HRA & Other Account Types
HRA & Other Account Types
Not every health spending account works with Truemed. This article covers the account types we get the most questions about, and explains exactly when each one does or does not work.
Health Reimbursement Arrangements (HRAs)
An HRA is an employer-funded benefit that reimburses employees for qualified medical expenses. Employees do not contribute to an HRA. Your employer sets an annual reimbursement limit, and you submit receipts to get reimbursed.
Depending on your plan, unused funds may roll over at the end of the year or expire.
Types of HRAs
- Standard HRA: The most common type. Employers reimburse employees for a wide range of qualified medical expenses.
- ICHRA (Individual Coverage HRA): Reimburses employees for individual health insurance premiums and sometimes other medical expenses.
- QSEHRA (Qualified Small Employer HRA): Available to employers with fewer than 50 employees. 2026 contribution limits are 13,100 for family coverage.
Does your HRA work with Truemed?
It depends on what your HRA covers.
- If your HRA covers general medical expenses: Truemed might work. Please check with your HRA first to confirm expenses tied to Letters of Medical Necessity are eligible. If so, you pay out of pocket at checkout, then submit your receipt and Letter of Medical Necessity (LMN) to your HRA administrator for reimbursement.
- If your HRA is restricted: It does not work with Truemed.
HRA reimbursement is a manual process. You pay first, then submit your LMN and receipt to your HRA administrator. Contact your HR department or benefits provider if you are unsure what your HRA covers.
Limited Purpose FSA (LEX HCFSA)
A Limited Purpose FSA (also called a LEX HCFSA) is restricted to dental and vision expenses only. It is designed to be used alongside an HSA without disqualifying you from HSA eligibility.
Because Truemed processes health purchases, not dental or vision expenses, a LEX HCFSA does not work with Truemed.
If you have both a LEX HCFSA and an HSA, use your HSA funds for Truemed purchases. Your LEX HCFSA can handle dental and vision costs separately.
Dependent Care FSA
A Dependent Care FSA covers childcare and dependent care costs: daycare, preschool, after-school programs, and similar expenses. It is separate from a Health Care FSA and has nothing to do with medical expenses.
A Dependent Care FSA does not work with Truemed.
If you want to use pre-tax funds for a dependent’s medical or health purchases, you need a Health Care FSA or HSA. See HSA/FSA Accounts for Dependents for details on covering a dependent’s eligible purchases.
Does Truemed work for Medicare / Medicaid?
Medicare
Enrolling in Medicare means you can no longer contribute to an HSA. However, any HSA balance you accumulated before enrolling in Medicare stays yours and remains fully accessible. You can continue spending those funds tax-free on qualified medical expenses, including Truemed purchases backed by an LMN.
Your existing HSA funds do not disappear when you enroll in Medicare. If you have a balance, you can still use it with Truemed.
Medicaid
Medicaid is a government program, not a private employer benefit. Medicaid recipients typically do not have HSA or FSA accounts, since those accounts are tied to private employer health plans.
If you are on Medicaid and do not have an HSA or FSA, you cannot use Truemed. If you have an HSA balance from a previous employer plan, those funds are still accessible and can be used with Truemed.
Truemed availability in the US
Truemed is available in the United States only. HSA and FSA accounts are defined and governed by US tax law, so these benefits do not apply outside the US.
If you are located outside the US, you are not able to use Truemed at this time.
