Truemed Letter of Medical Necessity: How It Works and Where It Doesn't
How a Truemed letter of medical necessity works, what it costs, and where there's no letter. Plus the $35 letter for any store, filed for you, $0 if it fails.
6 minute read
Short answer
A Truemed letter of medical necessity is a Letter of Medical Necessity you get at a Truemed partner brand's checkout. You pick Truemed as the payment option, answer a health survey, and if an independent licensed clinician decides you qualify, you get the letter and pay with your HSA/FSA card. What it costs varies by program. The letter is only available through partner brands. Buy from a store that isn't a partner and there's generally no letter. Once you have the letter, filing the claim, answering your administrator, and any appeal are yours.
If you want a letter that works at any store, with the claim filed for you, Burst is $35 for everything, and $0 if you don't get paid back. It's the only all-in-one option. No letter, no charge. Claim denied, money back.
Here's what you get with Burst:
Shop anywhere and pay the way you already pay.
A clinician-reviewed letter within 24 hours, or within 2 hours with expedited review.
Burst files the claim.
The money comes back to your bank account.
If the claim is denied, Burst writes the appeal and refunds you.
$35 once. On a gym membership or any monthly charge, the same letter covers the whole year.
Say you pay $60 a month for a gym, so $720 a year. Money in your FSA or HSA was never taxed, so paying from there instead of your checking account keeps about $216 that would have gone to taxes. The letter is $35 once. You come out about $180 ahead this year, and the same letter covers every payment after it. The exact figure depends on your tax bracket. Spend more than about $120 a year on anything eligible and the letter pays for itself.
How you get a Truemed letter
Truemed's how-it-works page has three steps. You browse their marketplace or shop at a partner brand. At checkout you select Truemed and complete a health survey. If you qualify, you receive your Letter of Medical Necessity and pay with your HSA/FSA card in one step. Support is available afterward for questions about the letter or reimbursement. All of it happens inside the partner's checkout. You can't request a Truemed letter on its own for a store that isn't a partner. Burst writes a letter for any store, and you request it directly from Burst in about two minutes.
What a Truemed letter costs
It varies by program, and Truemed's pages don't list it in one place. In the gym programs Truemed publishes, you buy the membership at full price with a regular card, pay for the letter, and get "a guide on how to submit your purchase to your HSA/FSA administrator," so the claim is yours. Burst is $35 once, and that covers the letter, the claim filing, and the appeal.
What you do with the letter once you have it
At a partner whose checkout takes your HSA/FSA card
You paid on the card, so there's no claim to file. Keep the letter with the receipt in case your administrator asks for proof later. If they do ask and you have a Burst letter, Burst answers them and writes the appeal if needed.
At a partner whose checkout doesn't take the card
Truemed's page says to pay with any card, complete the health survey, receive your letter if you qualify, and submit it to your HSA/FSA administrator for reimbursement. You do the submitting. Truemed's gym pages say claims are typically paid out in one to two weeks once your administrator approves them. Nobody at Truemed files the claim. If your administrator asks a question or says no, Truemed's help center says to contact support, which can clarify what the administrator wants and update or reissue the letter, and to file the appeal yourself under your plan's process. Their terms refund the letter price to people who signed up directly if a rejection can't be resolved.
Where a Truemed letter doesn't work
Truemed's help center says it generally cannot issue a standard letter for products bought at a merchant that isn't a Truemed partner. It can't issue a letter for a purchase already made outside Truemed checkout. The exceptions it publishes are gym memberships, saunas, exercise equipment, and fitness trackers, where it may issue a generic letter that you file yourself. For anything else from a non-partner store, a massage therapist down the street, or a brand that never signed up with Truemed, there's no Truemed letter. Burst works everywhere. The request form takes any product or service, and a licensed clinician decides whether a letter is medically supportable for you.
