Need six months same-as-cash to buy a new knee or to pay to unclog your arteries?

A new credit card with a six-month interest-free option for Medical Mutual of Ohio enrollees is among the latest financing options being offered to cash-strapped patients facing rising health-care costs.

But some consumer advocates see potential pitfalls in turning to any form of credit to pay off mounting medical bills.

The Cleveland-based health insurer is partnering with financial services firm E-Duction Inc. in suburban Philadelphia to offer the Clear MasterCard to workers at participating companies with 100 or more employees.

The credit card is linked to employees' paychecks, with automatic payroll deductions to pay off purchases.

Enrollees get six months to pay off health-related or educational charges of $200 or more without interest charges through automatic deductions from their paychecks by E-Duction.

Other purchases are paid off interest-free during a two-month period.

Medical Mutual decided to offer the card because employers increasingly are picking health plans with higher out-of-
pocket costs for workers, said Aaron Graham, director of product development for Medical Mutual, which has 1.6 million enrollees in Ohio.

In addition, he said, the credit card could help make sure doctors get paid by Medical Mutual patients.

According to the nonprofit Kaiser Family Foundation's 2007 annual employer health benefits survey, the average annual deductible for the most popular type of insurance plan is $461 for single coverage and $1,040 for family coverage.

The credit card ''is not a solution to the whole health-care infrastructure, but it is something that can help people manage their costs,'' Graham said.

Medical debt

Increasingly, patients are turning to debt to deal with medical bills.

A poll earlier this year by CreditCards.com found that more than a third of Americans say they would resort to some form of borrowing to pay medical debts.

A recent report by management consulting firm McKinsey & Co. determined that consumers charge $45 billion worth of out-of-pocket medical expenses on credit cards.

The consulting firm estimates uncovered health-care costs could reach $420 billion by 2015.

Several banks and credit-card companies are trying to capitalize on the trend by marketing medical credit cards and lines of credit, sometimes in partnership with health-care providers.

'' . . . With the right business models,'' the McKinsey concludes, ''credit card spending in the health-care sector could reach $150 billion by 2015.''

And that's exactly what some consumer advocates fear.

''The seeping of the financial service industry into health-care finance is very troubling,'' said Mark Rukavina, executive director of The Access Project, a nonprofit medical consumer research and advocacy group in Boston.

The threat of reporting to credit bureaus if the bills aren't paid ''is a major sword over the heads of people struggling to pay the health bills,'' Rukavina said.

Even cards with appealing no- or low-interest terms ''may turn out to be less appealing should your circumstances change'' and higher interest rates and penalties kick in, he said.

Taking responsibility

But E-Duction President and Chief Executive Paul Chicos said the Clear card program differs from typical credit cards and encourages responsibility.

E-Duction has been marketing its Clear Card MasterCard through employer groups and some other health insurers since 2002 and has about 20,000 card-holders.

If enrollees lose their jobs, they get 30 days to pay off the balance without interest, Chicos said.

Balances that aren't paid off during the required time period are subject to interest rates of 14.99 percent or 24.99 percent, depending on the circumstances, he said.

The Clear card is issued without any credit check to employees at participating companies who earn at least $20,000 annually, meaning workers who often can't get credit will qualify, Chicos said.

Jay Seaton, Northeast Ohio area president for the Consumer Credit Counseling Service in Cleveland, said the Clear card concept could be an innovative option for some consumers.

The fact that payments are automatically pulled from paychecks could help people avoid racking up bad debt, he said, as long as they maintain their jobs.

''It's another tool, and that's useful,'' he said. ''What I tell people with credit is, 'Be as rational as you can. Understand the current situation and what would be the worst-case scenario.' ''

How it works

Medical Mutual is waiving the $48 annual fee for card users, Graham said. Participating companies will pay less than $1 per person in the group to cover administrative costs for Medical Mutual and E-Duction.

The credit limit is based on enrollees' incomes: 2.5 percent of base salary for workers earning $20,000 to $74,999 per year and 4 percent of base salaries for those earning $75,000 or more. (A person earning the minimum $20,000 would qualify for a $500 credit limit.)

''Our line of credit is a pay-related line of credit because we want to protect them from having more credit than they can manage,'' Chicos said. '' . . . The individual who we're really helping is the individual who struggles with paying the bills — the same person who otherwise isn't eligible for credit cards.''

Novant Health, a not-for-profit health system in North Carolina, has been offering the Clear card to its 22,147 employees for about six years.

Almost 3,000 employees are using the card for everything from health-care purchases to new computers, said Lisa Kinney, Novant Health's director of compensation and benefits.

''We do have positive feedback,'' she said. ''Just like with any tool that you put out there for an employee, they have to manage it themselves. So you do have those folks who may not manage as wisely as they should. But that population is small compared to the population that does a great job of managing the tool and appreciates the value it gives them.

''I have one and I love it. When you're in a pinch, sometimes it's great to pull that Clear card out.''

Hospital payment plans

Credit counseling experts agree the best option for someone who can't afford medical bills is to talk with the doctor or hospital to work out a reasonable payment plan.

Akron's three major hospital systems — Akron Children's Hospital, Akron General Medical Center and Summa Health System — each offer payment plans on a case-by-case basis, as well as reduced-cost charity care for those who qualify.

Children's, for example, allows families to pay off their bills interest-free over 12 months.

''Our goal out of the box is not to ruin people's credit,'' said Alicia LaMancusa, director of finance for Children's.

In addition to providing charity care and prompt-pay discounts, the Cleveland Clinic partners with banks to help patients get loans at lower interest rates, spokeswoman Heather Phillips said.

Akron General also is considering offering low-interest loans for patients along with existing interest-free payment plans and charity programs, hospital spokesman Jim Armstrong said.

''We have been exploring this possibility on and off for the past few years,'' he said. ''It's coming back to the top of the list again as we see more and more patients applying for financial assistance.''