 hours, or within 2 hours with expedited review.
Burst files the claim.
The money comes back to your bank account.
If the claim is denied, Burst writes the appeal and refunds you.
$35 once. On a gym membership or any monthly charge, the same letter covers the whole year.
Say you pay $60 a month for a gym, so $720 a year. Money in your FSA or HSA was never taxed, so paying from there instead of your checking account keeps about $216 that would have gone to taxes. The letter is $35 once. You come out about $180 ahead this year, and the same letter covers every payment after it. The exact figure depends on your tax bracket. Spend more than about $120 a year on anything eligible and the letter pays for itself.
Dr. B vs Burst, side by side
What matters | Burst | Dr. B |
|---|---|---|
What you get | The letter, the claim filed, the appeal, the refund | The letter, after a $19 online consultation |
What it covers | Any product or service: gym, trainer, massage, equipment, wearables, supplements, a mattress, whatever you're buying | Fitness, nutrition counseling, and massage, per their page |
Price | $35 once, everything included | $19 consultation, per their page |
Who files the claim | Burst files it for you | You |
If your plan pushes back | Burst writes the appeal | Not described on their pages |
If the claim is denied | Send Burst the denial and your $35 comes back | No refund described on their pages |
How fast | Within 24 hours, or within 2 hours on expedited review ($10 more, weekdays 8am to 8pm ET) | Same day in many cases, per their page |
Monthly charges like gym dues | Covered under the same letter for 12 months | Covered for the period the letter states |
Sources, read November 3, 2026: Dr. B on letters of medical necessity. Burst's facts are from this site and the request page.
What your $35 covers
Everything, not just a PDF
Dr. B's $19 is one document. Burst's $35 pays for the letter, the claim filed with your plan in the format they want, the answers when they ask questions, the appeal if they say no, and a refund if the appeal fails. It also includes the Burst Shopping Assistant, which shows you what's eligible and how much you'll get back while you shop, and an account that finds eligible purchases you've already made. Dr. B sells the letter.
It pays for itself
A $19 letter looks cheaper. Then you file the claim, answer the questions, and write the appeal. If your plan says no, the $19 is gone. Burst's $35 covers all of that. If you don't get a letter, you're refunded on its own. If the claim is denied, send Burst the denial and your $35 comes back.
A decision within 24 hours, and your claim gets filed
It takes about two minutes to request. A licensed clinician decides within 24 hours. Expedited review is $10 more and gets you a decision within 2 hours, weekdays 8am to 8pm ET. Both fees are refunded if the letter isn't approved. Once you have your receipt, Burst files the claim. Dr. B stops at the letter.
The only all-in-one platform
Burst is the only all-in-one option. Connect your FSA/HSA account once. The Shopping Assistant works across hundreds of brands. Every claim is filed for you. Every pushback gets an appeal. At brands Burst already works with, reimbursement is automatic. The same account works for the next thing you buy. Dr. B is a consultation that ends with a PDF in your inbox.
How Dr. B's letter works
Dr. B is an online consultation service. Its HSA/FSA page says it can help qualifying patients get a Letter of Medical Necessity online with a $19 consultation. You start the consultation, answer questions about your health and what you want the letter for, and if you qualify, a licensed provider emails you the letter, same day in many cases. Its list of covered expenses is fitness (classes, personal trainers, gym memberships), massage therapy as rehabilitation, and nutritionist counseling, which has its own $19 consultation. Many gyms and studios send their members to Dr. B for this.
What Dr. B leaves to you
Filing the claim
The letter arrives by email. Dr. B's page doesn't describe filing on your behalf. Their general guidance is that when a card isn't accepted, you submit the receipt to your HSA administrator. So the receipt, the letter, the dates, and the administrator's form are yours to get right. Burst files the claim for you, included in the $35. You can file it yourself if you'd rather, but most people let Burst do it because Burst files faster, with fewer mistakes, in the format your administrator wants.
Questions and appeals
Administrators ask for more information, and sometimes they say no the first time. Nothing on Dr. B's pages says what happens then, and nothing says they'll write the appeal for you. Burst writes the appeal for you, every time.
A denied claim
If your plan denies the claim after you paid Dr. B, nothing on their page says you get the $19 back. With Burst, send in the denial and your $35 comes back. If the clinician decides a letter isn't appropriate for you, you aren't charged at all.
What Dr. B's letter doesn't cover
Dr. B's HSA/FSA page covers fitness, nutrition, and massage. If you're buying a mattress, a red light panel, a walking pad, an air purifier, a sauna, supplements, or a wearable, it isn't on that list. Burst's request form takes any product or service. A licensed clinician decides whether a letter is medically supportable for you, and if it isn't, you don't pay.
When Dr. B makes sense
If you only want a letter, your expense is a gym, a class, a trainer, or a massage, and you're fine filing the claim and handling any follow-up yourself, Dr. B's $19 consultation is the lowest published price for that letter. Add the filing, the appeal, and the $19 you lose if the plan says no, and Burst's $35 costs you less. It's filed for you, and it works for anything you buy, not just fitness.
Frequently asked questions
How much is a Dr. B letter of medical necessity?
Dr. B's page lists a $19 consultation for the fitness letter. Other visit types are priced separately. Burst is $35 once, with the claim filing and the appeal included, and a refund if the claim is denied.
Does Dr. B file my HSA or FSA claim?
Not that their page describes. You get the letter by email and submit it with your receipt to your administrator yourself. Burst files the claim for you.
Can I use a Dr. B letter for my gym membership?
Yes, gym memberships are on Dr. B's list. Keep paying the gym the way you already do. Payments before the letter's date can't be claimed, so request the letter now. With Burst, every monthly charge from that date forward is covered under the same letter for 12 months, and Burst files each claim.
Can Dr. B or Burst write a letter for something I already bought?
No. IRS rules require the letter to be dated on or before the purchase it covers. That applies to every provider. Get the letter first, then buy.
Do I need my own doctor?
No. A licensed clinician in the Burst network reviews your information. You don't need an existing doctor, an appointment, or a copay.
Which is better, Dr. B or Burst?
Dr. B if you want the lowest-priced letter for a fitness expense and you'll file the claim yourself, with no appeal help and no refund if the plan says no. Burst if you want all of it done for $35 once, $0 if it fails, for anything you buy. See the best online LMN providers, compared.
Get the letter first, then buy. We handle the rest.
$35 once, about two minutes, and a licensed clinician signs your Letter of Medical Necessity within 24 hours if approved, or within 2 hours with expedited review. Then buy from any store with any card, and Burst files the reimbursement claim for you, start to finish; your administrator pays the reimbursement out of your account to you. If your administrator pushes back, we write the appeal. 20,000+ letters issued. Works with every FSA/HSA administrator.
No letter, no charge. Claim denied, money back.
More for shoppers: Can You Use Your HSA or FSA for a Gym Membership?, Is Truemed legit?, and How to Get a Letter of Medical Necessity Online.
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