Why am I paying more on Health Spending Account cards if they look like regular debit?

Health Spending Account cards from Sun Life, Manulife, Canada Life, Green Shield, and other Canadian benefit administrators run on Visa or Mastercard networks, not Interac. The healthcare merchant category code (MCC) for medical, dental, and allied-health services routes those transactions through interchange categories that price 15 to 35 basis points higher than equivalent non-healthcare debit or credit. If you are on flat-rate pricing (Square, most legacy bank-bundled processing), you pay the same rate on the HSA card as a regular debit card, and your processor pockets the difference. On interchange-plus pricing, the actual interchange shows on your statement as a pass-through line.

Will I have to change my practice-management software?

In most cases, no. Most Canadian practice-management platforms (Jane App, ClearDent, Tracker, Power Practice, AbelDent, TELUS Health platforms, Accuro EMR, Oscar EMR, Mikata) have API integrations with multiple processors, even when they default-install with a preferred partner. Some software contracts include processing exclusivity clauses; in those cases, the answer depends on contract terms and renewal timing. We check compatibility on the application and tell you in writing what your switching options are before you sign anything.

What about Interac transactions? Are those handled differently?

Yes. Interac runs as a separate domestic debit network in Canada at flat per-transaction fees, typically 5 cents through Payzium. Interac transactions do not carry the healthcare-MCC premium because Interac is a domestic network outside the Visa and Mastercard interchange framework. We pass Interac through at Payzium's flat per-transaction cost. Practices with high Interac volume (typically 30 to 40 percent of card mix in Canadian medical) see meaningful cost reduction on that slice specifically.

What about PIPEDA and provincial health privacy compliance?

Card transaction data is not personal health information under PIPEDA or under the provincial health information acts (PHIPA in Ontario, PIPA in BC and Alberta, HIA in Alberta, HSIA in Saskatchewan, PHIA in Manitoba, and equivalents in other provinces). The card networks and processors are governed by PCI-DSS, which is a separate compliance regime focused on payment card security. Your practice's PIPEDA and provincial PHI obligations on the clinical data side are unchanged by your choice of payment processor. If your practice handles patient billing inside a PHI-covered system (most do), the integration between that system and our processing is the only PHI-relevant touch point, and the standard Canadian practice-management platforms handle that natively.

How fast can I switch?

It depends on your practice-management software. Standard processor-integration platforms plug in directly. Locked-processor platforms need a written analysis of your switching options first. We do not begin the switch until you have written confirmation of compatibility.

What is "Pay less or it's free"?

Your first 90 days on Payzium have to cost you less than your old processor did. We compare your effective rate on Payzium against your most recent prior-processor statement, like for like, normalized if your volume or card mix shifts so the comparison stays honest. If you do not pay less, we refund every Payzium fee you paid in those 90 days and put up to CA$1,000 (Canadian merchants) or US$1,000 (US merchants) toward moving you to another processor. You keep any savings either way. Full terms on /pay-less.

Independent practices

Health Spending Account cards are not regular debit. Your processor profits from the difference.

Health Spending Account cards from Sun Life, Manulife, Canada Life, and Green Shield carry healthcare-MCC interchange premiums. We pass interchange through at cost and charge our 0.30% margin on top, plus a $5 monthly account fee. The premium goes where it belongs, into the math, not into the processor's pocket.

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Interchange pass-through, in writing
Pay less or it's free
Honest Rate Promise: 2x junk fee refund
No junk fees

What you pay

A practice on Payzium at typical volumes.

$145/mo
$20,000 monthly volume. About $2,202 a year less than Square Canada.
$391/mo
$50,000 monthly volume. About $5,149 a year less than Square Canada.
$913/mo
$120,000 monthly volume. About $12,658 a year less than Square Canada.
$1,897/mo
$250,000 monthly volume. About $26,435 a year less than Square Canada.

Math is for 35% Interac debit, 25% Visa and Mastercard debit, 40% credit, $165 average ticket, 80% card-present. Interac transactions pass through at Payzium's flat per-transaction cost. The calculator runs it on your numbers.

Common patterns

Four cost mechanisms every independent practice pays for.

