Key takeaways
- Financing is a conversion tool: it turns high-ticket elective treatments into booked appointments, and in most models the practice gets paid up front while the patient pays the lender over time.
- There are six distinct models—aesthetics-built BNPL (Cherry, PatientFi), healthcare credit cards (CareCredit, Alphaeon), services/POS BNPL (Sunbit, Wisetack), general BNPL (Affirm, Klarna), no-credit-check/subprime (Denefits, HFD), and cosmetic installment/established platforms (LendingUSA, GreenSky).
- Deferred interest is not 0%: healthcare-card promos can charge retroactive interest on the whole balance if a patient misses the window—favor true-0% products and disclose terms in writing.
- Merchant fees range from ~1.7% on aesthetics-built plans to ~10–15% on 0%-deferred promos; weigh paid-up-front vs collect-over-time, soft vs hard pull, and real approval rates—not just the headline fee.
- Match the stack to your patients: prime clients are covered by Cherry/PatientFi plus a healthcare card, while a credit-diverse base needs a near-universal-approval option like Denefits or HFD.
- Native integration with Aesthetic Record, Zenoti, or PatientNow drives consistent offering; many lenders have none, so confirm workflow fit before you commit.
Patient financing is one of the highest-leverage decisions a med spa makes, and most owners treat it as an afterthought. Aesthetic treatments are elective and increasingly higher-ticket: a full liter of filler, a laser package, a body-contouring series, or a year of memberships can run into the thousands. Many patients want the treatment but won't put it all on a card in one swipe. A financing option turns "let me think about it" into a booked appointment, which is why financing is fundamentally a conversion tool, not just a payment method.
The economics are friendlier than people assume. With most modern financing, the practice gets paid up front (usually within 1–3 business days) for the full treatment price, minus a merchant fee, while the patient pays the lender over time. You are not the bank, you don't carry the receivable, and in most cases you don't absorb the default risk. That separation is the whole point—and it's exactly what varies across the models below. Browse the full lineup on our patient financing category pillar.
The model types
There is no single "financing" product. There are six meaningfully different models, and picking the wrong one quietly costs you in fees, approvals, or patient goodwill.
(a) Aesthetics-built BNPL / installment. Purpose-built for cosmetic and med-spa practices: Cherry and PatientFi. These use a soft credit pull (no ding to the patient's score to check eligibility), frequently offer true 0% APR plans with no deferred interest, pay the practice up front, carry the lowest merchant fees in the category, and ship with native med-spa integrations. For most aesthetic practices this is the default starting point.
(b) Healthcare credit cards. CareCredit and Alphaeon Credit are revolving lines of credit, widely accepted across medical and dental offices, with strong brand recognition. The catch: their promotional plans are typically deferred-interest (more on why that matters below), and their merchant fees are higher and more variable, especially on longer 0%-promo terms. Great reach, but read the structure carefully.
(c) Services / POS BNPL. Sunbit and Wisetack come from the broader services and point-of-sale world. They tend to have high approval rates and a soft pull, and they're smooth at the counter—but they are not aesthetics-native, so the workflow and integrations are more generic than a Cherry or PatientFi.
(d) General BNPL. Affirm and Klarna are mainstream consumer names patients already trust. They're retail-first, which means smaller financing caps and a checkout designed for e-commerce rather than a treatment plan quoted in the room. Fine as a secondary option or for lower-ticket retail and product sales.
(e) No-credit-check / subprime plans. Denefits and HFD exist to approve the patients everyone else declines—near-universal approval for credit-challenged patients. Denefits is structured as a collect-over-time model with built-in payment protection rather than a lender that pays you the full amount up front, and these plans carry subprime APRs for the patient. Indispensable for a practice that serves a credit-diverse base, but understand the trade-offs.
(f) Cosmetic installment lenders and established platforms. LendingUSA specializes in point-of-need consumer installment loans for cosmetic and elective procedures, while GreenSky is a large, established financing platform with deep lender relationships. Both broaden your approval funnel beyond a single aesthetics-built provider.
