Most of what you’ll read about paying for care with an HSA is written by someone who needs the answer to be yes. We’ll tell you no — in writing, for free — before you spend anything. When care for a chronically ill person does qualify, a licensed physician documents it properly; when it doesn’t, you get that in writing too, and you keep your money. Everything else your family needs lives here as well — the plan, the documents, the directive, the emergency card — private and yours, where everyone you love can reach it.
Sixty seconds, no signup — you’ll get a “no” on some of it, and that’s the point. Ready instead? Tell us who you’re caring for →
Pick the one closest to you and we’ll show the three steps that matter — free to start, with a licensed physician behind anything medical.
Tap to add a room. Each one is a real service that talks to the others — one identity, one sign-in. Add or drop rooms anytime; nothing is re-entered twice.
The real question is how long your care money lasts — see your runway in ten seconds. The one honest lever that stretches it: care that qualifies is paid pre-tax. Move the two answers below to see what that lever is worth — and we’ll tell you, in writing and for free, when a situation doesn’t qualify.
Surgery on the calendar this year? See the full recovery savings profile — item by item →Prefer it automated? AgenticHSA watches your transactions and flags eligible spending for you — same card, same physician network.
Illustrative only. Companion care priced at $39/hr illustrative; membership $59/mo. These figures assume the person receiving care is chronically ill under IRS §7702B(c) — needing help with two or more daily activities expected to last 90+ days, or living with severe cognitive impairment — that a physician has certified it with a written plan of care, that your plan administrator approves HSA/FSA use, and that expenses are incurred and approved. Membership dues are counted as out of pocket here. Your actual savings depend on your tax bracket, your plan document, and case-specific physician judgment. An LMN is issued only when clinically warranted — not all situations qualify. This is not tax advice.
Tap where you think each everyday expense belongs. Some are HSA/FSA-eligible outright, some qualify only when a physician documents them as medical care, 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.
See what the ER sees →Some of what your family needs — mobility aids, home-safety equipment, care for a diagnosed condition — can be paid with HSA or FSA money when a physician documents it as medical care. The card sorts what qualifies. The AI drafts the letter. A physician signs only when it’s clinically warranted — and you get a written no, for free, when it isn’t. Your plan administrator makes the final call.
Sort what’s eligible →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.
Start the conversation →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.
See the wallet view →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.
Open the family card →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.
Begin a free assessment →Nearly 90% of older adults want to age in their own home. The things that make it possible — a safer home, help during the day, catching a fall before it happens — can qualify as medical care when a physician documents them — and we say no, in writing and for free, when they don't.
Grab bars, a stair rail, brighter halls, a ramp, the rug that has to go. Most home-safety modifications are HSA/FSA-eligible with an LMN — and a fall is the single most common reason people lose their home. Start with a free fall-risk check.
Check the fall risk →A few hours of companion care — meals, a shower, a ride, company — is often the difference between staying home and moving out. Worker-owned, local, and routed to the pre-tax and public dollars you qualify for.
See the care →Who speaks for you, what you’d want, what you’d never want — in your own words, while it’s easy. The signed plan lives in the card, ready at any care setting. The conversation is free; the document is HSA-eligible.
Make the plan →The home mods, the mobility aids, the in-home care, the directive — much of it can qualify with the right physician documentation. The card knows what qualifies, the AI drafts the letter, a physician signs when warranted — and the paperwork is submission-ready the same day. Your plan administrator makes the call.
Sort what’s eligible →Aging in place runs on a family caregiver — usually unpaid, often burning out. The VA already pays a veteran’s caregiver up to ~$2,750/mo; we route you to every dollar you qualify for, then a care-income floor on top.
See care income →Family across the country sees the care plan, today’s caregiver, the meds, what changed this week — one membership identity, one dashboard, reachable by QR at any care setting. Nobody flying in just to find out.
Open the family card →Eleanor Hayes’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.
Physician-signed documentation is what can turn qualified care from an after-tax expense into a pre-tax health expense. Here’s exactly how it works — and where the bar actually sits.
You answer a short intake through Vera, 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 only what your situation supports. Diagnosis-tied items (therapy, equipment, treatment for a documented condition) are documented in a Letter of Medical Necessity under IRS §213(d). Companion care at home is held to a higher bar: IRS §7702B(c) — a physician certification that the person is chronically ill (needs help with two or more daily activities expected to last 90+ days, or has severe cognitive impairment) plus a written plan of care. If your situation qualifies, the physician documents it; if it doesn’t, we tell you honestly.
The physician-signed LMN is on file in your wallet. Submit it to your HSA or FSA plan administrator to establish eligibility for qualified expenses. If approved, pay with your existing HSA card or request FSA reimbursement — ComfortCard tracks the documentation automatically.
Any AI can draft a medical letter now — drafts are free, and getting freer. What can’t be downloaded is a licensed physician who reviews the draft and stakes a license on the signature. The LMN is drafted by AI from your Vera 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 Vera 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.
The card is free, forever. Membership is one price — and it makes you an owner. Care itself is priced as delivered, never bundled.
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 Vera 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, Vera AI, LMN generation, and advance directive conversations are available nationally. The physician network operates via licensed telehealth physicians. 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. Sector data finds cooperative home-care agencies run roughly half the industry’s turnover — about 30% versus about 64% — and ownership is only half of our answer: the other half is careful, personalized matching, with Vera carrying your family’s context so every shift starts warm instead of cold. We can’t promise any one caregiver stays; we build the levers that make staying likely.
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.
The number that keeps you up isn’t a balance — it’s how many months the care is funded. See your runway in ten seconds →
Then here’s the one honest lever that stretches it: when the person you care for meets the IRS chronic-illness standard and a physician certifies a written plan of care, the qualifying care is paid pre-tax — and over the years you’re a member, that adds up. Figures assume a qualified situation, $400/mo companion care (dues out of pocket), and a 30% effective tax rate.
ComfortCard is one identity that carries you across the whole co-op — so you never re-enter what you’ve already told one door. Each room is its own place; your card opens all of them.
Each door does one thing well. Together they’re a care economy owned by the people in it — and your card is how you belong to it. See the whole movement →
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.
Ready now? See membership — $59/mo → · Or start the free assessment →