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, you're choosing a logo. The real decision is between that model and Burst: self-serve, live in 30 minutes, no integration, $100 a month flat 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.)
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 |
Getting live | Sales call, then integration, typically weeks | Sales call, then integration, typically weeks | Self-serve, 30 minutes |
Engineering required | Yes | Yes | None |
Merchant pricing | Not public; typically a rev share | Not public; typically a rev share | $100/month, month to month, no contract, no revenue share |
Built for | Online brands in their partner network | Online brands in their partner network | Every business: retail, gyms, spas, studios, online or in person |
Recurring billing | Limited support | Limited support | Your existing billing, untouched |
Customer protection | None advertised | None advertised | Automatic refund if no letter is issued or the claim is denied |
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 consumer fee that varies by store and program. 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 aren't published anywhere and usually 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; a shopper's letter fee differs from store to store; the demo calls have different faces on them. None of it changes what you're buying: someone else's checkout in yours, a cut of your revenue, 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: $100 a month, published, month to month, no contract, and never a percentage of your revenue. Members pay a $20 one-time letter fee unless you cover it. And it's the only option here with a customer guarantee: 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
HSA/FSA card payments must be substantiated in real time under IRS rules (the IIAS framework, Notices 2006-69 and 2007-2), so recurring card charges need a fresh 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 consumer fees, not the model.
What do Truemed and Flex cost merchants?
Neither publishes merchant pricing; you learn your terms inside their sales process (typically a rev share %). Burst publishes its terms: $100 a month, month to month, no contract, no percentage of revenue.
Which works for a brick-and-mortar business?
Truemed and Flex are built around online checkout integration. Burst requires no integration at all, 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.
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