Most well-run med spas end up running two providers: one aesthetics-built prime option (Cherry or PatientFi) plus one near-universal-approval backstop (Denefits, HFD, or a healthcare card) to catch the patients the first one declines.
Deferred interest — the #1 thing to understand
If you learn one thing from this guide, learn this. Deferred interest is not the same as 0% interest. With a true 0% plan, the patient pays the principal in equal installments and never owes interest. With a deferred-interest plan—common on healthcare credit cards—interest is accruing the whole time behind the scenes. If the patient pays the balance in full before the promo period ends, they pay no interest. But if they're even one dollar short on the final day, the lender charges retroactive interest on the entire original balance, often at an APR north of 25–30%.
Patients rarely understand this until the bill lands, and the surprise lands on your front desk and your reviews. The CFPB has scrutinized and acted on deferred-interest medical financing for exactly this reason. The practical guidance: favor true-0% / no-deferred-interest products where you can, and whenever you do offer a deferred-interest plan, disclose the terms clearly and in writing—what the promo window is, what happens if it's missed, and the APR that kicks in. Clear disclosure protects the patient and protects you.
Merchant economics
Financing is not free to the practice, and the cost structure is where models diverge most. You pay a merchant discount fee—a percentage of the financed amount that the provider keeps.
- Aesthetics-built BNPL (Cherry, PatientFi) runs lean, with merchant fees that can start around ~1.7% on standard plans.
- 0%-deferred and long-promotional plans, especially on healthcare credit cards, can run far higher—~10–15% of the transaction—because the lender is funding that promotional interest for the patient. Someone pays for "0% to the patient," and on those plans it's you.
Three other levers matter as much as the headline rate:
- Paid up front vs. collect-over-time. Most lenders (Cherry, PatientFi, CareCredit, Sunbit, Wisetack, Affirm) deposit the full amount up front and assume the patient's repayment risk. Collect-over-time models (e.g., Denefits) instead help you collect installments over time with payment protection—better approvals, but a different cash-flow and risk profile.
- Soft pull vs. hard pull. A soft pull lets a patient check their offer with no impact to their credit score, which dramatically increases the number who are willing to apply in the chair. A hard pull suppresses application rates.
- Approval rates. A provider that pays the lowest fee but approves few of your patients is worse than a slightly pricier one that approves most. Ask every vendor for their real approval rate on a med-spa book of business.
Match to your patients
The right stack depends on who walks through your door. For a prime, higher-income clientele financing four- and five-figure treatment plans, an aesthetics-built option like Cherry or PatientFi plus a healthcare card covers nearly everyone at low cost. For a credit-challenged or credit-diverse patient base, you need a near-universal-approval product like Denefits or HFD in the mix or you'll lose patients at the quote. Also weigh ticket size: general BNPL (Affirm, Klarna) suits lower-ticket retail and product sales, while aesthetics lenders and healthcare cards handle the large treatment plans and packages where financing actually drives the sale.
Integrations
A financing product that doesn't fit your workflow won't get offered consistently—and a tool that isn't offered doesn't convert. Native integrations with your practice platform (think Aesthetic Record, Zenoti, or PatientNow) let staff send an application or run a plan without leaving the chart or checkout. Aesthetics-built providers like Cherry and PatientFi invest here; many lenders, especially general BNPL and some subprime plans, have no native integration at all and rely on a separate portal, a text link, or a QR code. That's workable, but it adds friction at exactly the moment the patient is deciding. Confirm precisely how a provider plugs into your existing software before you commit.
Demo / onboarding checklist
Drive the evaluation yourself and confirm:
- Is the eligibility check a soft pull with no impact to the patient's credit?
- Are plans true 0% / no deferred interest, deferred-interest, or interest-bearing—and which terms?
- What is the merchant discount fee on each plan tier, and who pays for 0%?
- Do you get paid up front, or is this collect-over-time? How fast does funding hit?
