Overview

Core Concepts

This page explains how Truemed works and defines the terms you’ll see throughout these docs. If you’re new to HSA/FSA payments, read this before choosing an integration path.

What Truemed does

Truemed enables your customers to spend pre-tax HSA (Health Savings Account) and FSA (Flexible Spending Account) dollars on eligible health and wellness products. Many products require a Letter of Medical Necessity (LMN) from a licensed provider, while others are pre-approved and need no LMN at all. Truemed determines which is which, runs any required eligibility screening, generates the LMN when one is needed, and handles the compliance paperwork—so your customers get tax-free spending and you don’t have to build any of it.

The two flows

Truemed supports two distinct models. They solve the same problem—letting customers use HSA/FSA funds—but the customer experience and your integration differ. Don’t conflate them.

Pay at checkout

The customer pays directly with their HSA/FSA card as part of your normal checkout.

  1. The customer selects Truemed as a payment option.
  2. They complete a short health survey so Truemed can determine eligibility.
  3. If eligible, Truemed collects their HSA/FSA card details and processes the payment.
  4. Truemed notifies you of the final status so you can fulfill the order.

Most integrations on this site—Shopify, WooCommerce, Stripe, and custom/iFrame—implement this flow. See How Truemed Checkout Works for the end-to-end sequence.

Post-checkout reimbursement

The customer pays as usual with a regular card, then gets reimbursed afterward.

  1. The customer completes a normal purchase.
  2. Truemed issues a qualified LMN and an itemized receipt.
  3. The customer submits these to their HSA/FSA administrator and is reimbursed from their pre-tax funds.

This flow requires no change to how payment is collected at checkout—the value is the qualified documentation Truemed provides.

Product eligibility

Not every product qualifies for HSA/FSA spending the same way. Truemed sorts the items you sell into two eligibility categories, and the category determines the customer’s checkout experience:

  • Pre-approved — Eligible for HSA/FSA purchase without an LMN. Customers buy these directly with HSA/FSA funds—no health survey, faster checkout.
  • Eligible with LMN — Qualify only if the customer completes a medical-necessity health survey and receives an LMN, which Truemed generates as part of the flow.

If a cart mixes the two, the health survey appears only because of the LMN-eligible items.

Truemed classifies the products you submit—see the Product Catalog overview for how eligibility is determined and kept up to date.

Key terms

TermWhat it means
HSA / FSATax-advantaged accounts customers can use for qualified medical expenses.
EligibilityWhether a given product can be purchased with HSA/FSA funds. Truemed determines this.
Letter of Medical Necessity (LMN)Provider documentation that qualifies a purchase for HSA/FSA spending. Truemed generates it.
Pre-approvedA product that’s HSA/FSA-eligible with no LMN required—no health survey, faster checkout.
Eligible with LMNA product that qualifies only when the customer completes a health survey and receives an LMN.
Health surveyA short questionnaire the customer completes so Truemed can assess eligibility.
Payment sessionThe Truemed-hosted flow a customer is redirected to in order to verify eligibility and pay. The core object behind the pay-at-checkout integrations.
Authorization & captureFunds can be authorized first and captured later (manual capture), or captured immediately.

How a Truemed checkout works

No matter which integration you use, the customer experience follows the same path:

1

The customer checks out with Truemed

At checkout, the customer chooses to pay with their HSA/FSA through Truemed.

2

They're redirected to a Truemed session

The customer is sent to a secure, Truemed-hosted session to complete the next steps.

3

They qualify via a health survey

The customer completes a short health survey to determine eligibility for HSA/FSA spending.

4

They enter their HSA/FSA card

Once qualified, the customer pays with their HSA/FSA card.

5

Truemed collects the payment

Once the LMN is approved, Truemed charges the customer’s HSA/FSA card and notifies you that the payment is complete so you can fulfill the order.

Where to go next