Family document vault — private beta
In 2023, 47% of FSA holders forfeited money (EBRI). Most families don't know which documents are missing until the moment they need them. Advance directives. LMNs that document care which may qualify for HSA/FSA. Power of attorney. Insurance policies. PolicyApp helps you find the gaps and fill them — with a physician signing or declining any letter through co-op.care where one is required.
See what your family is missingPolicyApp is the document layer. co-op.care delivers the care.
What you can use today, and what is still being built.
The Problem
Filing cabinets
Advance directives buried in a drawer no one can find in an emergency.
Build one that travels →
Phone photos
Insurance cards photographed at odd angles, lost in the camera roll.
Put them on one card →
Email threads
Letters of medical necessity buried hundreds of messages deep.
How co-op.care handles it →
When you need them — in an ER, during a transition, after a diagnosis — you cannot find them.
The gaps — with real numbers
These aren't hypothetical risks. Each one has a cost and a mitigation. The document you prepare today is the one you can actually use in the moment you need it.
Custodial home care — not covered by Original Medicare
Original Medicare does not cover help with bathing, dressing, meal preparation, or daily living activities. This is the single largest unmet need for older adults.
LMN-backed companion care through a physician-supervised cooperative can qualify as §213(d) medical care when documented correctly. Prepare the documentation before the need arrives.
FSA forfeiture — 47% of holders forfeited in 2023
In 2023, 47% of FSA holders forfeited money (EBRI). The use-it-or-lose-it rule applies to most Health FSAs. Employers keep the unused funds. Where a plan allows a rollover, its annual cap captures only part of typical year-end balances.
Know your run-rate before December. Fund only what you'll spend plus your one-year projection of unexpected care. A physician LMN can expand what qualifies — home modifications, companion care, equipment — giving you more ways to use the balance.
Dental — completely excluded from Original Medicare
Medicare does not cover routine cleanings, fillings, dentures, or extractions. 20% of adults over 65 have lost all their teeth — largely because care went unaffordable.
Note your dental plan's renewal date and coverage cap where you will see them; the vault is being built to track this. Most Medicare Advantage plans include some dental — but the yearly coverage limit is frequently exhausted before major work. Document it so you plan around it.
Hearing aids — not covered by Original Medicare
Medicare doesn't cover hearing aids or routine hearing exams. Untreated hearing loss is linked to accelerated cognitive decline.
Some Medicare Advantage plans now include a yearly hearing aid allowance. Know your plan's benefit. A physician LMN may help establish medical necessity for HSA/FSA use where plan language allows.
Advance directive — only 36% of adults have one
Without a valid advance directive, medical decisions default to whoever is present — or to state law. The healthcare proxy you intended may be ignored. A directive created in one state may not be honored in another without specific language. And if it's on paper in a drawer, it doesn't exist in an emergency.
An advance directive that is signed correctly for your state and kept where family and providers can find it addresses all three failure modes. Start one at CareGoals; the vault is where it will be kept.
International travel — zero Medicare coverage abroad
Original Medicare does not cover care outside the United States (with narrow exceptions near the border). Emergency care during international travel is fully out-of-pocket, and that includes medical evacuation.
Maintain a current travel insurance policy for international travel. Keep the policy number, 24-hour emergency line, and evacuation company contact where family can reach them; the vault is being built to hold them.
Skilled nursing — covered only 20 days in full
Medicare covers skilled nursing fully for days 1–20 after a qualifying hospital stay. Days 21–100 require a daily copay (set by Medicare and adjusted annually). Day 101+: zero coverage. Families often assume Medicare covers nursing home stays — it covers rehabilitation, briefly, not custodial residence.
If long-term care insurance is in place, keep the policy and the insurer's claims contact, with the renewal date, where family can find them (the vault is being built for this). If not, document the gap explicitly — it changes the care-planning conversation now, before a hospitalization forces it.
Power of attorney — lapses at incapacity without the right document
A standard POA becomes invalid exactly when you need it most — when the principal loses capacity. A Durable Power of Attorney survives incapacity; a standard one doesn't. Many families discover this distinction in the ER. A financial POA and healthcare POA are separate documents.
Confirm your POA is Durable (for finances) and that you have a separate Healthcare Power of Attorney or Patient Advocate Designation. Keep both, with the date, attorney contact, and a copy of the signed document, where family can find them (the vault is being built for this).
Cost figures reflect publicly reported 2025–2026 data. Medicare coverage descriptions reflect Original Medicare (Parts A & B). Medicare Advantage plans vary. Not insurance advice — confirm your specific plan with your plan administrator or benefits coordinator.
The vault we're building
In private beta: the vault is still being built. Today you can use the coverage gap finder and print the ER wallet card below.
