FINANCING APPLICATION FORM

Apply for healthcare financing in seconds.

How it works: By partnering with physicians and hospitals, MedPlan is able to provide affordable payment plans for patients with high deductibles or other large out-of-pocket medical bills.

Apply for healthcare financing in seconds.
What you'll need to apply:

  • Your bank account number
  • Your routing number
  • Your online banking username and password

MedPlan uses your online banking login to verify that you have a bank account and to ask your bank some questions that allow us to approve your application right away! Don't worry, we can't make any withdrawals until you give us permission. If you don't have online banking, you can still apply and we'll give you a decision in less than 2 days.



You must select an amount.
  • 6
  • 12
  • 18
  • 24
  • 30
  • 36
  • 42
  • 48
  • 54
  • 60

Payments over months selected.

Estimated Monthly Payments: $

Estimated One Time Enrollment Fee: $

Are you currently employed?

Please Enter Card Information
No charge to your card untill your loan process is complete with authorized signature.

Check Here to Enter Bank Account Information (Optional)
Check this box if you have online banking and provide deposit account info below.
I understand that I am applying for credit and I hereby authorize Medplan Credit to obtain my credit information.


Please provide the Cosigner's Name and Email address. An email will be sent to them containing a link to complete the application.