# Process Health Savings Account (HSA) or Flexible Spending Account (FSA) cards

This article describes how you can enable Health Spending Account (HSA) or Flexible Spending Account (FSA) payments on your account
### Accepting HSA/FSA payments with Compliant MCCs or the “90% Rule”
Stripe is an approved acquirer for merchants who need to process HSA/FSA funds. There are two paths a merchant can take to accept HSA/FSA payments:
1. If providing qualified medical services, use one of the HSA/FSA-eligible merchant category codes (MCCs).
1. Attest that over 90% of their volume processes HSA/FSA goods.
Enabling an account to accept HSA/FSA payments doesn’t guarantee a card won’t be declined. Card issuers can still authorize or decline payments as they would with any other type of card.
### **Information Inventory Approval System (IIAS) Certification**
For merchants who don't qualify for one of the medical/pharmacy MCCs but still want to process HSA/FSA funds, Stripe offers integration with the IIAS certification process so that businesses can accept HSA/FSA payments
The IIAS integration setup requires merchants to have an up-to-date list of the items in their inventory that qualify for HSA/FSA funds.
* Merchants that have an inventory system that tracks HSA/FSA items can work directly with Stripe to enhance their integration to process HSA/FSA funds. Reach out to Stripe support to learn how to begin the certification process.
* For merchants that don't have a ring-fenced inventory for HSA/FSA items, Stripe [has partnerships](https://stripe.com/partners) to enable any merchant to accept HSA or FSA cards at checkout. Depending on your type of business, you may be immediately eligible to accept HSA/FSA funds or you may require some additional steps to accept payments in a manner that is IRS-compliant.
### SIG-IS registration
**Merchants that are selling products** must register with SIG-IS for their products to be deemed as “Eligible,” “Dual-Purpose” or “Ineligible.” In addition, the merchant must have an Inventory Information Approval System (IIAS) in place to restrict the use of HSA/FSA cards only to eligible products. Finally, the merchant must be certified with SIG-IS and registered with Visa and Mastercard. Following these steps ensures that HSA/FSA payments will be processed properly, and that purchases will be auto-substantiated, so that there's no need to provide receipts to prove eligibility of items purchased. Furthermore, as long as these requirements are met, no special MCC code is required in order to accept HSA/FSA funds.
### Requirements for merchants who sell products
**Merchants that are** **exclusively** **providing healthcare services** (for ex., doctor’s offices, optometrists, hospitals, and dentists), can accept HSA/FSA cards without the need for further registration, provided they have an eligible MCC. However, due to prohibitions on the use of HSA/FSA funds for cosmetic healthcare purchases, payments that are processed by healthcare services merchants may not be auto-substantiated. If a healthcare services business sells **any** products (for ex., an ophthalmologist who also sells glasses), they're subject to the same requirements as merchants selling products: product registration, IIAS certification, and registration with SIG-IS, Visa, and Mastercard.
Some Stripe [partners](https://stripe.com/partners) offer full-service solutions for merchants that need to navigate HSA/FSA payments.
Learn more about [SIG-IS and IIAS certification](https://sig-is.org/).