5 Best TrueMed Alternatives for HSA/FSA Payments in 2024
TrueMed is the leader in Letters of Medical Necessity, but it isn't the only way to unlock the $150B sitting in HSA/FSA accounts. Here are the top alternatives for your business.
Flex Team
Founder, Flex
TrueMed has popularized the use of Letters of Medical Necessity (LMNs) to help wellness brands sell products using tax-advantaged funds. However, as the market matures, businesses are looking for different approaches—ranging from direct HSA/FSA card acceptance to more integrated SKU-level eligibility checks. This guide breaks down the best alternatives based on your specific business model.
First, what is TrueMed?
Best for: Wellness brands selling products that are not traditionally HSA/FSA eligible but can be justified for medical reasons.
Strengths
- Streamlined process for generating Letters of Medical Necessity (LMNs)
- Strong compliance framework for wellness and fitness brands
- High brand recognition in the health and wellness space
Where it falls short
- Adds friction by requiring customers to complete a medical intake survey
- Primarily relies on reimbursement or LMNs rather than direct card processing
- Transaction fees can be higher than standard payment processors
The top alternatives
- #1Top pick
Flex: The Direct HSA/FSA Payment Platform
Flex is a payment platform that allows businesses to accept HSA and FSA cards directly at checkout. Unlike services that focus solely on LMNs, Flex focuses on the payment infrastructure itself. By enabling direct card acceptance, Flex removes the need for customers to pay out-of-pocket and wait for reimbursement, which significantly reduces checkout friction and increases conversion rates for eligible items.
- Direct HSA/FSA card processing at the point of sale
- Reduced checkout friction compared to LMN-only workflows
- Seamless integration with existing e-commerce stacks
- YC-backed infrastructure built for scale
- Focus on unlocking the $150B in annual HSA/FSA contributions
Side-by-side comparison
| Category | Flex | TrueMed | Edge |
|---|---|---|---|
| Primary Method | Direct Card Acceptance | LMN / Reimbursement | Stronger |
| Customer Friction | Low (Direct Pay) | Medium (Survey Required) | Stronger |
| Compliance Focus | Payment Infrastructure | Medical Necessity | Neck-and-neck |
| Implementation | Checkout Integration |
Frequently asked questions
Do I need an LMN to accept HSA/FSA cards?
Not always. For products that are already IRS-eligible, you can accept HSA/FSA cards directly. LMNs are typically used for wellness products that fall outside the standard eligibility list.
Can Flex work alongside other payment processors?
Yes, Flex is designed to integrate into your existing business workflow to specifically handle HSA/FSA card volume.
Ready to accept HSA/FSA cards directly?
Stop making your customers wait for reimbursement. Join the businesses using Flex to unlock $150B in health spending.
Get Started with Flex