Advance Directives
Planned: signed and kept where family can find it
Letters of Medical Necessity
Where care may qualify for HSA/FSA, a physician signs or declines through co-op.care
Insurance Policies
Planned: renewal dates in one place
Care Agreements
Planned: caregiver contracts that protect both sides
Power of Attorney
Planned: healthcare and financial, kept where family can find them
HIPAA Authorizations
Planned: a record of who may see your health information
For your wallet
Print a wallet-sized card that tells an ER who your healthcare proxy is and where your documents live.
Nothing you type leaves this page — the card is rendered in your browser and never sent or stored.
In an emergency
policyapp
Patient
Your name
Healthcare proxy
Proxy name · phone
Documents — advance directive, POA, insurance
Where they live
Prints at true wallet size with a dashed cut guide.
Coverage Gap Finder
Pick your plan type. See the care it typically doesn’t cover — and which lever (HSA/FSA dollars, or a physician’s Letter of Medical Necessity) closes the gap.
High-deductible health plan — usually paired with an HSA.
4 of 4 gaps below can be cushioned with HSA/FSA dollars where a physician LMN documents care that qualifies.
Everything up to the deductible
You pay full freight on most care until the deductible is met — exactly what the HSA is built to fund, pre-tax.
HSA / FSA dollarsIn-home companion / non-medical care
Almost never a covered medical benefit. A physician LMN can document it as medical care under §213(d) where it qualifies.
Physician LMN documents medical necessityDental & vision
Typically excluded from the medical plan. HSA/FSA dollars apply to qualifying expenses.
HSA / FSA dollarsTherapeutic extras (massage, CGM, certain supplements)
Not covered without documentation. A physician LMN documents which items qualify as medical care under §213(d) — it can't make one that doesn't.
Physician LMN documents medical necessityGeneral education, not a determination about your specific plan or situation. Coverage varies by plan and carrier; HSA/FSA eligibility is plan- and case-specific and is decided by your plan administrator. A Letter of Medical Necessity is issued by a licensed physician only when clinically appropriate. Not tax or insurance advice.
After the gap check
CareGoals →
Write down who speaks for you and what you would want, one card at a time. Saved only on your device.
ComfortCard →
A family readiness check, and a sort of which care expenses may qualify for HSA/FSA.
familycaregive.com →
A one-question check-in for the person carrying it. Private; nothing leaves the page.
Quality Death →
Find an end-of-life doula, or become one.
How It Works
In the vault you will add existing documents or start new ones: advance directive, LMN, POA.
The vault is being built to track renewal dates and flag expiring coverage.
The vault will let you send a document to your clinician, your caregiver, or your family.
When It Mattered
Two illustrative scenarios — the common, avoidable moments this page exists to prevent.
The ER question nobody could answer
Her father was brought in by ambulance. The attending needed a decision about intubation. The family was in a waiting room calling each other. Nobody had a copy of the advance directive. He had one — it was in a filing cabinet at home, two states away.
The attending documented “family unable to confirm directive.” The default care path proceeded. It was not what her father had wanted.
If the wallet card had said where the directive lives, the ER could have found it.
Make your wallet card now →
The FSA balance that expired
He had been paying out of pocket for caregiver support for seven months. His wife’s FSA had money in it. He didn’t know a Letter of Medical Necessity could document that care for the plan. Nobody told him. The plan year ended and the unused balance was forfeited.
The balance, gone. A Letter of Medical Necessity would have documented that care, if a physician judged it appropriate and the plan accepted it.
The gap finder shows which kinds of care an LMN may help document. It does not estimate savings.
Run the gap finder →
The Policy Agent (planned)
Planned: track insurance renewals before they lapse.
Planned: point out care that may qualify. Where a physician signs a letter through co-op.care, it documents that care.
Planned: after a new diagnosis, new home, or new caregiver, flag which documents may need updating.
The Fund Layer
PolicyApp is the "Fund" step in a five-part care network: Assess, Define, Fund, Deliver, Live well. Once your documents are in order, co-op.care provides worker-owned companion care. Where care may qualify for HSA/FSA, a physician signs or declines the letter.
PolicyApp is in private beta. Join the list.
Claude users can add the SolvingHealth connector for care-planning tools. It is separate from the vault, which is still being built.
Claude Desktop MCP Config
"solvinghealth": {
"command": "npx",
"args": ["-y", "mcp-remote",
"https://solvinghealth-mcp-489007249571.us-central1.run.app/mcp"]
}Don't have Claude? Get it at claude.ai.
PolicyApp stores and organizes personal documents. It does not provide medical or legal advice. Where a letter of medical necessity is appropriate, a licensed physician signs or declines it through co-op.care; a letter is not a diagnosis or treatment recommendation. HSA/FSA eligibility depends on your specific plan — consult your plan administrator.