01
Health Spending Account interchange premiums
Health Spending Account cards from Sun Life, Manulife, Canada Life, Green Shield, Beneva, and other Canadian benefit administrators run on Visa or Mastercard rails. They look like regular debit or credit cards to your terminal. They are not. The healthcare merchant category code (MCC) routes them through interchange categories that price 15 to 35 basis points higher than equivalent non-healthcare transactions. On a flat-rate processor like Square Canada (2.5% on credit in person), the merchant pays the flat rate regardless. The premium goes to the processor. On interchange-plus, the actual interchange shows on the statement as a pass-through line. On a $250 HSA transaction at a typical healthcare-MCC interchange of 1.40%, the merchant pays roughly $3.50 in interchange plus our 0.30% margin (75 cents), total about $4.30. On Square Canada at 2.5%, the same transaction costs $6.25. The gap is about $1.95 on every HSA swipe.
02
Patient-pay-after-visit keyed transactions
Patient-pay-after-visit transactions are typically keyed (entered into the terminal manually from a statement) or processed online through a billing portal. Both are card-not-present (CNP), which prices 30 to 60 basis points higher than card-present at the same interchange category. Practices that bill 30 to 50 percent of revenue this way are paying CNP rates on roughly half their volume. Our base rate is 0.40% on keyed and online transactions, plus the actual interchange. We do not surcharge CNP volume beyond the interchange cost.
03
Practice-management-software-locked processing
Most Canadian practice-management platforms have a preferred or default processor partner. Jane App (allied health), ClearDent, Tracker, Power Practice, AbelDent (dental), TELUS Health platforms (Med Access, PS Suite, Wolf), Accuro EMR, Oscar EMR, and Mikata (primary and specialty care) all integrate with multiple processors, but most install with a default and most practices never change it. When you bought the software, the processor came attached. We integrate with most Canadian practice-management platforms through standard APIs or through standalone terminal-plus-software setups. We check compatibility on the application before you sign. If your software locks the processor contractually, we tell you in writing what your switching options are. US toggle note: similar dynamics apply with Dentrix, Eaglesoft, athenahealth, DrChrono, and Practice Fusion in the US market.
04
Solo-practitioner volume penalties
Most processor contracts include a monthly minimum fee, $25 to $50, charged when your processing fees fall below the threshold. Plus a monthly statement fee, $10 to $20. Plus a PCI compliance fee or non-compliance penalty, $99 to $199 quarterly. A solo practitioner doing $15K a month in card volume can pay $60 to $80 in flat fees against $300 to $400 in processing fees, an effective rate inflation of 15 to 25 percent on top of whatever rate they were quoted. We do not charge monthly minimums, statement fees, or non-compliance penalties. The scam-fee list is published on /honest-rate-promise.

What changes

Three practices. Three switches.

Toronto, ON
Family dental, 2 dentists
$95,000 per month, 50% HSA, on ClearDent
On Square Canada at roughly 1.64%. Paying $1,558 per month on processing.
On Payzium at 0.30% plus interchange. Paying $688 per month.
$10,438
Lower annually
Vancouver, BC
Solo dermatology
$40,000 per month, 65% patient-pay-after-visit
On Square Canada at roughly 1.64%. Paying $656 per month on processing.
On Payzium at 0.30% plus interchange. Paying $293 per month.
$4,360
Lower annually
Ottawa, ON
Multi-specialist physiotherapy
$130,000 per month, on Jane App
On Square Canada at roughly 1.64%. Paying $2,132 per month on processing.
On Payzium at 0.30% plus interchange. Paying $920 per month.
$14,540
Lower annually

Illustrative composite. Numbers reflect Payzium's published rates and typical practices card mix at the stated volumes. Not a real customer case.

Open account

Apply online in minutes. No sales call, no commissioned rep.

Step 1
Tell us about your medical
Business name, role, monthly volume, your POS.
Step 2
Connect your bank
Plaid or manual.
Step 3
Sign and go live
Sign and go live. If your practice-management software supports standard processor integration (most Canadian platforms do), we plug in directly. If your software locks the processor contractually, we provide a written analysis of your options before you commit.

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No phone calls. No quote forms. Rates are on /pricing.

FAQ

Health Spending Account cards are not regular debit. Your processor profits from the difference.

A practice on Payzium at typical volumes.

Four cost mechanisms every independent practice pays for.

Health Spending Account interchange premiums

Patient-pay-after-visit keyed transactions

Practice-management-software-locked processing

Solo-practitioner volume penalties

Three practices. Three switches.

Apply online in minutes. No sales call, no commissioned rep.

Tell us about your medical

Connect your bank

Sign and go live

Frequently asked questions

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