How to Promote HSA/FSA Acceptance to Customers
Where to put the offer, the wording that converts customers, the three seasons that matter, and what to measure. A practical playbook for merchants.
8 minute read
Short answer
Most businesses that offer HSA/FSA reimbursement under-promote it, then conclude it doesn't work. The offer only converts where the customer is already deciding, so placement matters more than creative, and the wording matters more than either.
The line that does the work is "may be reimbursable with a letter of medical necessity." Customers who have had a card declined at a counter trust a careful claim faster than a confident one, and it keeps the decision where it belongs, with their plan and the clinician writing the letter.
This page is the playbook: where to put it, what to say, when to push, and what to measure. It assumes you're running reimbursement alongside your existing checkout, which is what Burst does, free for merchants with no integration.
To offer it this week, start at getburst.com/self-serve.
(Reading this as a customer, not a business? You can get a letter for your own purchase directly from Burst.)
Where to put it, in order of impact
Placement | Why it works | What to write |
|---|---|---|
Product or pricing page, near the price | It's where the number is being weighed | "May be reimbursable with a letter of medical necessity" plus a link |
The consult, the fitting, or the front desk | A person can answer the follow-up | The four-sentence script below |
Cart or checkout page | Last moment before the decision closes | One line and a link, no interstitial |
Order confirmation email | High open rate, and the letter must predate future orders | A short block explaining the two-minute intake |
Subscription welcome and renewal notices | Catches existing customers | "Payments from here forward" framing |
A printed card at the counter | Works in person, where most of this category doesn't | A QR code and one sentence |
The single most common mistake is putting it only in a post-purchase email. By then the customer has already decided, and if the letter is dated after the order it can't cover it.
The words that sell it
One line does most of the work: this may be reimbursable with a letter of medical necessity. Customers who have had a card declined at a counter believe a careful claim faster than a confident one, so the accurate phrasing is also the phrasing that converts.
Let the clinician and the plan be the authority. A clinician decides whether the letter is appropriate and the customer's plan decides the claim, so you are offering the path rather than the verdict. That is a lighter promise to make and a much easier one to keep.
Say who it is for. It works for customers managing a condition a clinician will name. Naming that out loud costs you nothing with the people it was never going to work for, and it is what makes the customers who do qualify trust you.
The named options, side by side
Truemed | Flex | Burst | |
|---|---|---|---|
What it is | Card-rail HSA/FSA checkout, LMNs, partner marketplace | Card-rail HSA/FSA checkout, LMNs, partner marketplace | LMN and reimbursement platform, no checkout involvement |
Who files the reimbursement claim | Nobody; the customer is left to file | Nobody; the customer is left to file | Burst files it for the member |
Getting live | Sales call, then checkout integration, typically weeks | Sales call, then checkout integration, typically weeks | Self-serve, live in 30 minutes, no integration |
What it costs you | Not public; typically a rev share | Not public; typically a rev share | Free for merchants, no revenue share |
Customer letter fee | One-time letter fee, paid by the customer | ||
If no letter is issued, or the claim is denied | No published guarantee | No published guarantee | The one-time letter fee is refunded to the customer automatically |
Business types accepted | Partner application | Partner application | Any business, no application |
Contract | Set in their sales process | Set in their sales process | No contract |
Everything below assumes the honest version. The businesses that get burned here are the ones that promised coverage they don't control.
Why Burst is the best HSA/FSA option for a business
Burst files the claim. Clinician writes the letter. Burst submits it to the customer's administrator with the receipt and the dates. No paperwork for the customer.
No letter, no charge. Claim denied, money back. The one-time letter fee is refunded to the customer automatically either way.
Free for merchants. No contract, no revenue share.
The refund makes the offer safe to promote. If no letter is issued or the claim is denied, the one-time letter fee is refunded to the customer automatically, so recommending it never costs your customer anything.
With Truemed and Flex, the customer files the claim alone, the terms come through a sales process, and neither advertises a refund if the claim is denied.
See how it works or go live now.
What does it look like for a customer?
The customer pays you normally, then fills out a two-minute intake. A licensed clinician reviews it and, if appropriate, signs the letter, usually the same day. Burst files the claim. Their administrator pays them back by deposit or check. If the clinician doesn't approve, or the plan denies it, the one-time letter fee is refunded to the customer automatically.
One timing rule: the letter has to predate the purchase, so place it before the purchase, not in a post-purchase email a week later. The line that works on your site: "may be reimbursable with a letter of medical necessity."
The four-sentence script
For anyone who talks to customers, this is the whole thing:
"If you're managing something a doctor is already treating, this may be reimbursable through your FSA or HSA with a letter of medical necessity. We work with Burst. You do a two-minute intake online, a clinician reviews it, and if they write the letter, Burst files the claim with your plan for you. It's a one-time letter fee paid by the customer, and you get it back if it doesn't go through."
Then stop. The most common failure in delivery is continuing to talk, which turns a benefit into a pitch.
The three seasons
Season | When | What to say |
|---|---|---|
Open enrollment | November to December | People are choosing contributions. Frame it as a reason to fund the account. |
Use it or lose it | December, and this applies to FSAs specifically | Unspent FSA money can expire. This is the highest-urgency window of the year. |
Tax season | February to April | People are thinking about pre-tax money and reconciling receipts. |
Keep the use-it-or-lose-it language on FSAs only. HSA balances roll over, and telling an HSA holder their money expires is both wrong and the kind of error that costs you credibility with the people most likely to use this.
What to measure
Four numbers, all of which you can see without anyone's dashboard.
Conversion rate on the pages carrying the offer, compared to before. Average order value on orders containing a product that can carry a letter. Retention or rebooking rate for customers who requested a letter versus those who didn't. And letters requested through your link, which is the leading indicator that tells you a placement is working before revenue moves.
What not to measure: claim approval rate as a business metric. Approvals happen between the customer and their administrator, they vary by plan, and treating them as your KPI pushes you toward overclaiming.
How to roll this out
Sign up at getburst.com/self-serve. About 30 minutes, and none of it requires a developer.
Place the offer at the decision point first, then the confirmation, then the lifecycle emails. In that order, because that's their order of impact.
Keep your checkout and your billing as they are while you test placements.
Start with one placement, measure it for two weeks, then add the next. Rolling out five at once tells you nothing about which one worked.
Frequently asked questions
What am I allowed to tell customers about HSA/FSA?
That a purchase may be reimbursable with a letter of medical necessity. Don't say it's covered or eligible, because the customer's plan decides each claim.
Where does the offer convert best?
At the decision point: the product or pricing page near the price, and in person at the consult or front desk. Post-purchase emails convert worst, and a letter dated after the order can't cover it.
When is the best time of year to push it?
December, for FSA holders specifically, because unspent FSA money can expire. Open enrollment and tax season are the other two windows.
Does use-it-or-lose-it apply to HSAs?
No. That's FSAs. HSA balances roll over, so don't use expiry language with HSA holders.
What should I measure?
Conversion on pages carrying the offer, AOV on qualifying orders, retention for customers who got a letter, and letters requested through your link.
Can I promote it to customers who bought last month?
You can tell them about it for future purchases. A letter can't cover a purchase that predates it, and for subscriptions the honest framing is payments from the letter date forward.
Is the letter a guarantee the customer gets paid back?
No. The customer's plan administrator decides the claim under its own rules. Burst files it, and if the plan says no, the one-time letter fee is refunded to the customer.
More on this:How to Accept HSA and FSA Payments,The Merchant's Guide to FSA/HSA Eligibility,HSA/FSA for Subscriptions and Memberships, and Truemed Alternatives for Your Store, Gym, or Spa.
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