Does Health Insurance Cover Auto Accident Injuries In New Jersey?

If you've been injured in a car accident in New Jersey, you may be wondering which insurance policy will cover your medical expenses. The short answer is that it can be either your Personal Injury Protection (PIP) or your health insurance, or even both. PIP is a mandatory auto insurance coverage in New Jersey, covering medical expenses and lost wages after a car accident, regardless of who is at fault. On the other hand, health insurance can also be used to pay for car accident injuries, but it depends on the specific policy.

Personal Injury Protection (PIP) insurance

PIP can cover various costs for both the policyholder and their passengers. This includes medical bills, rehabilitation costs, lost wages, childcare or housekeeping expenses, and funeral and survivor benefits. The minimum amount of PIP coverage required in New Jersey is $15,000, but you can purchase up to $250,000 in coverage. There are two types of PIP coverage available in New Jersey: the standard policy, which offers minimum coverage of $15,000 per person or $30,000 per accident, and the basic policy, which provides minimum coverage of $15,000 per person and per accident, with the option to purchase additional coverage for certain injuries.

It is important to note that PIP does not cover all expenses. Typically, it does not cover trips to the emergency room or hospitalization for other drivers or their passengers, damage to vehicles involved in the accident, or damage to another person's property. Additionally, if you choose to list your health care provider as your primary coverage for medical expenses, you may be responsible for a copay and a higher deductible when filing a PIP claim.

When it comes to choosing between health insurance and PIP as your primary coverage in the event of an accident, there are a few considerations to keep in mind. Firstly, check the terms and exclusions of your health insurance policy to see if it covers auto accident injuries. Secondly, using your health insurance as primary coverage can save you money on premiums, but it may come with deductibles and copays, so it is important to compare the costs and coverage limits of both options. Lastly, health insurance policies often include a "subrogation clause", which allows the insurer to recoup their expenses from any money you receive from other sources, such as a settlement from the other driver's insurance company.

Health insurance as primary coverage

In New Jersey, you can choose between Personal Injury Protection (PIP) and health insurance as your primary source of coverage for auto accident injuries. When you select one as the primary source, the other could become the secondary source.

If you opt for health insurance as your primary coverage, it will be the first payer for health-related expenses incurred from a motor vehicle accident, for you and all family members residing at your policy address. Your auto insurance will then provide secondary benefits under your PIP plan.

There are several benefits to choosing health insurance as your primary coverage:

• You can save money on premiums.
• You can avoid the $750 deductible that applies when your primary coverage is PIP and your health insurance is the secondary provider.
• You can avoid the potential complications of a "subrogation clause" in your health insurance plan. Under this clause, your health insurer may be legally entitled to money paid to you relating to your accident expenses, such as a settlement from the other driver's insurance company.

However, there are also some potential drawbacks to using health insurance as your primary coverage:

• You will likely have to pay deductibles and copays until your health insurance limits are reached, at which point PIP will kick in as the secondary insurer.
• Your health insurance plan may not cover vehicle accidents, or may have restrictions on what it covers.
• If you are covered by Medicare or Medicaid, you are not eligible to choose health insurance as your primary coverage.

Auto insurance policy coverage

In New Jersey, Personal Injury Protection (PIP) is a mandatory auto insurance coverage that pays for your medical expenses and lost wages following a car accident. This type of insurance is also required in 12 other states and is available as an option in others. PIP covers medical bills, rehabilitation costs, lost wages, childcare or housekeeping costs, and funeral and survivor benefits. The minimum coverage in New Jersey is $15,000 per accident or per person, and $250,000 for certain injuries, including permanent or significant brain injury, spinal cord injury, and disfigurement.

When it comes to choosing between health insurance and PIP as the primary source of coverage for auto accident injuries in New Jersey, it can be either or both. If you select one as the primary source, the other can become the secondary source. If your primary coverage is exhausted, the secondary provider will contribute to the payments.

It is important to check the terms and exclusions of your health insurance policy, as some policies may not cover auto accident injuries. Using health insurance as the primary provider can save on premiums, but it may come with deductibles and copays. Additionally, health insurance plans often include a "subrogation clause," which allows the insurer to recoup expenses from any money received from other sources, such as a settlement from the at-fault driver's insurance.

On the other hand, PIP provides valuable financial protection as it covers various costs associated with auto accidents, regardless of who is at fault. It is essential to compare the deductibles, copays, and premiums between health insurance and PIP to determine the most cost-effective option.

In summary, while both health insurance and PIP can cover auto accident injuries in New Jersey, it is important to carefully consider the specifics of each policy and seek legal advice if needed to make an informed decision about primary and secondary coverage.

