Troubleshooting HSA/FSA Card Declines at Checkout

If you're having trouble checking out with your HSA or FSA card through Truemed, you're not alone. There are a few specific reasons why your card might be getting declined — and in most cases, there’s a clear next step you can take.

This article covers the most common issues specific to Truemed’s checkout system and how to resolve them.

Truemed only processes HSA/FSA payments for items that are medically eligible. At checkout, your cart is reviewed in real time.

Here’s how eligibility affects payment:

• If none of the items in your cart qualify, you won’t be able to use your HSA/FSA card.

• You’ll see a message letting you know your cart is ineligible.

• To proceed, you’ll need to check out with a regular debit or credit card instead.

• If your cart includes both eligible and ineligible items, some merchants support split payments.

• This means:

  • You can use your HSA/FSA card for the eligible portion

  • And a personal card for the rest

• Not all merchants support this — you’ll see an option to split payments only if it’s available.

Think an item was marked ineligible by mistake?
Let us know! We can check the product category on the backend and confirm.

Our system checks directly with your card issuer when you attempt payment. If you see a message about “insufficient funds,” this came from your HSA/FSA provider.

A few things to consider:

• Your account may have money, but:

  • Some of it could be invested and not liquid

  • You may have a daily spending cap

  • Your card might not cover the full eligible portion

• To resolve this, we recommend contacting the HSA/FSA card provider directly — they can see the full account status, while we cannot.

Sometimes, your HSA/FSA card provider simply blocks the transaction without giving us details. This is known as a generic decline.

In this case:

• You’ll need to contact your card issuer to ask why it was declined.

• As a workaround, you can:

  • Check out using your personal debit/credit card

  • Submit your receipt to your HSA/FSA administrator afterward for reimbursement (we’ll confirm the eligible portion at checkout)

If your cart should be eligible and you're still getting declined, we’re happy to help investigate. Email us at support@truemed.com with:

• A screenshot of the error message

• The email you used at checkout

• Any details about the product you're trying to buy

We’ll help guide you through it.