Truemed raises $34M Series A led by a16z to unlock HSA/FSA spending on preventive health

Summary

Truemed closed a $34 million Series A led by Andreessen Horowitz, announced in early January 2026. The raise actually occurred in the first half of 2025 but was held until the company could package it with a separate milestone: 3x revenue growth over the same period. The company is now 51 people.

Truemed's core business is unlocking HSA and FSA spending on preventive health products — exercise equipment, sleep technology, supplements — by generating the clinical documentation required under IRS rules. Justin Mares, co-founder and CEO, describes the company in its plainest form as a B2B SaaS compliance layer for HSA and FSA eligibility, built on top of Stripe. Partners include Peloton, Eight Sleep, and Lifetime Fitness. At least one merchant partner is routing 20% of total sales through Truemed, a figure Mares cites as evidence of meaningful conversion impact.

The value proposition to consumers is straightforward: top-bracket earners in high-tax states like California can save up to 50% on eligible purchases by using pre-tax dollars. HSA accounts grew approximately 11% last year and have tracked 10–15% annual growth over the past three years. Mares believes total HSA and FSA balances could reach $1 trillion over the next decade without any regulatory changes, driven largely by younger consumers who currently view these accounts as irrelevant.

The IRS standard Truemed applies requires evidence that an intervention treats, reverses, or alleviates a diagnosed condition. A medical advisory board evaluates each merchant category before onboarding. The company deliberately excludes GLP-1 pharmaceuticals, noting that existing payment rails already handle drug purchases adequately. The priority for 2026 is unlocking food as an eligible category, specifically medically tailored meals, which Mares describes as having strong efficacy data but significant IRS resistance.

Internally, Mares has structured a small "venture bets" team — himself plus two others — focused on rapid prototyping of new revenue lines using AI tooling. The approach is deliberately low-infrastructure: landing pages and lightweight products designed for iteration speed, not uptime. He targets a new revenue line within 12 to 18 months.

On the regulatory and political environment, Mares flags that HSA eligibility debates remain surprisingly contentious even within the healthcare industry, where categories as basic as bug spray are still contested. He is directionally optimistic that the current political climate around preventive health — he references RFK Jr.'s role in the Trump administration without naming him explicitly — creates a favorable backdrop, but notes health policy has become unexpectedly polarized.

On peptides as a 2026 trend, Mares is selectively bullish. He expects FDA guidance this year, given the volume of research-use purchases. His concern is long-tail safety data: adverse effects that take years to surface, particularly from stacking compounds over extended periods. He contrasts this with the broader market mood, which he characterizes as uncritically optimistic.

On geography, Mares views Austin as the primary destination for tech talent leaving California, with Boulder, Denver, and Miami as secondary options. A California wealth tax, if it gains meaningful political traction, would in his view accelerate an already visible outflow from both the Bay Area and Los Angeles.