Question 1

How does HSA and FSA payment processing work?

Accepted Answer

An HSA and FSA payment processing tool like Flex helps businesses accept HSA/FSA payments while handling eligibility and compliance requirements during checkout. When a customer selects Flex as a payment option, Flex confirms whether the purchase is eligible based on applicable guidelines. If additional documentation is required, the customer may be guided through a telehealth consultation to determine eligibility. Once complete, the customer enters their HSA/FSA card details just like they would with a credit card, and Flex processes the payment. Flex adheres to IRS eligibility guidelines and applicable compliance requirements to support HSA/FSA transactions at checkout. Flex works with your team to review product eligibility and integrate HSA/FSA payments into your existing checkout flow.

Question 2

Is the process to accept HSA & FSA card payments the same as other payment methods?

Accepted Answer

For businesses, accepting HSA and FSA payments involves additional eligibility and compliance considerations compared to standard payment methods. Flex manages these requirements with ease, enabling your team to handle eligibility and compliance at scale. For customers, the experience is similar to other payment methods once Flex is enabled. At checkout, the customer selects Flex and enters their HSA or FSA card details just like they would with a credit or debit card. If needed, Flex may guide the customer through a telehealth consultation during checkout to help determine purchase eligibility before completing the payment.

Question 3

Is my business eligible to accept HSA & FSA payments?

Accepted Answer

Flex can help you through the process of determining whether your business is eligible to accept HSA and FSA payments based on IRS guidelines. Once you connect with our team, we can review your product offerings and identify which items you sell are always eligible and which may be considered dual-purpose. If you have eligible products, Flex can also support the integration of HSA/FSA payment acceptance into your existing checkout experience. Flex works with both custom-built checkouts and supported platforms, allowing teams to enable HSA/FSA payments without disrupting their current payment flow.

Question 4

Do Flex HSA/FSA payments adhere to the IRS guidelines?

Accepted Answer

Yes, Flex's HSA/FSA infrastructure adheres to the IRS guidelines.

Question 5

Do I need a different tool to provide Letters of Medical Necessity to my customers at checkout?

Accepted Answer

No. Flex includes support for Letters of Medical Necessity, so you do not need a separate tool at checkout. When a Letter of Medical Necessity is required for a purchase, Flex prompts a brief, chat-based telehealth consultation as part of the checkout flow. The customer completes the consultation, and a licensed healthcare practitioner reviews the information to determine eligibility. If approved, the customer receives their Letter of Medical Necessity. Flex handles the consultation workflow and documentation delivery, so businesses do not need to source, integrate, or manage an additional solution.

Question 6

What if my customer wants to split their purchase between their HSA/FSA card and a credit or debit card?

Accepted Answer

Yes. With Flex, customers can split a purchase between their HSA or FSA card and a standard credit or debit card. During checkout, the customer can choose how much of the purchase to apply to their HSA or FSA card and place the remaining balance on their credit or debit card. This allows customers to complete purchases even when their HSA or FSA balance does not cover the full amount, helping reduce checkout friction and support completed transactions.

Question 7

Can Flex HSA/FSA payments handle subscriptions and memberships?

Accepted Answer

Flex is set up to handle a wide range of subscription models, empowering you to offer your customers more options that suit their preferences, all while driving even more recurring revenue.

Question 8

Does the Flex HSA/FSA checkout integration work with coupons and promotions?

Accepted Answer

Yes. Flex's checkout integration supports coupons and promotional codes, allowing businesses to apply existing discount strategies without changing their checkout flow. Promotions and discounts work alongside Flex payments, so teams can continue to run standard campaigns, measure performance, and maintain consistency across payment methods. This allows Flex to fit into existing marketing and revenue operations without requiring separate tooling or workflows.

Question 9

Does Flex integrate with any ecommerce website?

Accepted Answer

Flex integrates into your existing ecommerce technology stack and works with both custom-built checkouts and leading ecommerce platforms. Businesses can integrate Flex directly into a custom checkout experience, or use one of Flex's supported platform integrations, including Shopify, WooCommerce, Shopline, RevenueCat, and others. This flexibility allows teams to adopt Flex without restructuring your current checkout architecture.

Question 10

Does Flex offer an API for integrating HSA/FSA payments into my checkout?

Accepted Answer

Yes. Flex is built API-first and provides APIs that allow businesses to integrate HSA/FSA payments into their checkout experience. Using the Flex API, businesses can create checkout sessions, redirect customers to complete their purchase, and listen for checkout events through webhooks to support order fulfillment and downstream workflows. This approach allows teams to integrate Flex into custom checkout flows and existing systems without changing their core architecture. Flex's developer documentation includes detailed guides and API references that walk through session creation, webhook configuration, and supported checkout events, helping engineering teams implement Flex in a way that fits their technical requirements.

Question 11

How do I get started accepting HSA/FSA payments?

Accepted Answer

To get started, reach out to a Flex expert. Flex works with your team to help you skip manual and costly steps to becoming eligible to accept HSA and FSA payments. Our team assists with product eligibility, compliance considerations, and implementation, so you can get ready to offer HSA/FSA payments with confidence. Once you connect with Flex, we'll guide you through the setup process and support your team as you integrate Flex into your checkout.

Make HSA/FSA payments your next revenue driver

Transform checkout. Drive more revenue.

Your all-in-one HSA/FSA payments infrastructure

Seamless HSA/FSA Payments

Simplified HSA/FSA Eligibility

Subscriptions

Split Payments

Off-Session Payments

Reimbursements

Advanced Analytics

Streamlined Reporting & Exports

Flexible integration for modern e-commerce

API-first and fully customizable

Built for enterprise scale

Fast, reliable implementation

Hands-on support

A new revenue channel

Integrate with any checkout or payment system

See why leading brands choose Flex

Flex HSA/FSA payments frequently asked questions

Start accepting HSA/FSA payments to drive more revenue