- What is the realistic approval rate for med-spa patients, and what are the financing caps?
- Does it integrate natively with your booking/EMR (Aesthetic Record, Zenoti, PatientNow), or is it a separate portal?
- How are disclosures handled, and what does the patient see and sign?
Common mistakes
- Treating all "0%" the same—confusing true-0% with retroactive deferred interest and surprising patients with a back-dated APR.
- Optimizing only for the lowest fee—and ignoring approval rate, so you save on paper but lose patients at the quote.
- Running a single provider—with no near-universal-approval backstop for credit-challenged patients.
- Skipping disclosure—letting patients sign deferred-interest plans without clearly explaining the promo window and penalty.
- Ignoring integration—buying a tool your staff won't open because it lives outside your checkout.
Ready to choose? Start with the full patient financing category for our independent reviews, model the real cost in our pricing guide, and if you've narrowed it to the two best-known names, our Cherry vs CareCredit comparison breaks down exactly where each one wins. For how we evaluate every vendor, see our methodology.
Frequently asked questions
Does the med spa get paid up front, or do we wait for the patient to pay?
With most financing providers—Cherry, PatientFi, CareCredit, Sunbit, Wisetack, Affirm, and others—the practice is paid the full treatment price up front (typically within 1–3 business days), minus a merchant discount fee, and the lender collects from the patient over time. You don't carry the receivable or, in most cases, the default risk. The main exception is collect-over-time models like Denefits, which help you collect installments with payment protection rather than funding you in full immediately. Always confirm funding speed and who holds the repayment risk before you sign.
What is deferred interest, and why does it matter?
Deferred interest is a promotional structure—common on healthcare credit cards like CareCredit and Alphaeon—where interest accrues in the background during the promo period. If the patient pays the balance in full before the window closes, they owe no interest. But if they're even slightly short on the final day, the lender charges retroactive interest on the entire original balance, often at a 25–30%+ APR. This is different from a true 0% plan, where no interest ever applies. The CFPB has scrutinized deferred-interest medical financing for this reason. Favor true-0% products and, when you do offer a deferred-interest plan, disclose the terms clearly in writing.
How much does patient financing cost the practice?
You pay a merchant discount fee, a percentage of the financed amount. Aesthetics-built BNPL like Cherry and PatientFi runs lean—fees can start around 1.7% on standard plans—while 0%-deferred and long-promotional plans, especially on healthcare credit cards, can run roughly 10–15% because the lender is funding the patient's promotional interest. Beyond the headline rate, weigh whether you're paid up front or collecting over time, whether the eligibility check is a soft or hard credit pull, and the provider's real approval rate. A low fee with low approvals can cost more in lost patients than a slightly higher fee that approves most of your book.
Which financing provider fits a prime versus a credit-challenged patient base?
For a prime, higher-income clientele financing four- and five-figure treatment plans, an aesthetics-built option like Cherry or PatientFi plus a healthcare credit card covers nearly everyone at low cost and with soft credit pulls. For a credit-challenged or credit-diverse base, you need a near-universal-approval product such as Denefits or HFD in the mix, or you'll lose patients at the quote. Most well-run med spas run two providers—one prime aesthetics-built option plus one near-universal-approval backstop—so they can catch the patients the first provider declines. Ticket size matters too: general BNPL like Affirm and Klarna suits lower-ticket retail and product sales.
Do I need financing that integrates with my booking or EMR software?
It helps enormously. A financing tool that staff have to open in a separate portal gets offered inconsistently, and a tool that isn't offered doesn't convert. Aesthetics-built providers like Cherry and PatientFi invest in native integrations with platforms such as Aesthetic Record, Zenoti, and PatientNow, letting staff send an application or run a plan without leaving the chart or checkout. Many lenders—especially general BNPL and some subprime plans—have no native integration and rely on a text link or QR code. That's workable but adds friction at the exact moment the patient is deciding, so confirm how a provider fits your existing software before you commit.
