Burst or FSA Store: When to Use Each
A plain comparison of FSA Store's eligible catalog and Burst's LMN route, including card use, plan review, and when each fits.
5 minute read
Short answer
FSA Store is the direct route when the item is already in its eligible catalog and you want to buy there. Burst fits when the purchase needs a Letter of Medical Necessity and you want to buy from another retailer. The clinician decides whether to write a letter; your plan administrator decides the claim.
The IRS rules are separate from a store's checkout. Publication 502 explains medical expenses, and Publication 969 covers HSAs and other tax-favored health plans. Neither is a store's item-by-item list.
When FSA Store is the better choice
If the product is listed in FSA Store's catalog, buying there is the straightforward option. FSA Store describes its catalog as exclusively FSA-eligible products. It accepts FSA and HSA cards, and says most card purchases auto-approve. Keep the receipt because your FSA administrator may ask for it later.
No FSA card? FSA Store says you can pay with a regular credit or debit card. If you have an FSA plan, print the receipt and submit it with a claim to your administrator. That is a useful route when the item is already eligible and you want to pay out of pocket first.
If a properly filed claim for an item bought directly from FSA Store is denied, its Help Center says it can provide product substantiation. It asks for the order number, the item's SKU, the FSA provider's name, and any emails or letters explaining the denial. FSA Store says it will send supporting documentation in the next few business days. If the administrator still denies the claim after you submit that substantiation, FSA Store says it will refund that specific product. The policy applies to items bought directly from FSA Store, not purchases from another retailer.
When Burst is the better fit
FSA Store also offers its own LMN process, but for selected products on its page. It lists Miko air purifiers and humidifiers, AlterMe's weight-loss offering, and Shed supplements. You choose an item and complete a short medical questionnaire, and a licensed provider reviews the request and issues a letter if approved. FSA Store's terms say a provider may issue a letter only when the product is medically necessary and would not otherwise be used for general wellness or non-medical purposes. The page describes a process for its featured products, not every product in its catalog. For an FSA card charge, FSA Store instructs shoppers to send a copy of the letter to their plan administrator.
Burst fits when you need a letter for a purchase you want to make somewhere else. The retailer does not need to be a Burst partner, whether it is Costco, Amazon or Walmart. Request the letter first, then buy from any store with any card once it is dated. Send Burst the itemized receipt and we file the claim.
The letter costs $35. If the clinician decides against a letter, the charge reverses on its own. A denied claim means the $35 comes back to you. The letter must be dated on or before the purchase.
Find out if my purchase can be reimbursed
How to choose
Start with the item and where you want to buy it. The two routes have different starting points: FSA Store starts with a product already listed as eligible, while Burst starts with the condition and the letter. A letter does not add a product to FSA Store's catalog, and a catalog listing does not replace a pre-purchase letter for an item that needs one. Choose the route before placing the order so the request and purchase happen in the right order.
FSA Store's regular eligible catalog and its featured LMN offerings are different filters. Check the exact product before paying; the LMN page describes its listed products, not every item in the catalog.
If the product is already listed as FSA eligible and you want to pay at checkout with your card, start at FSA Store and keep the receipt.
If the product needs an LMN and appears on FSA Store's LMN page, compare its questionnaire, provider review and plan-submission steps before paying.
If you need an LMN for an item you plan to buy elsewhere, make the Burst request before purchase. The retailer does not need to be a Burst partner.
For Burst, the order matters: request the letter, wait for its date, buy the item, then send the receipt so Burst can file the claim. Do not buy first and ask for a letter afterward.
New to letters? Start with the complete guide to Letters of Medical Necessity.
Frequently asked questions
Can I shop at FSA Store without an FSA card?
Yes. FSA Store says you can use a regular debit or credit card. If you have an FSA plan, submit the receipt with a claim to your administrator.
Does FSA Store offer Letters of Medical Necessity?
Yes, for the selected products and brands on its LMN page. It uses a questionnaire and licensed-provider review, and its page explains that the plan administrator requires a copy of the letter for an FSA card charge.
Does an LMN guarantee reimbursement?
No. A letter is not claim approval. The clinician decides whether to write it, and the plan administrator decides the claim. For Burst requests, a denied claim means the $35 comes back.
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