By PYMNTS | October 19, 2026
Employers know exactly what their health plan costs. What they usually don’t know is what it costs them when an employee needs care and doesn’t get it because a credit check got in the way of the bill.
That happens more often than most benefits teams realize. In the past 12 months, 36% of adults said they skipped or put off care because of what it would cost, and among uninsured adults under 65, that number was 75%, according to “Americans’ Challenges with Health Care Costs,” a September report from research, polling and news firm KFF.
It’s a cost that rarely shows up in the budget conversation, said Augusto Ruiz-Eldredge, chief operating officer of PayMedix, the parent company of TempoPay, a healthcare financing platform offered through employer and health plan benefits.
“The gap purchasers often miss is between an individual or family having health insurance coverage and how they will pay their share when care is needed,” he said.
That gap keeps widening as out-of-pocket costs keep climbing for healthcare consumers in the United States, Ruiz-Eldredge said.
His point lined up with a theme in PYMNTS Intelligence’s September Embedded Finance Tracker®, “Making Health and Wellness Benefits Perform.” A benefits program is only worth what participants can actually use, not what’s been budgeted for it.
The Tracker made the case in infrastructure terms: real-time eligibility, automatic controls and a single platform for every benefit type.
TempoPay takes the same question one step further back, to whether a patient qualifies for financing in the first place.
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Plenty don’t. The Federal Reserve’s “Report on the Economic Well-Being of U.S. Households in 2025” found that 33% of adults applied for some form of credit that year. One-third of them were turned down or approved for less than they asked for, up 5 percentage points from 2021.
Take Away the Credit Check, and People Use Care Differently
HPS/PayMedix acquired TempoPay in 2024 and brought two decades of interest-free financing experience with it. Rather than launch as a standalone brand, the product plugs straight into a health plan’s existing infrastructure. Today it runs through carriers including Meritain and Cigna Clearity. Eligible employees get a dedicated line of funds for healthcare, dental, vision and even veterinary expenses, with no credit check and no partial approvals. They pay it back through payroll deduction or a linked bank account, and the member pays no fees or interest.
Lowering the financial barrier to care seems to change how people use it over time. Separate longitudinal data from HPS/PayMedix looked at 114 employer groups with 25 or more subscribers each, all active with PayMedix for at least five years. Over that stretch, healthcare spending spread out more evenly across the year. The gap between the first and fourth quarters’ share of annual spending shrank from about 8 percentage points in year one to about 2 points by year five.
TempoPay’s own usage numbers tell a similar story, Ruiz-Eldredge said. Among registered users, 5% make their first purchase the day they sign up, 52% do so within 90 days and another 22% get to it later. Cardholders use the card about six times a year.
That cadence suggests TempoPay turns into an ongoing way to manage healthcare costs rather than a one-time fix, Ruiz-Eldredge said. It’s also a different model from buy now, pay later. Most BNPL options show up per purchase at checkout, and even the interest-free ones can run a creditworthiness check every time and often carry fees. Because TempoPay comes through an employee’s health plan or benefits program, eligible members sign up without a credit check, pay no interest or fees, and can repay purchases over up to 12 months. That same structure separates it from consumer credit cards and the medical credit cards offered in provider offices.
The benefit goes beyond having money available upfront, Ruiz-Eldredge said.
“Because TempoPay runs through the health plan itself, it can also support incentives for using preferred providers, encourage treatment adherence and promote health-seeking behavior, all without adding to a member’s overall cost of care,” he said.
Augusto Ruiz-Eldredge is the chief operating officer of PayMedix.