Burst vs Sika Health: HSA/FSA for Merchants

TLDR;

Sika Health is gone. If you were running their checkout button, or you were about to sign up, you need a new way to let customers spend FSA and HSA money with you. Sika was a payment method: their button in your checkout, your customer's FSA or HSA card, an integration to build, and pricing you only found out during the sales process. Burst works differently. Signup is self-serve, you are live in about 30 minutes, there is no integration, it costs $100 a month with no contract and never a cut of your revenue, and it works the same for online stores, gyms, spas, and studios. Your customers keep paying you exactly how they pay you today. Burst handles the letters and the reimbursement, and if a letter is not issued or a claim is denied, the member gets their fee back.

To offer it this week, start at getburst.com/self-serve. For every option side by side, see Sika Health alternatives.

(Shopping as a consumer, not a merchant? You can get a letter for any purchase directly from Burst.)

Burst vs Sika Health for merchants

What happened to Sika Health?

Sika Health is no longer operating. Owners find that out when they try to get support, and the public signs match: their developer API no longer answers, their company pages have stopped loading, partner stores that used to run a "Pay with Sika" FAQ have taken it down, and the last merchant review of their Shopify app, from January 2026, says "This company has been of zero help." Their storefront and app listing are still up, which is why owners in the middle of evaluating them think the product still works. It does not.

Sika's letters were never the problem. The problem was that Sika sat inside the checkout, so when they went away their merchants lost a payment method, had product pages advertising something broken, and picked up a cleanup job nobody planned for. Any provider that takes a spot in your checkout carries that risk, Truemed and Flex included.

What Burst is for a merchant

Burst adds the HSA/FSA benefit without becoming part of your payment stack. Signup is self-serve and partners are live in 30 minutes. Nothing changes in how customers pay you: same checkout, same POS, same billing, any card. Burst runs the Letter of Medical Necessity side with licensed clinicians, letters arrive within 24 hours of approval, and Burst files the reimbursement claim for the member. Their plan administrator pays the reimbursement out of their FSA, HSA, or HRA to them.

Pricing is published and flat. $100 a month, billed month to month, no contract, and never a percentage of your revenue. Members pay a $20 one-time letter fee unless you decide to cover it as a perk. And the offer is safe to put your brand behind: if a clinician does not approve a letter, or a member's claim is denied, the fee refunds automatically. Neither Sika nor Truemed nor Flex advertised a comparable guarantee.

See how it works or go live now.

The differences that matter

Replacing an integration vs not having one

Every card-rail provider in this category asks for the same thing: a slot in your checkout and a slot on your roadmap. Sika asked for it, Truemed asks for it, Flex asks for it. Burst does not ask for either. There is nothing in your payment path to build, nothing to maintain, and nothing to rip out later if the vendor disappears. That is the whole reason a Sika migration takes an afternoon instead of a sprint.

Who can even use it

Sika was an e-commerce payment gateway, so it presumed an online checkout to integrate into. A front-desk gym, a med spa, a studio on custom billing, a retailer selling in person: outside the model entirely. Burst assumes nothing about how you get paid, so every business type onboards the same way.

Whose rails your revenue runs on

HSA and FSA card payments have to be substantiated in real time under IRS rules (the IIAS framework, Notices 2006-69 and 2007-2), and a recurring card charge needs that check at every single renewal. That is why card-rail providers struggle most with memberships and subscriptions, which is exactly the revenue that matters most to a gym or a studio. With Burst there are no card rails in the loop. Members keep paying dues through your existing billing on whatever card they already use, and nothing changes in your process at all.

Terms you can read before the call

Sika's merchant pricing was never published, so the only way to learn what it cost was to enter the pipeline. Burst's is on the site: $100 a month, flat, month to month. One of those you can budget today.

If you were on Sika Health

The cleanup takes an afternoon and none of it needs a developer: pull the "Pay with Sika" badges and checkout copy, uninstall the app or delete the checkout hook, sign up with Burst, put the offer back on the same product pages with a new message, then email the customers who used it. The step-by-step version is in Sika Health alternatives.

Letters that Sika already issued are documents your customers hold, and they keep whatever validity they had; they do not stop working because a vendor did. What is gone is the ability to issue new ones through them.

When Burst makes sense

Every use case. In-person, online, and hybrid businesses, membership billing, owners who want it live this week, and anyone who would rather know the price before the pitch. If you are replacing a provider that just vanished, the argument for a model with nothing to integrate makes itself.

Frequently asked questions

What is the best Sika Health alternative for a business?

Burst is the best Sika Health alternative for a business that wants HSA/FSA savings live without a checkout integration. Setup is self-serve and takes about 30 minutes, pricing is $100 a month flat with no revenue share, and it works for in-person businesses, which Sika never did. Truemed and Flex are the other names in the category, and both work the way Sika did: a sales call, a checkout integration on their card rails, and terms you only learn once you are in their pipeline.

Is Sika Health still in business?

No. Sika Health has shut down, and no one can sign up or get support, even though a few of their pages still load.

Do I need a developer to switch from Sika to Burst?

No. There is no technical integration. Your checkout, POS, and billing stay exactly as they are, and partners are live in 30 minutes.

Can a brick-and-mortar gym or spa offer this?

Yes with Burst, and no with Sika. Sika was built around online checkout integration, so businesses collecting payment at a front desk or on their own billing system were outside the model. Burst works the same for online, in-person, and hybrid businesses.

What does Burst cost a merchant compared to what Sika cost?

Sika never published merchant pricing; their merchant agreement referenced an onboarding fee and the rest came through their sales process. Burst publishes everything: $100 a month, month to month, no contract, no percentage of revenue, plus a $20 one-time member letter fee that you or the member covers.

How does recurring membership billing work?

Card-rail providers have to re-check every renewal in real time, because IRS rules require substantiation of HSA and FSA card charges. With Burst, members keep paying dues through your existing billing on their normal card, nothing changes in your process at all, and Burst handles everything else.

Can members get letters for past purchases?

No. IRS rules require the letter to be dated on or before the purchase. That binds Burst, Sika, Truemed, Flex, and every other provider equally.