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The costs of certain types of healthcares are sky high. To wit, if you’ve been to the dentist recently and had to price out a root canal or crown (or, heaven forbid, been told that your kids need to go get fitted for braces), you can understand that dental pain and suffering has a long reach… all the way into your wallet! If your insurance doesn’t cover most of the cost of these sorts of procedures, or of you lack insurance altogether, you could be left high and dry wondering how, exactly, you will pay for the care you need. Many dentists will offer you a healthcare credit card to cover the cost of your necessary work. These cards seem tempting: your work will be paid for, over time, with flexible repayment terms, and no up-front costs. You might be thinking, ‘sign me up!’ But you really should think twice. Or three times, even. Make sure that you really understand what you are signing up for.

In August, New York’s Attorney General, Andrew M. Cuomo, took healthcare credit card lenders to task for accusations of deceptive and fraudulent practices. Cuomo reported that his office received “hundreds” of complaints having to do with various healthcare credit card issuers. The consumers in question used the cards to fund dental work as well as certain elective medical procedures not covered by insurance – Lasik eye surgery, cosmetic procedures, hearing aids, optical services, and chiropractic care. New York isn’t alone in attacking these lenders. Minnesota’s Attorney General, Lori Swanson, has a current case pending against two chiropractors who allegedly signed patients up for credit cards without their consent or approval and charged up the cards for several thousand dollars in services that had not yet been performed. The lawsuits remain open. California law changed at the beginning of this year to reflect a change in dentists’ ability to charge patients for services not yet rendered. As of January, unless the dentist has provided the patient with a comprehensive breakdown of the services and their costs, they may not be charged. Patients may also get full refunds for work not yet completed within fifteen days of requests.

It’s alarming to know, as patient advocates have noted, that many patients sporting healthcare credit cards are not even aware that they actually have a piece of plastic. Many of these customers believe that they have an extended payment plan with the doctor(s) in question, and that they are simply providing their financial information so that the agreement can be solidified. When these customers get the actual card in the mail, say consumer groups, they are often shocked and alarmed.

Unfortunately, receiving a piece of unasked-for plastic is often the least of these borrowers’ concerns. The terms of the healthcare credit cards are far from transparent, and generally don’t work in the favor of customers. For example: one of the most popular cards available in the industry touts interest-free borrowing within a certain time frame. In other words, as long as the consumer pays back everything they owe within six months / nine months / one year, they won’t pay any interest. What isn’t so prominently advertised, however, is the fact that customers who let their balance drag beyond that term can expect to be blindsided with interest rates of over twenty-five percent, with charges starting back at the original date of purchase and for the full amount charged. Some customers don’t realize until this point that they’ve been charged for work that was never completed.

The article I read on this topic relayed the case of one Maxine Veach, a sixty-year old retiree from the United States Postal Service who has two forms of dental insurance, yet still needed assistance with the costs of work not covered fully by her plans. She was getting three crowns and needed three teeth pulled. Veach furnished he dentist with all her insurance information (through Excellus BlueCross BlueShield and MetLife), but also decided to willingly sign up for a healthcare credit card to cover the costs beyond her insurance. She then scheduled the actual work for a later date. Imagine Veach’s surprise when she quickly received her first credit card bill for twenty-three hundred dollars, after having only had her teeth cleaned and a set of x-rays taken! The office had charged her in advance for the work not yet done. She says that she made phone call after phone call in an attempt to straighten out the fiasco, to no avail. Veach, who lives in New York, got in touch with the office of Attorney General Cuomo, who was successful in partially negotiating down the amount that Veach owed. Still, Veach believes that she was scammed and is looking for a new dentist. She still owes over eighteen hundred dollars for work that she never got done.

There has been a spate of new credit card industry legislation that was supposed to address the many concerns that consumers and consumer advocates have been harboring about the credit card industry and its many shady practices. The so-called Credit Cardholders’ Bill of Rights (the CARD Act) addressed the amount of allowable late fees and unjustified interest rate increases on balances. Unfortunately, none of the Act’s many changes specifically prohibit “teaser” or promotional rates, and it also (equally unfortunately) does not address the issue of charging consumers for services before they’re provided.

One of Attorney General Cuomo’s targets, GE CareCredit, has a business model through which it charges medical practitioners a fee to offer the card to their patients/customers, and then provides rebates when these providers bring in a certain volume of business through sales generates on the cards’ usage. GE CareCredit’s spokespeople underplay this element of the doctor/credit card issuer relationship, saying that it only happens in certain, “limited instances.” GE CareCredit is not alone, as Cuomo is investigating several different issuers. It just might be the largest and best-known, however. GE CareCredit is offered by as many as one hundred thirty thousand medical practices across the country. It says that it will cooperate fully with the New York Attorney General’s probe. Other targets of Cuomo’s fury? Chase Health Advance and Citi Health Card, two products offered by some of the financial industry’s heaviest hitters. Both agreed that they would furnish Cuomo with any information necessary to aid his investigation, but otherwise declined to comment.

Many consumer advocates are particularly insulted by the healthcare credit card industry and doctors’ joint exploitation of patients because these underhanded and despicable practices prey upon people who need medical help of some sort and are probably in pain. Patients might feel pressured to apply due to their discomfort, and really, how pathetic and horrible is that? The Access Project, a Boston-based nonprofit that helps consumers solve medical-debt problems, points out that people are innately conditioned to trust their doctors. If their doctor is heavily pushing the medical credit cards as a form of payment, they will most likely feel the pressure to go ahead and use them.

Experts say that the easiest way around using medical credit cards and avoiding those issues altogether is to ask doctors for a payment plan. It beats using plastic to pay for your care, and risking financial headaches down the road (the kind that no doctor’s help can cure, in other words!). You’d be surprised how many doctors are amenable to these kids of arrangements, and they don’t even charge interest for you to participate in them. You are in an especially good position to ask for a payment arrangement if you have a good and long-standing patient relationship with the doctor, say the pros – most physicians do not want to sever a patient relationship, and will work out the money details rather than to turn someone away. If there is anything you can do to avoid putting medical costs on credit cards of any kind, you should definitely do it. Like oil and water, medicine and plastic simply don’t mix.