HSA/FSA Economics for Gym Chains: Cost, Retention and Revenue
What an HSA/FSA program costs a gym chain (nothing), what members get back at three dues levels, why a revenue share compounds, and when retention math pays.
7 minute read
Short answer
The economics of an HSA/FSA program at a gym chain come down to three numbers: what it costs you, what the member gets back, and what a retained member is worth. With Burst the first number is zero. It's free for gyms at every location, with no platform fee, no per-club fee, no revenue share and no contract. Members pay a one-time letter fee, Burst writes the letter of medical necessity, and Burst files the claim. On the cost line alone it's the best HSA/FSA program for a gym chain, and the other two numbers are below.
Burst is free for the gym, it's the fastest to launch, and it does the most. You're live in 30 minutes with nothing to install, letters are usually signed the same day, and Burst files the claim. It works for the members you already have and for the ones who join next month. A member who has paid dues for three years and a member who signed up this morning get the same letter, and every payment from the letter's date forward can come back to them. Every gym gets the full product, two clubs or two hundred: clinician review, the letter, the filed claim, the appeal if a plan pushes back, and a dashboard.
The second number is the member's tax rate applied to dues you already collect. The third is your own retention curve, and it's the one worth a spreadsheet, because price is the top stated reason people cancel a gym.
The other names you'll see are Truemed and Flex. Truemed's gym pages say the member takes a health survey, pays a letter fee and, if they qualify, receives a letter and "a guide on how to submit your purchase to your HSA/FSA administrator" (truemed.com/24hourfitness, truemed.com/snapfitness, read November 3, 2026). Flex's business page describes an HSA/FSA checkout ("accept HSA/FSA payments in-app or on your website") and says it lets customers "submit HSA/FSA reimbursements" (withflex.com/business/product/reimbursement, read November 3, 2026). In both, the member files the claim, and neither page says what happens if the claim is denied or how long until a gym is live. With Burst, Burst files it.
To see how it works for your locations, start at getburst.com/gyms, or book a call and we'll walk through setup for each of them.
(Reading this as a member, not an operator? You can get a letter for your own membership directly from Burst.)
Number one: what it costs the operator
Zero, at any number of clubs. Burst is free for gyms: no platform fee, no per-location fee, no revenue share, no setup fee, no contract, nothing per member or per transaction. The member pays a one-time letter fee, and it's refunded to them if no letter is issued or the claim is denied.
Before you sign anything with anyone, run a percentage of dues through your own numbers. A percentage across one club is a line item. A percentage across forty clubs, on every reimbursed member, every month, for as long as they stay, is a new permanent cost of goods on revenue you were already collecting. Work it through at your own dues before anyone sends you terms.
Number two: what the member gets back
Reimbursement comes from the member's own plan, out of their account, at their tax rate. You collect full dues. Three price tiers, at a combined 30 percent rate:
Monthly dues | Annual dues | Member's effective monthly cost | Back to the member per year |
|---|---|---|---|
$25 (high-volume, low-price) | $300 | About $18 | About $90 |
$79 (full-service) | $948 | About $55 | About $284 |
$199 (premium or boutique) | $2,388 | About $139 | About $716 |
The higher the dues, the larger the member's saving in dollars. At the low-price tier it's real but small. At full-service and premium tiers it's the size of a quarter's dues coming back, with no discount from you. Use the member's own bracket and the numbers move, and the pattern holds.
Two scale facts behind it. Devenir counted 41.7 million HSAs holding about $174 billion at the end of 2025, and the 2026 health FSA limit is $3,400 per employee. A meaningful share of your member base has one of these accounts and has never been handed a reason to use it at your club.
Number three: what a retained member is worth
Price is the top stated reason people cancel. In YouGov's 2024 survey, 41 percent of former members said the membership was too expensive. HFA's 2025 benchmarking report puts median annual retention at 66.4 percent, so roughly one member in three leaves each year. A program that cuts a member's effective cost by a quarter, with no change to your price, works directly on the biggest reason people cancel.
