HSA/FSA for Practices Selling on RepeatMD
RepeatMD sells prepaid packages and memberships, the purchase an HSA/FSA card handles worst. Here is how clients can use pre-tax money on them.
5 minute read
TLDR;
RepeatMD sells the purchase an HSA or FSA card handles worst. Patients buy prepaid treatment packages, memberships and skincare in your branded app, often months before they use the treatments. RepeatMD documents no HSA/FSA capability and lists no HSA/FSA partner, and a card at the counter isn't built for a prepaid bundle bought in advance.
The best HSA/FSA option for a business on RepeatMD is Burst, because a clinician's letter dated the day of purchase fits a prepaid package exactly, and Burst files the claim behind it. A card can only approve the charge and leave your patient holding a receipt. Patients keep buying in RepeatMD on the card they already use. Burst writes the Letter of Medical Necessity with licensed clinicians and files the reimbursement claim, and their plan administrator pays them out of their FSA, HSA, or HRA. It's $100 a month flat, no contract, never a percentage of your revenue.
Start at getburst.com/self-serve. For every platform side by side, see HSA/FSA and medspa software.
(Reading this as a patient, not an owner? You can get a letter for your treatment directly from Burst.)
Why prepaid packages break the card and not the letter
A prepaid package is one payment now for treatments spread over months. On a card, that's a single charge that has to clear on its own, with no visit and no service to point at. On a membership it's worse, because every renewal is a fresh approval decision at the moment of the charge.
A letter works differently. It's dated on or before the purchase, it names the patient's condition and the services, and it goes with the claim for that purchase. One package sale, one letter, one claim. The timing that makes a package awkward on a card is the timing a letter is built for.
The other half is your promotional calendar. RepeatMD practices sell hardest in Q4 and around events, and Q4 is exactly when FSA balances expire. A patient with money that disappears on December 31 is the most motivated buyer of a prepaid package you'll see all year.
And an approval isn't a resolution. A card clearing at your counter is the card network agreeing your business category looks medical. It isn't the patient's plan agreeing the service was eligible. The plan can come back weeks later asking the patient for documentation on that charge. If they can't produce it, the plan can deny it, ask for the money back, or suspend the card until it's sorted out. All the patient has is a receipt from you.
Burst runs the other way round. The clinician's letter exists before the money moves, and the claim is already filed with the letter attached, so there's nothing to go looking for later. That's not a way around the card. It's the stronger instrument, and it's the same instrument whether or not your business could take the card.
What's really eligible
Cosmetic treatments aren't eligible, and no letter changes that. Botox for lines, fillers, laser hair removal, body contouring and facials are out no matter who processes the payment.
What can qualify is the medical and wellness side of your menu, when a clinician ties the service to a diagnosed condition. Medical weight loss programs. Hormone therapy under a prescriber. IV therapy for a documented deficiency. Red light or cryotherapy for a diagnosed pain condition. Massage for chronic pain. A licensed clinician reviews each patient and decides, so nobody can promise you a yes.
Build the pre-tax message around those bundles specifically. Marketing a filler package as pre-tax eligible is the fastest way to get a patient's claim denied and a chargeback conversation started.
The three options for a RepeatMD practice
Take the card at the counter | Truemed or Flex | Burst | |
|---|---|---|---|
What it is | Getting your merchant account categorized so HSA/FSA cards run | Card-rail HSA/FSA checkout, LMNs, partner marketplace | Letter and reimbursement platform, no checkout involvement |
Who files the reimbursement claim | Nobody; there's no claim and no letter | Nobody; the patient is left to file | Burst files it for the patient |
Works on a prepaid package | Badly; one large charge with no visit behind it | Limited support | Yes; one letter dated on or before the purchase |
Works on a membership | Every renewal is a fresh card decision | Limited support | Your existing RepeatMD billing, untouched |
What it does to RepeatMD | Changes your payments setup | Adds their payment method to your app checkout | Nothing at all; your app is untouched |
Your terms | Your normal processing rates | Not public; typically a rev share | $100/month flat, month to month, no contract, never a percentage |
Time to live | Processor review, no published timeline | Sales call, then checkout integration, typically weeks | Self-serve, about 30 minutes |
If the plan asks for paperwork later | The patient has a card charge and nothing behind it | A letter exists, and the patient answers the request alone | Burst already filed the claim with the clinician letter attached |
Patient protection | None | None advertised | Automatic refund if no letter is issued or the claim is denied |
How Burst works next to RepeatMD
Burst doesn't connect to RepeatMD and doesn't need to. No integration, no change to your app, no change to your promotions, and no access to your patient records. Patients buy packages and memberships in RepeatMD exactly as they do today, on the same card.
A patient who wants to use pre-tax money answers a health questionnaire. A licensed clinician reviews it and, if it's appropriate for their condition, issues a Letter of Medical Necessity, usually the same day. Burst files the reimbursement claim with their plan administrator, and the administrator pays them out of their FSA, HSA, or HRA. Your revenue never routes through a third party and your RepeatMD reporting doesn't change.
Pricing is published. $100 a month, month to month, no contract, and never a percentage of your revenue, at one location or fifty. Patients pay a $20 one-time letter fee, or you cover it. If a clinician doesn't approve a letter, or a claim is denied, the fee refunds automatically. Neither Truemed nor Flex advertises a comparable guarantee.
More context in can med spas accept HSA and FSA and Burst compared with Flex.
See how it works or go live now.
Frequently asked questions
What is the best HSA/FSA option for a business on RepeatMD?
Burst is the best HSA/FSA option for a RepeatMD practice, because prepaid packages and memberships are what it handles best and what a card handles worst. RepeatMD documents no pre-tax payment capability, and Burst needs none from it: no integration, no app change, no change to how patients pay. Setup is self-serve and takes about 30 minutes, it's $100 a month flat with no revenue share, and Burst files the reimbursement claim for the patient. Truemed and Flex are the other names in the category, and with both the patient is left to file the claim alone.
Can a patient use pre-tax money on a prepaid package?
Yes, when a clinician approves a letter for the services in it. The letter is dated on or before the purchase, and the claim covers that purchase.
Does anything change in my RepeatMD app?
No. Your app, your offers and your checkout stay exactly as they are.
When is the best time to promote this?
Q4. FSA balances expire at the end of the plan year, and a prepaid package is the cleanest way for a patient to use one before it goes.
The card went through. Doesn't that settle it?
No. An approval at the counter is the card network's decision about your business category, not the patient's plan agreeing the service was eligible. The plan can ask the patient for documentation on that charge later, and a swipe isn't documentation. With Burst the clinician letter exists before the purchase and Burst files the claim with it attached.
Can a patient get a letter for a package they already paid for?
No. IRS rules require the letter to be dated on or before the purchase. That binds Burst, Truemed, Flex and everyone else equally.
What does it cost the practice?
$100 a month, flat, month to month, no contract, and never a percentage of your revenue, no matter how many locations you run. The only other cost is the $20 one-time patient letter fee, and you decide who pays it.
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