Medical costs covered by health insurance

In New Jersey, you can choose between Personal Injury Protection (PIP) and health insurance as your primary source of injury coverage after a car accident. When you select one as the primary source, the other becomes the secondary source.

Health insurance will likely cover your car accident injuries, but it depends on the details of your specific policy. Some health insurance policies cover accidents, while others don't.

If you are injured in a car accident, your health insurance will usually pay for treatment related to your injuries. However, there may be restrictions on what is covered. For example, there may be in-network or out-of-network distinctions when it comes to care providers, or similar restrictions on what is covered. Certain kinds of treatment, including alternative forms of treatment, may not be covered under your health insurance.

If you are injured by another driver, your health insurer will probably have the right to reimbursement if you receive money from the at-fault driver's insurer or from some other source. This is known as a subrogation clause.

If you use your health insurance to pay for treatment of your car accident injuries, you will likely need to pay a deductible and/or some kind of co-pay.

Medical Costs Covered by PIP

PIP can cover medical bills and rehabilitation costs after a car accident. It can also cover lost wages, childcare or housekeeping costs, and funeral and survivor benefits.

PIP covers medical costs such as medication and prescriptions, rehabilitative and diagnostics services, hospital and ambulance expenses, and treatment in accordance with religious traditions.

There are limits to PIP coverage. A basic policy provides $100 a week in lost wages, with total coverage capped at $5,200. For services you cannot do yourself, such as lawn care, PIP pays up to $12 a day, with a total coverage of $4,380.

In New Jersey, the minimum required amount of PIP is $15,000 per person or accident, but drivers can choose a coverage limit of up to $250,000 for certain injuries. PIP usually pays 80% of medical costs, with the policyholder paying a 20% copayment.

Choosing between PIP and health insurance

In New Jersey, you can choose between Personal Injury Protection (PIP) and health insurance as your primary source of injury medical care coverage after a car accident. When you select one as the primary source, the other could become the secondary source. In the event that your primary source of coverage is exhausted, the secondary provider should kick in to contribute to your payments.

Specific Health Insurance Exclusions

First, check whether your health care policy covers auto accident injuries. While many health insurance policies do cover accidents, some don't. Carefully check the terms and exclusions of your health insurance plan.

Cost Comparison

Using your health insurance as a primary provider can generally help you save on premiums, but it likely also comes with deductibles (out-of-pocket expenses before the insurance takes effect). Compare the deductibles, copays, and premiums between your health insurance and PIP to see which option is more cost-effective.

Subrogation Clause

Health insurance plans commonly have a "subrogation clause". This means that if you are legally owed money relating to your accident expenses – for example, if PIP can pay for your injuries, or if you receive a settlement from the other driver’s insurance company – your health insurer may be legally entitled to some of that money as reimbursement for the expenses they covered. Subrogation can complicate your insurance situation, so if you have this clause in any of your policies, you may want to consult a lawyer.

Lifetime Limits

Check the lifetime limits on each of your policies. If you get into an accident when your primary-source health insurance is no longer in effect, your PIP will have to step in for your payments, but you will be required to pay an additional deductible of $750.

Primary and Secondary Coverage

Your health plan might explicitly state that your health insurance is "secondary" if you're injured in a car accident and there's other ("primary") insurance available to cover your injuries. In this case, you would turn first to the available car insurance coverage, and if the cost to treat your car accident injuries exceeds the amount of that coverage, your health insurance would kick in and pay for the remainder of your care.

Treatment Restrictions

Depending on the details of your health insurance, there might be in-network or out-of-network distinctions when it comes to care providers, or similar restrictions on what's covered. Certain kinds of treatment you receive in connection with your car accident injuries might not be covered under your health insurance, including alternative forms of treatment.

Passengers' Injuries

If you have passengers in the car who don't have their own car insurance coverage, their injuries will not be covered by your health insurance. PIP, on the other hand, covers the injuries of both the policyholder and their passengers, regardless of who is at fault.

Lost Wages

If injuries from a car accident prevent you from working, you'll want PIP coverage to reimburse a percentage of your lost wages. Short-term and long-term disability policies could help you make up for lost income, but they are taxable benefits and are usually received as less than 100% of your normal wages. PIP coverage, on the other hand, is a nontaxable payment.

Other Expenses

In addition to medical bills and lost wages, PIP can cover various other costs that can occur after a car accident, including rehabilitation costs, childcare or housekeeping costs if you're unable to care for your children or your home, and funeral and survivor benefits.

Frequently asked questions