Getting StartedCustomer Experience

Customer Journey: Pre-Approved Products

Truemed allows customers to pay for pre-approved HSA/FSA products directly with their HSA/FSA card at checkout. Because the product category is pre-approved, no clinical intake form or Letter of Medical Necessity (LMN) is required. Customers complete their purchase using pre-tax HSA or FSA funds with no reimbursement filing needed.

What “Pre-Approved” Means

A product is pre-approved when its category already meets established regulatory standards for medical care, meaning customers can pay with their HSA or FSA card directly without additional clinical review.

Core Criteria for Pre-Approval

  1. Recognized eligible category (SIGIS / IRS-aligned). Categories explicitly listed under SIGIS “Eligible: Devices & Supplies” qualify automatically. These are items with clear medical intent and established reimbursement precedent: diagnostic devices like thermometers and glucose monitors, durable medical equipment like crutches and wheelchairs, and condition-specific supplies like compression hosiery and breast pumps. Reference: SIGIS Eligible Product List Criteria.
  2. Meets IRS Section 213(d). The product is used for diagnosis, cure, mitigation, treatment, or prevention of disease, or affects a structure or function of the body. Not for general health or wellness.
  3. Primary purpose is medical, not dual-purpose. The product has a clear, singular medical use and would not be purchased for any other reason.
  4. Strong regulatory and TPA precedent. Third Party Administrators consistently approve the category without additional documentation, and claim-denial risk is low.
  5. Fits cleanly into Truemed’s eligibility framework. Maps directly to an existing eligibility category with no clinical interpretation needed.

What Disqualifies a Product From Pre-Approval

  • General wellness items (vitamins, gym memberships, healthy food)
  • Dual-purpose items (ergonomic chairs, mattresses, fitness equipment)
  • Products that require personalization to a specific condition
  • Products lacking clear IRS precedent
  • Products that need clinical judgment to justify use

Pre-approved = obviously medical, zero ambiguity, widely accepted by TPAs.

LMN required = could be medical, but depends on the person, condition, or use case.

Pre-Approved vs. LMN Flow: Key Differences

Pre-Approved FlowLMN (Dual-Purpose) Flow
Clinical intake formSkippedRequired (60 to 90 sec)
LMN issuedNoYes
Practitioner reviewNoWithin 24 to 48 hours
Payment capture timingImmediateAfter practitioner approval
Customer saves for auditReceipt (3 years)LMN + Receipt (3 years)
HSA/FSA card at checkoutYesYes (after intake form)

Customer Journey

The journey for pre-approved products is shorter than the standard LMN flow because there is no clinical review step.

  1. Customer sees HSA/FSA eligibility signaled on the product page
  2. Customer adds items to cart and sees eligibility reinforcement
  3. At checkout, customer selects Truemed as the payment method
  4. The clinical intake form is skipped, and the customer enters their HSA/FSA card directly
  5. Payment captures immediately
  6. Customer receives a receipt and order confirmation (no LMN)
  7. Customer saves the receipt for 3 years in case of an IRS audit

Edge Cases

What if the HSA/FSA card is declined?

For pre-approved products there is no clinical approval step, so the only failure scenario is a card issue (insufficient balance, TPA restrictions, card not activated for medical purchases). Troubleshoot as usual:

  • Check the card’s restrictions and TPA rules
  • The customer can pay with a regular credit or debit card and submit the receipt for reimbursement through their HSA/FSA administrator

What if the cart contains both pre-approved and LMN-required items?

If a customer adds both pre-approved and dual-purpose items to the same cart:

  • The dual-purpose items trigger the standard LMN intake flow
  • The pre-approved items do not generate an LMN independently
  • The order processes based on each product’s status

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