Payments · Telehealth7 min readUpdated November 2, 2026

Trial Offers for Telehealth Companies: Rules and Conversion

The FTC, Visa, Mastercard and Stripe rules for telehealth free visits, first-month prices and membership trials, FTC cases and a compliant flow.

Nick Bonnassies, CMO at Tagada · checked against 12 sources

Article summary

TL;DR

Free visits, discounted first months and membership trials are legal, but the FTC has pursued these offers in telehealth. Show the full cost before the card fields (visit, membership, treatment, commitment, fees), get separate consent, remind the patient at least 7 days before the price changes, and allow online cancellation. Never start recurring charges before the clinician decides.

ROSCA requires clear terms before billing details, express informed consent, and "simple mechanisms" to stop recurring charges.
Visa requires a notice at least 7 days before a trial or intro price ends, and online cancellation for online sign-ups (rules of April 18, 2026).
In 2025, the FTC alleged a telehealth company hid a one-year membership term, charges every 28 days and an early termination fee; the proposed order carried $150,000.
In July 2026, the FTC and two states alleged Hims & Hers enrolled consumers in subscriptions "shortly after receiving consumers' intake forms".
As of November 2, 2026, the FTC has proposed no new negative option rule since its March 2026 notice.

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On this page

This guide is part of our hub on telehealth payment processing. The general guide, for any business: free trials and negative option billing.

What counts as a trial in telehealth

Any offer where a low or free start turns into a recurring charge unless the patient acts is a negative option. In telehealth, that covers more than the classic free trial.

Offer	What renews	Main risk
Free or discounted first visit	Often a membership or care plan behind it	Patient didn't see the plan price
Low first-month price	The plan at full price, sometimes with treatment billed apart	Total cost not shown7
Membership trial	The membership, sometimes with a minimum term	Commitment or exit fee not disclosed7
"Cancel anytime" plan	Every cycle	Cancellation harder than sign-up9

Fig. 1An intro offer from checkout to renewal, and the rule at each step

CheckoutROSCA: full terms before billing, express consent
Clinician decisionHold only; capture on approval
ReminderVisa: at least 7 days before the intro price ends
Full-price chargeVisa 13.5 if the patient wasn't clearly advised
RenewalsOnline cancellation, visible next to any save offer

Each FTC case sits on one of these steps.

15 U.S.C. § 8403; Visa Core Rules, April 18, 2026; Cal. Bus. & Prof. Code § 17602; FTC press releases and orders, 2024 to 2026.

What the FTC has alleged

Three cases show where the FTC looks. Two are settled orders; one is an open lawsuit with allegations, not findings.

Case	Date	What the FTC alleged or ordered
NextMed (Southern Health Solutions)	Proposed order published July 17, 2025	Price that didn't show the medication cost or required services; a one-year membership term, charges "every 28 days" and an early termination fee not disclosed; $150,000 to the FTC; consent records kept 3 years7
Cerebral	Proposed order April 15, 2024	A "cancel anytime" promise with a cancellation process the FTC called "complex, multi-step, and often multi-day"; over $7 million in total9
Hims & Hers (with Utah and California)	Complaint July 29, 2026, case open	Subscriptions started "shortly after receiving consumers' intake forms"; consumers "charged for and subscribed to a prescription […] without having a chance to review or approve it"; a hidden cancel button8

The pattern: price that doesn't add up, a commitment the patient didn't see, a charge that comes before the patient or the clinician has agreed, and a cancellation that's hard to find.

The rules that apply

The FTC's 2024 click-to-cancel rule was vacated in July 2025. The FTC opened a new rulemaking in March 2026, and as of November 2, 2026 no new rule has been proposed2. ROSCA, state laws and card network rules set the requirements today.

Rule	What it requires
ROSCA	Terms before billing details; express informed consent; simple way to stop charges1
California	Express consent; acknowledgment; online cancellation; notice 3 to 21 days before a trial over 31 days ends; consent records kept 3 years3
Visa	Trial terms on the checkout screen; click-to-accept consent; notice at least 7 days before a trial or intro price ends; online cancellation4
Mastercard	Confirmation with cancellation instructions; a reminder before billing for trials longer than 7 days5
Stripe	Prohibits "reduced price trials with unclear or hidden pricing"6

7 days

Visa's minimum notice before a trial or intro price ends

3 to 21 days

California's notice before a trial over 31 days ends

3 years

How long California and the NextMed order keep consent records

Other states have their own automatic renewal laws; the FTC cites Colorado, Vermont and Virginia alongside California2. Check the states where your patients live with counsel.

