Coming soon. Early access list open now. Active launch Q3 2026.
agenticHSA
agentichsa · early access open now

Pre-tax dollars for the care you actually need — and an honest no on the rest.

Most people have no idea what's eligible. The agent does. Paste your EOB — in 30 seconds it shows which expenses may qualify for pre-tax treatment. It watches your spend, routes what qualifies for physician review where a documented condition supports it, and organizes HSA, FSA, and HRA in one place. No HR department. No insurance expertise required.

Join the early access list See how it works
no w-2 needed · 1099 + Stripe + Plaid · HIPAA-aware architecture
You'd sandbox any dependency this deep in your stack. So did we.
care tied to a documented condition · pre-tax when clinically appropriate

When care is medically necessary, it should be pre-tax.

Effective savings depend on your federal + state bracket and HSA contribution capacity · Letters issued under IRS §213(d) only where clinical review supports medical necessity · physician-reviewed via altru.care
2026 IRS limits · live calculator

How much can you actually shelter pre-tax this year?

$0 / $4,400 IRS max
0% funded
 
$0
Saved · 22% bracket
$0
Saved · 30% blended
$0
Saved · 37% bracket
Federal bracket only · state savings additional · effective rate varies · not tax advice
the agentic layer

Six agents run in the background. Every month. For you.

You connect your accounts once. The agent watches your spend, drafts the LMNs, gets them signed, and prepares your pre-tax reimbursement for approval. You write code; we handle the paperwork.

1

Spend agent

Connects to your card + Plaid + Stripe + Apple/Google Pay. Categorizes every health-relevant transaction (clinical care, therapy, devices, services) and flags the ones that may qualify when tied to a documented condition.

connectors · Plaid, Stripe, Apple/Google Pay
2

LMN drafter

Where your record already documents a relevant diagnosis, prepares a draft Letter of Medical Necessity under IRS §213(d) for clinical review. A licensed physician evaluates the request and decides. No documented condition means no letter — the agent will not build a case around a purchase.

physician overlay · altru.care · 24-hr SLA
3

HDHP + HSA opener

If you don't have an HDHP yet, the agent identifies the best one for your state and prepares the enrollment and contribution plan — you review and approve. If you already have one, it just plugs in. Either way: max-out your annual HSA contribution ($4,400 individual / $8,750 family in 2026) with almost none of the manual tracking.

irs-correct · approve-to-fund
4

Reimbursement agent

For each LMN-approved purchase, the agent prepares your HSA reimbursement — pre-tax — for one-click approval. End of year, exports a clean ledger for your CPA: every purchase, every LMN, every receipt, every dollar saved. Stripe-grade reporting.

reimburse · CPA-ready ledger
5

Audit shield

Every LMN is hashcare-signed (cryptographic timestamp + physician signature + diagnosis basis). If the IRS ever asks, your audit packet is one click. Your evidence chain survives every probe — you don't have to.

hashcare-signed · §213(d) defensible
6

ComfortCard wallet

Every LMN, every receipt, every reimbursement lives in your ComfortCard health identity wallet. Auditable. Portable. Yours forever — even if you cancel.

identity · persistent · digital
IRS §213(d) · §7702B(c) · the standard we hold

A letter cannot make a personal expense medical. It can document care that already is.

In March 2024 the IRS warned specifically that notes based on self-reported information do not convert food, wellness or exercise spending into medical care — and that real documentation requires a visit with the diagnosing and treating provider, in person or by telehealth. We agree with that, and we build to it.

Where the ground is genuinely solid is long-term care. Qualified long-term care services are already medical care under the statute when two conditions hold: the person is chronically ill, and the services follow a plan of care prescribed by a licensed practitioner. Nothing is being converted — the certification is what the law asks for.

The test we apply. Unable to perform at least two activities of daily living for 90 days or more without substantial assistance, or requiring substantial supervision due to severe cognitive impairment. Certified within the last twelve months, renewed annually.

What we decline. General fitness and wellness. Food and supplements for general health. Any request that arrives as “write me a letter so I can pay for this.” A review that never says no is not a review — so we publish that we decline, and we do it before you pay.

Check this first: HSA funds cover you, your spouse and your tax dependents. Paying for a parent usually means they must qualify as your dependent.

General information, not tax or legal advice. Eligibility depends on IRS rules, your plan terms and your circumstances.

one membership · everything pre-tax

AgenticHSA runs inside ComfortCard.

ComfortCard is your health identity wallet. AgenticHSA is the engine that finds you eligible spend, drafts LMNs, and prepares pre-tax reimbursement for your approval. One membership. Two products. Zero paperwork.

spend scan

$0 · one-time

How much am I leaving on the table?
  • Connect your card → see what could've been HSA-eligible last year
  • Personalized LMN-eligibility report (typical: $400–$3,000/yr)
  • Your ComfortCard wallet created (free forever)
  • No commitment — see the savings before you subscribe
Free spend scan
comfortcard protected

$19 · per month

Designed to pay for itself in your first month — could save $1k+/yr.
  • All 6 agents running monthly
  • Up to 6 physician-signed LMNs per year (via altru.care, 24-hr SLA)
  • HDHP + HSA opening if you don't have one (or plug into your existing)
  • Annual CPA-ready ledger export (every LMN, every receipt, every dollar saved)
  • Hashcare-signed audit shield — IRS-probe defensible
  • Full ComfortCard health identity wallet — yours forever, even if you cancel
Join early access · launching Q3 2026
how the ecosystem connects

Three brands. One mission. Your coverage, protected.

Join Early Access List · Q3 2026
no w-2 required · cancel anytime · wallet stays yours