Truemed letter vs Burst letter
What matters | Burst letter | Truemed letter |
|---|---|---|
Where you get it | From Burst, for any purchase | At a partner brand's checkout |
Where it works | Any store, any card | Partner brands only; outside them, generally no letter |
Price | $35 once, everything included | Varies by program |
Who files the claim | Burst files it for you | Nobody; you're left to file |
If your plan pushes back | Burst writes the appeal | You file the appeal; Truemed can reissue the letter, per their help center |
If the claim is denied | Send Burst the denial and your $35 comes back | Refund for direct sign-ups only, per their terms |
Monthly charges like gym dues | Covered under the same letter for 12 months | Limited support |
How fast | Within 24 hours, or within 2 hours on expedited review ($10 more, weekdays 8am to 8pm ET) | At checkout, if you qualify |
Sources, read November 3, 2026: Truemed how it works, Truemed terms, Truemed help center on denied claims, Truemed help center on letter requirements, a Truemed gym program page. Burst's facts are from this site and the request page.
What your $35 covers
Everything, not just a PDF
A letter at a partner's checkout is one document. Burst's $35 pays for the letter, the claim filed with your plan in the format they want, the answers when they ask questions, the appeal if they say no, and a refund if the appeal fails. It also includes the Burst Shopping Assistant, which shows you what's eligible and how much you'll get back while you shop, and an account that finds eligible purchases you've already made. Truemed sells the letter.
It pays for itself
With Truemed, after the letter you file the claim, answer the questions, and write the appeal yourself. If your plan says no, the fee is gone unless you signed up directly and Truemed can't resolve it. Burst's $35 covers all of that. If you don't get a letter, you're refunded on its own. If the claim is denied, send Burst the denial and your $35 comes back.
A decision within 24 hours, and your claim gets filed
It takes about two minutes to request. A licensed clinician decides within 24 hours. Expedited review is $10 more and gets you a decision within 2 hours, weekdays 8am to 8pm ET. Both fees are refunded if the letter isn't approved. Once you have your receipt, Burst files the claim. Truemed stops at the letter.
The only all-in-one platform
Burst is the only all-in-one option. Connect your FSA/HSA account once. The Shopping Assistant works across hundreds of brands. Every claim is filed for you. Every pushback gets an appeal. At brands Burst already works with, reimbursement is automatic. The same account works for the next thing you buy. Truemed is a button that only works at a partner's checkout.
The dating rule applies to every letter
IRS rules require a Letter of Medical Necessity to be dated on or before the purchase it covers. Truemed says it can't issue a letter for a purchase already made. The same is true for Burst and every other provider. If you're a gym member already, keep paying the gym the way you do today. Payments before the letter's date can't be claimed, so request the letter now. With Burst, every monthly charge from that date forward is covered under the same letter for 12 months.
Frequently asked questions
How do I get a Truemed letter of medical necessity?
Shop at a Truemed partner brand, select Truemed at checkout, and complete their health survey. If an independent licensed clinician decides you qualify, you receive the letter and pay with your HSA/FSA card. You can't request one on its own for a non-partner store.
How much does a Truemed letter cost?
It varies by program, and Truemed's pages don't list one price. Burst is $35 once, with the claim filing and the appeal included.
Does Truemed submit the claim to my administrator?
No. If the checkout takes your HSA/FSA card, there's no claim. If it doesn't, you submit the letter and receipt yourself. Burst files the claim for you and writes the appeal if your administrator pushes back.
Can I use a Truemed letter at a different store?
A Truemed letter is issued for the purchase you made at that partner. For a purchase somewhere else, Truemed's help center says there's generally no letter unless the item is one of its published exceptions. Burst writes a letter for whatever you're buying, from any store.
Can Truemed issue a letter after I've already bought something?
No. Truemed says it can't issue a letter for a purchase already made outside its checkout. IRS rules require every provider's letter to be dated on or before the purchase. Get the letter first, then buy.
Is a Truemed letter legitimate?
Yes. It comes from an independent licensed clinician, and administrators review it like any other Letter of Medical Necessity. For the longer answer, read Is Truemed legit?
Get the letter first, then buy. We handle the rest.
$35 once, about two minutes, and a licensed clinician signs your Letter of Medical Necessity within 24 hours if approved, or within 2 hours with expedited review. Then buy from any store with any card, and Burst files the reimbursement claim for you, start to finish; your administrator pays the reimbursement out of your account to you. If your administrator pushes back, we write the appeal. 20,000+ letters issued. Works with every FSA/HSA administrator.
No letter, no charge. Claim denied, money back.
More for shoppers: The best online LMN providers, compared, Burst vs Truemed vs Flex for shoppers, and Can You Use Your HSA or FSA for a Gym Membership?
More in
