Truemed vs Flex: Which Should Your Business Offer?
Truemed vs Flex for merchants: functionally the same model. Compare the sales-call-and-integration path with the self-serve third option, side by side.
6 minute read
TLDR;
Functionally, Truemed and Flex are the same product. Both put an HSA/FSA card option in a partner brand's checkout, both issue Letters of Medical Necessity, both run a marketplace of partner brands, and both start with a sales call and end with an integration on their card rails, typically weeks later, on terms that usually include a rev share. If you're a merchant choosing between them, the model is the same either way. The real decision is between that model and Burst: self-serve, live in 30 minutes, no integration, free for merchants with no contract and no revenue share, for every kind of business.
(Shopping as a consumer, not a merchant? You can get a letter for any purchase directly from Burst, or see how Burst compares to Truemed and Flex for shoppers.)
Truemed vs Flex vs Burst for merchants
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 integration, typically weeks | Sales call, then integration, typically weeks | Self-serve, 30 minutes |
Engineering required | Yes; their checkout in your stack | Yes; their checkout in your stack | None; checkout, POS, and billing untouched |
Merchant pricing | 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 | ||
Built for | Brands accepted into their partner network | Brands accepted into their partner network | Every business, no application: retail, gyms, spas, studios, online or in person |
Recurring billing | Limited support | Limited support | Your existing billing, untouched |
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 |
What Truemed and Flex both are
Strip the branding and the two companies sell the same thing. A shopper at one of their partner brands picks the HSA/FSA option at checkout and pays on card rails, with the purchase substantiated in real time. Where a Letter of Medical Necessity is needed, their survey or telehealth flow produces one, for a $15 customer fee per their published programs (Truemed,Flex), and the customer takes that letter to their administrator and files the claim alone. Each runs a marketplace of partner brands (truemed.com/shop, Flex Market) to send those shoppers somewhere. And for you as a merchant, each starts the same way: a sales call, terms that come out of their sales process and typically include a rev share, and an integration project before your first customer sees the button.
Where they actually differ
At the margins. One roster may already include brands in your category, and you'll be talking to a different sales team. None of it changes what you're buying: someone else's checkout in yours, terms set in their sales process, and a launch date measured in weeks.
The real comparison: their model vs Burst
Burst doesn't ask for your checkout. Signup is self-serve, partners are live in 30 minutes, with no technical integration: customers keep paying you exactly as they do today, on any card, through any billing system. Burst runs the Letter of Medical Necessity side with licensed clinicians (letters 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.
The terms are the opposite of a pipeline: Free for merchants, no contract, and never a percentage of your revenue. Members pay a one-time letter fee. Neither Truemed nor Flex publishes a comparable guarantee. With Burst, if a clinician doesn't approve a letter or a claim is denied, the fee refunds automatically.See how it works or go live now.
Recurring billing decides it for membership businesses
The card networks only approve HSA and FSA card charges at businesses coded as medical providers, or at retailers that check every item against an eligibility list in real time, and a recurring charge needs that check at every renewal. That constraint lives inside both Truemed's and Flex's models because both run on card rails. Burst works differently: your members' dues keep flowing through your existing billing, and nothing changes in your process at all. For gyms, spas, and studios, this single difference is usually the whole decision. Burst handles the rest.
When each one makes sense
Truemed or Flex: you're an online brand, you have weeks to integrate, and a rev share pencils for you. Between the two, pick whichever roster fits your category; the model is the same.
Burst: every use case: you want it live today, you sell in person, you bill memberships, or you want a price you can read before you commit.
Frequently asked questions
What's the difference between Truemed and Flex?
Functionally, almost nothing. Both are card-rail HSA/FSA checkouts with LMN services and partner marketplaces, both onboard merchants through a sales process, and both take an integration to go live. The differences are rosters and sales teams, not the model.
What do Truemed and Flex cost merchants?
Neither publishes pricing for its checkout program; your terms come out of their sales process and typically include a rev share. Flex does publish a $99 one-time setup fee for a separate letter page for gyms, studios and spas, where the customer gets a letter and files alone. Burst is free for merchants, with no contract or revenue share. The one-time letter fee is paid by the customer.
Which works for a brick-and-mortar business?
Truemed and Flex work through a checkout integration and a partner application. Burst requires no integration and no application, so gyms, spas, studios, and in-person retail run on the same setup as online stores.
Can members get letters for things they already bought?
No provider's letters work retroactively. IRS rules require the LMN to be dated on or before the purchase, and that binds Truemed, Flex, and Burst equally.
Related guides
Offer HSA/FSA savings this week
Self-serve setup in about 30 minutes. Free for merchants, no contract, no revenue share, no integration.Get started with Burst or see how it works.
More in
