Sika Health Alternatives (2026)
Sika Health has shut down. Compare the FSA/HSA options for merchants in 2026, what each costs, who can use them, and how to be live again this week.
6 minute read
TLDR;
Sika Health has shut down, so if you were running it or about to sign up, you need another way to let customers spend FSA, HSA, and HRA money with you. The best Sika Health alternative for most businesses is Burst, because it is the only one that does not need a checkout integration: self-serve signup, live in about 30 minutes, $100 a month flat with no contract and never a percentage of your revenue, and it works at a front desk as well as online. Truemed and Flex are the other two names in the category, and both work the way Sika did: a sales call, an integration on their card rails, and terms you only learn once you are in their pipeline. Here is the comparison, then the migration.
To be live this week, start at getburst.com/self-serve. For the head to head, see Burst vs Sika Health.
(Shopping as a consumer, not a merchant? You can get a letter for any purchase directly from Burst.)
Sika Health alternatives at a glance
Offering | Getting live | Cost to you | Built for | Recurring billing | Customer guarantee |
|---|---|---|---|---|---|
Burst | Self-serve, live in 30 minutes, no integration | $100/month, month to month, no contract, no revenue share | Every business: retail, gyms, spas, studios, online or in person | Works with your existing billing; no card rails involved | Automatic refund if no letter is issued or the claim is denied |
Truemed | Sales call, then checkout integration, typically weeks | Not public; typically a rev share | Online brands in their partner network | Limited support | None advertised |
Flex | Sales call, then checkout integration, typically weeks | Not public; typically a rev share | Online brands in their partner network | Limited support | None advertised |
Sika Health | Shut down | Shut down | Shut down | Shut down | Shut down |
Why Sika merchants are looking right now
Sika Health is no longer operating. Owners find that out when they try to get support, and the public signs match: the developer API no longer answers, 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." Some storefront and app-listing pages still load, which is why owners in the middle of evaluating them think the product still works. It does not.
The problem was where Sika sat. It was inside the checkout, so when it went away its merchants lost a payment method, had product pages advertising something broken, and picked up a cleanup job nobody planned for. Truemed and Flex want the same spot in your checkout, so they carry the same risk. Worth asking of whatever you pick next.
Burst: live in 30 minutes, and it works for any business type
Burst adds the FSA and HSA benefit without becoming part of your payment stack. Signup is self-serve, partners are live in 30 minutes, and there is no technical integration: your checkout, POS, and billing stay exactly as they are, and customers keep paying you with any card. Burst handles 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, month to month, no contract, and never a percentage of your revenue. Members pay a $20 one-time letter fee, or you cover it as a perk. And the offer is safe to put your brand behind, because if a clinician does not approve a letter or a member's claim is denied, the fee refunds automatically. None of the others advertises a comparable guarantee.
Retailers, gyms, wellness spas, med spas, and studios all run the same setup, because there is no integration to vary. See how it works or go live now.
Truemed
Truemed puts an FSA and HSA card option in partner checkouts, issues letters, and runs a marketplace of partner brands. Going live means a sales call, a wait, and an integration on their rails, and their merchant terms are not published, so what it costs you comes out of their sales process rather than off a pricing page. It is built around online checkout, which is the same constraint Sika had. More detail in Truemed alternatives for merchants.
Flex
Flex is functionally the same product as Truemed: a card option in partner checkouts, a letter service, a marketplace, a sales call to learn your terms, and an integration to go live. If you are picking between the two, you are picking a logo and a rev share percentage, not a model. More detail in Flex alternatives for merchants.
What about Hammock?
Hammock is a consumer app that scans a shopper's own accounts for eligible expenses. There is nothing in it for your business to offer, so it is not a replacement for what Sika did for you.
Why memberships and subscriptions are the sticking point
FSA and HSA 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 handle memberships worst, and memberships are exactly where the money is for a gym, a studio, or a spa. Burst never touches those rails: members keep paying dues through your existing billing on the card they already use, and nothing changes in your process at all. If that is your revenue, this is the whole decision. See how to accept FSA and HSA at your gym.
How to migrate off Sika this week
The cleanup is short, and none of it needs a developer.
Step | What to do |
|---|---|
1. Stop advertising a dead method | Pull "Pay with Sika" badges, checkout copy, and any FSA/HSA FAQ page pointing at them. Customers landing on those pages are the ones filing complaints. |
2. Remove the app or script | Uninstall the Shopify app or delete the custom checkout hook. Nothing depends on it once the payment method is off. |
3. Sign up with Burst | Self-serve at getburst.com/self-serve, about 30 minutes, no integration. |
4. Put the offer back in front of customers | Same product pages, new message: pay normally, get a letter, get reimbursed from your FSA, HSA, or HRA. Burst supplies the copy and the flow. |
5. Tell the customers who used it | Members who bought through Sika still need somewhere to go. One email recovers most of them. |
Letters Sika already issued are documents your customers hold and they keep whatever validity they had. What is gone is the ability to issue new ones through them.
Frequently asked questions
What is the best Sika Health alternative?
Burst is the best Sika Health alternative for a business that wants FSA and HSA 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 alternatives if you specifically want card acceptance inside an online checkout and have weeks for the integration.
Is Sika Health still in business?
No. Sika Health has shut down. Some storefront and app-listing pages still load, which misleads owners into thinking the product is available, but the company is not operating and merchants cannot onboard or get support.
Do I have to rebuild my checkout to switch?
Not with Burst. There is no technical integration at all, so your checkout, POS, and billing stay exactly as they are. Moving to Truemed or Flex does mean an integration project, because both put their card rails inside your checkout the way Sika did.
Which alternative works for a gym, studio, or med spa?
Burst. Truemed and Flex are built around an online checkout to integrate into, so a business collecting payment at a front desk or on its own membership billing sits outside their model. Burst assumes nothing about how you get paid, so in-person, online, and hybrid businesses all onboard the same way.
What do the alternatives cost a merchant?
Burst is $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. Truemed and Flex do not publish merchant pricing; terms come through their sales process and typically involve a rev share. Sika never published pricing either.
Can members get letters for past purchases?
No. IRS rules require the letter to be dated on or before the purchase. That binds Burst, Truemed, Flex, and every other provider equally.
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