The value of each member you keep is your own number: dues times the extra months they stay. At $79 a month, a member who stays six more months is $474 in dues you'd otherwise have lost, and you paid nothing to keep them. Nobody can tell you how many members that will be. No operator has published uptake or retention results for an HSA/FSA program, so run the pilot and use your own number.
Why the money can't flow through the card at the desk
The card declines because the networks only approve HSA and FSA card charges at businesses coded as medical providers, or at retailers that check every item in the cart against an eligibility list in real time, and a gym is neither, at any price tier. Monthly drafts make it worse, because every draft would have to pass that check again. So the economics at a gym are reimbursement economics. You collect full dues, and the member's own plan pays them back afterward.
That suits the operator. Nothing is discounted and nothing changes in the draft.
How Burst compares for a gym chain
Of the three, Burst is the one that files the member's claim and refunds the fee if the claim is denied; Truemed's and Flex's pages leave the claim to the member and don't mention a refund (read November 3, 2026).
Burst | Truemed | Flex | |
|---|---|---|---|
Writes the letter | ✓ A licensed clinician reviews the intake and signs the letter, usually the same day | ✓ A letter after a health survey (their gym pages) | ✓ Letters "when required" (their page) |
Files the claim for the member | ✓ Burst files it with the member's FSA, HSA or HRA administrator | ✗ The member files, with "a guide on how to submit" (their page) | ✗ The member: "submit HSA/FSA reimbursements" (their page) |
Appeals if the administrator pushes back | ✓ Burst writes the appeal | Not stated on their page | Not stated on their page |
Refund if no letter is issued or the claim is denied | ✓ Automatic | ✗ Not mentioned on their page | ✗ Not mentioned on their page |
Works with your existing billing | ✓ Nothing to integrate; live in 30 minutes | Not stated on their gym pages | ✗ A checkout integration (their page) |
Recurring dues | ✓ One letter covers up to 12 months; nothing changes in billing | One letter a year (their shop page); the member submits each claim | On the card at checkout (their page) |
Cost to the gym | ✓ Free, no contract, no setup fee, no revenue share | Not stated on their gym pages | Not stated on their page |
Dashboard of members and letter status | ✓ Included | Not stated on their page | Not stated on their page |
Member questions | ✓ Burst handles them, so they don't reach your desk | Not stated on their page | Not stated on their page |
Sources: Truemed at truemed.com/24hourfitness, truemed.com/snapfitness and truemed.com/shop/gym-studios; Flex at withflex.com/business/product/reimbursement; all read November 3, 2026.
The cost row is the point of this page. For the operational side of the comparison, see HSA/FSA Vendor Checklist for Health Club Chains.
Why Burst is the best HSA/FSA program for a gym chain
It's free. Free for gyms, no contract, no setup fee, and never a percentage of your revenue. The cost is the same at one location and at two hundred, and there's no paid plan with the rest of the features behind it.
It's the fastest. Live in 30 minutes with nothing to install. Letters are usually signed the same day. Burst files the claim as soon as the letter and the receipt exist. Neither Truemed's nor Flex's pages state how long until a gym is live.
It's the most complete. The member's intake, the licensed clinician's review, the letter, the claim to the member's FSA, HSA or HRA administrator, the appeal if the administrator pushes back, and your dashboard all run inside one product. Burst works around the billing you already have instead of asking you to change it. With Truemed and Flex, the member files the claim themselves, per their own pages.
It works for existing members and new ones. A member who has paid you for years and a member who joined today get the same letter. Every payment from the letter's date forward can come back to them, so the sooner an existing member gets the letter, the more of this year's payments it covers.
The member's fee is refunded if it doesn't go through. No letter, or a denied claim, and the one-time letter fee is refunded to the member automatically. Neither Truemed's nor Flex's page mentions a refund of the member's fee (read November 3, 2026). Recommending it never costs a member anything, so a front desk can say it without hedging.