Tagada follows Visa and Mastercard rules and the laws that apply to payments.

Trials and the clinician's decision

A telehealth offer has a step a retail trial doesn't: someone has to decide whether treatment is appropriate. The FTC's Hims & Hers complaint is built on charges that came before that step8.

Hold, don't charge, at checkout
Authorize the card; capture only when the clinician approves.
Show the plan after the decision
The treatment plan, its price and its cycle, before the first recurring charge.
Release the hold on a decline
A patient the clinician doesn't treat should pay nothing for the plan.
Keep the visit fee separate
If you charge one, so the patient knows what they paid for.

Watch out

A card hold is not clinical approval. Your checkout copy can't imply the patient will be prescribed anything because the payment went through.

The payment mechanics: prescription-gated checkout.

A compliant intro offer, step by step

Show the full cost before the card fields: visit fee, membership, plan price after the intro period, cycle, any minimum term or exit fee1 7.
Collect a separate consent: a click-to-accept tied to the recurring terms, apart from your general terms4.
Log it: the exact text shown, the page version, time and order; keep it 3 years3 7.
Confirm right away with terms, next charge date and a link to cancel online4 5.
Remind at least 7 days before the intro price ends; for monthly renewals, Stripe suggests a reminder 2 to 3 days before4 10.
Let patients cancel online the way they signed up, with the cancel button visible even if you show a save offer3 4.
Confirm the cancellation and stop the next charge.

Visa disputes 13.2 and 13.5 are won or lost on your consent record.

The cancellation side in depth: cancellation compliance for telehealth. Plans that patients keep without a trial: memberships for telehealth companies.

Trials and disputes

Two Visa dispute reasons fit trial problems exactly4:

13.2 Cancelled recurring transaction: the cardholder withdrew permission and you charged anyway.
13.5 Misrepresentation: a purchase through a trial or intro offer where the cardholder "was not clearly advised of further Transactions".

Both are won or lost on your consent record. Each one also counts in your dispute ratio: chargebacks for telehealth companies.

How Tagada helps

Intro offers with a clear way out

TagadaPay brings "native 3DS2, device intelligence, and rules engine: approve real customers, block the rest"12, with "enhanced review for regulated verticals". For intro offers:

Subscriptions with trials, cycles, retries and automatic recovery
Email and SMS fired by real events, for renewal reminders
Customer portal: "skip, pause, change frequency, swap product, cancel with your retention offers", with cancellation at the end of the paid period by default11
Your vault, portable: "Switch processors without re-onboarding customers"

Building the whole telehealth brand? With Tagada Rx, "the card is only captured once a doctor approves", refills rebill on ship day, and "declined, cancelled, and errored cases never rebill." US patients only, by selection.

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Updated on November 2, 2026

Nick Bonnassies

CMO at Tagada

CMO at Tagada. Before Tagada, Nick built direct-to-consumer brands that generated over $115M in sales, raised over $25M in crowdfunding and sold two of them. He also works as a fractional CMO on marketing operations and AI systems.

Frequently asked questions

Is a free trial legal for a telehealth subscription?

Yes, if the terms are clear and the patient consents. ROSCA, state laws such as California's and Visa's trial rules apply. Stripe prohibits trials with unclear or hidden pricing. Show the full cost, including any minimum term or exit fee, before the card fields.

Do I need to remind patients before a trial ends?

Yes. Visa requires a notice at least 7 days before a trial or intro price ends, with a way to cancel online. Mastercard asks for a reminder on trials longer than 7 days. California has its own window for trials longer than 31 days.

Can a telehealth membership have a minimum term or a cancellation fee?

It isn't banned outright, but it must be disclosed before payment. The FTC's 2025 NextMed case alleged an undisclosed one-year term and early termination fee. If you use one, show it next to the price and in the confirmation, and keep the consent record.

Does the FTC click-to-cancel rule apply in 2026?

No. The 2024 rule was vacated in July 2025, and as of November 2, 2026 the FTC has proposed no new rule after its March 2026 notice. ROSCA still requires a simple way to stop recurring charges, and Visa and California require online cancellation.

Should I charge the patient before the clinician reviews their case?

Hold the card, but capture only after approval. The FTC alleged in July 2026 that Hims & Hers enrolled consumers in subscriptions shortly after intake and that most got no consultation with a provider. Authorizing first and capturing on approval keeps the charge behind the clinical decision.

Sources

Checked November 2, 2026

TagadaPay

Intro offers charged only after the clinician decides

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