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HSA/FSA fitness platforms compared

Truemed vs Flex: Which Should You Use?

Both Truemed and Flex let you pay for gym memberships and fitness expenses with your HSA or FSA. But they charge differently, partner with different brands, and one is almost always cheaper.

The Short Answer

Truemed

Best for most gym members and equipment buyers. $30 one-time fee. 30+ gym partners including Barry's, Orangetheory, Life Time, and more. Also covers Peloton, Tonal, and supplements.

Flex

Best for Equinox members. 4% per transaction. Equinox exclusive partnership since February 2026. Higher cost for most users, but the only HSA/FSA option for Equinox.

Side-by-Side Comparison

Every major difference between Truemed and Flex in one table.

FeatureTruemedFlex
Fee Structure$30 one-time4% per transaction
Annual Cost ($150/mo gym)$30$72
Annual Cost ($250/mo gym)$30$120
Gym Network30+ brandsEquinox (exclusive)
Equipment PartnersPeloton, Tonal, HypericeNone
Supplement PartnersAG1, Momentous, SeedNone
LMN ProcessOnline health surveyOnline health survey
Turnaround TimeMinutes to 24 hoursMinutes to 24 hours
LMN Duration12 months12 months
HSA SupportYesYes
FSA SupportYesYes
Funding$34M Series A (a16z)Private

*Annual cost assumes consistent monthly membership payments. Truemed fee is one-time per LMN period. Flex fee applies to each transaction.

Fee Comparison Deep Dive

The math is straightforward. Truemed charges a flat $30. Flex charges 4% of every transaction. Here's how that plays out at different price points.

The Breakeven Point

Flex's 4% fee equals Truemed's $30 flat fee at $750 in total annual spending ($750 x 4% = $30). Any amount above $750/year and Truemed is cheaper.

Since most gym memberships cost $50-$300/month ($600-$3,600/year), Truemed is cheaper for nearly everyone.

Monthly SpendAnnual SpendTruemed CostFlex Cost (4%)You Save with Truemed
$50/mo$600$30$24Flex is $6 cheaper
$75/mo$900$30$36$6
$100/mo$1,200$30$48$18
$150/mo$1,800$30$72$42
$200/mo$2,400$30$96$66
$250/mo$3,000$30$120$90
$300/mo$3,600$30$144$114

Partner Network Comparison

The biggest difference beyond fees is which brands each platform supports.

Truemed Gym Partners (30+)

Barry's
CorePower Yoga
SoulCycle
24 Hour Fitness
CrossFit
YMCA
Club Pilates
SPENGA
F45
Life Time
Orangetheory
Title Boxing
Rumble
Pure Barre
CycleBar
StretchLab
Solidcore
Anytime Fitness

Truemed also partners with equipment brands (Peloton, Tonal, Hyperice) and supplement companies (AG1, Momentous, Seed).

Flex Partners

Equinox (Exclusive)

As of February 2026, Equinox is a Flex-exclusive partner. If you're an Equinox member, Flex is the only platform that offers direct HSA/FSA checkout integration. Equinox memberships typically range from $200-$400/month depending on location and tier.

Which Should You Choose?

For most people, the answer is clear. Here's a quick decision framework.

Choose Truemed if...

  • You go to any gym besides Equinox
  • You're buying fitness equipment (Peloton, Tonal, etc.)
  • You want the lowest possible fees
  • You have multiple fitness expenses (gym + supplements + equipment)

Choose Flex if...

  • You're an Equinox member
  • You prefer Flex's embedded checkout experience
  • You only need coverage for Equinox

Related Guides

How to Pay for a Gym Membership with Your HSA

Step-by-step guide to using HSA funds for gym memberships, including the LMN process.

Truemed HSA Guide

Complete guide to using Truemed for HSA/FSA fitness payments.

Is a Gym Membership HSA Eligible?

Eligibility rules, requirements, and how to qualify for HSA coverage.

Is a Peloton HSA Eligible?

How to use your HSA to buy a Peloton bike or pay for a Peloton membership.

Common Questions

What is the difference between Truemed and Flex?▼
Truemed charges a flat $30 one-time fee and partners with 30+ gym and fitness brands. Flex charges 4% per transaction and has an exclusive partnership with Equinox. Both facilitate Letters of Medical Necessity (LMNs) so you can pay for fitness with HSA or FSA funds, but their fee structures and partner networks are very different.
Which is cheaper, Truemed or Flex?▼
For most people, Truemed is significantly cheaper. Truemed charges a flat $30 one-time fee regardless of how much you spend. Flex charges 4% per transaction. For a $200/month gym membership, Flex costs $96/year in fees vs. Truemed's $30 - saving you $66/year with Truemed. The only scenario where Flex is cheaper is if your total annual fitness spend is under $750.
Can I use Truemed for Equinox?▼
No. As of February 2026, Equinox is a Flex-exclusive partner. If you're an Equinox member and want to pay with HSA/FSA funds, Flex is your only option through these platforms. You could alternatively get an LMN from your own doctor and submit for reimbursement directly.
Do both Truemed and Flex work with FSAs?▼
Yes. Both Truemed and Flex support HSA and FSA payments. The LMN process is the same for both account types - you complete an online health survey, and if you qualify, you receive a Letter of Medical Necessity that allows fitness expenses to be paid with pre-tax health funds.
How fast is the LMN process?▼
Both platforms offer fast LMN turnaround. You complete an online health survey, and approval typically takes anywhere from a few minutes to 24 hours. Neither platform requires an in-person doctor visit. The LMN is valid for 12 months with both services.
What if I don't qualify through either service?▼
If you don't qualify through Truemed or Flex, you are not charged for the LMN attempt (Truemed explicitly does not charge if you're not approved). You can also try getting an LMN from your own primary care doctor or a telehealth provider. The IRS allows fitness expenses when a doctor documents medical necessity.
Can I use both Truemed and Flex?▼
Technically yes - you could use Truemed for one gym and Flex for Equinox, for example. However, one LMN should cover most fitness expenses. The practical scenario for using both is if you're an Equinox member (Flex-only) who also buys equipment through Truemed partners like Peloton or Tonal.

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