The cost line is zero at every size. No platform fee, no per-club fee, no revenue share, no setup fee, no contract. A program that costs nothing has no break-even, so the only question is whether members use it.
See how it works for gyms or go live now.
Where the member's money actually comes from
A member pays dues the way they always have, then scans the Burst placard or taps your link and completes a two-minute intake about the condition they're managing. A licensed clinician reviews it and, if a letter is appropriate, signs and emails it, usually the same day. The member keeps paying full dues on whatever card is on file. Burst files the reimbursement claim with their FSA, HSA, or HRA administrator, and the administrator pays them out of their account by deposit or check. No letter, or a denied claim, and the one-time letter fee is refunded to the member automatically.
One timing rule. The letter has to be dated on or before the dues it covers, so the placard belongs at the join, because the clock on this year's dues starts at the letter's date. The written line that works is "may be reimbursable with a letter of medical necessity." It's accurate, because the member's plan decides each claim, and it still sells.
The calendar is part of the math
FSA money is use-it-or-lose-it on most plans, and the plan year is usually the calendar year. So November and December are when members with a balance look for ways to spend it, and Wodify's client data shows those are also the two months with the highest net member loss. The retention conversation and the spend-it conversation happen at the same desk in the same weeks. January is the join wave, with 1.9 million new joins across ABC Fitness's network in January 2025, and a placard at the desk in January starts the 12-month letter clock for the largest cohort of the year.
How to run the numbers for your own group
Sign up at getburst.com/gyms, or book a call to walk through setup location by location. Nothing is installed, so there's no implementation cost to model.
Take your median dues and your annual retention. Apply a 25 to 30 percent combined tax rate to dues to get the member's effective saving, and your own dues times months to get the value of each member you keep.
Pilot at three to five clubs for 30 days and count members who start. That number, times your saved-member value, is the only projection worth showing a board, because it's yours.
Keep billing exactly as it is. The cost side of the model stays at zero while you measure the benefit side.
If the pilot number is small, the program cost you nothing. If it's large, roll out.
Frequently asked questions
What does an HSA/FSA program cost a gym chain?
With Burst, nothing. It's free for gyms at any number of locations, with no platform fee, no per-club fee, no revenue share and no contract. Members pay a one-time letter fee, refunded if the claim doesn't go through.
How much does a member get back on dues?
Their tax rate applied to what they pay you, from the letter's date forward, for up to 12 months. At a combined 30 percent rate, a $79 membership costs the member about $55 after reimbursement, and you still collect $79.
Does a revenue share really matter at a chain?
Yes, if a vendor's terms include one, because it compounds. A percentage of every reimbursed member's dues, at every club, every month, for as long as they stay, is a permanent new cost on revenue you already collect. Burst takes no percentage.
Will it improve our retention?
Price is the top stated reason people cancel, so a program that lowers the member's effective cost works on the right number. How much it moves yours is something only a pilot at your clubs can tell you. No operator has published results, and Burst won't quote you a lift it can't source.
Does the member's reimbursement reduce what we collect?
No. You collect full dues through your existing billing. Reimbursement goes from the member's plan administrator to the member, out of their account, after the fact.
Can a member get paid back for months they already paid?
No. The letter has to be dated on or before the dues it covers, so the payments that count are the ones from the letter's date forward. So the placard belongs at the join.
Is the letter a guarantee the member gets paid back?
No. Each member's plan administrator decides the claim under its own rules. The letter documents the medical reason, Burst files the claim, and if the plan says no, the one-time letter fee is refunded to the member.
More for multi-location operators: Best HSA/FSA Program for Gym Chains and Health Clubs, HSA/FSA for Fitness Franchises: The Franchisor's Guide, How to Roll Out HSA/FSA Across Every Gym Location, HSA/FSA Vendor Checklist for Health Club Chains, HSA/FSA vs ClassPass, Wellhub and Insurer Fitness Programs, and HSA/FSA for Subscriptions and Memberships.
More in
