Auto Insurance Medical Coverage: Understanding The Basics

Auto insurance medical coverage, also known as MedPay, is an optional coverage in most states that can help pay for medical expenses for you or your passengers in the event of a car accident, regardless of who is at fault. MedPay can also cover medical expenses if you are injured as a pedestrian or while riding a bicycle. In some states, MedPay can cover your health insurance deductible and help with co-pays, dental and chiropractic services. Personal Injury Protection (PIP) is another form of auto insurance medical coverage that is mandatory in some states and optional in others. PIP covers medical costs, lost wages, and other services like childcare and funeral costs resulting from an accident, regardless of fault.

Medical payments coverage (MedPay)

Medical payments coverage, also known as MedPay, is an optional add-on to an auto insurance policy that covers expenses related to vehicular accidents. MedPay is available in most states and is required for drivers in Maine and for those in New Hampshire who purchase insurance. It covers medical expenses for the policyholder, their family, and passengers in the car at the time of the collision, regardless of who is at fault. It also covers medical expenses if you are injured in someone else's car or as a pedestrian or cyclist.

MedPay covers a range of expenses, including health insurance deductibles and co-pays, hospital visits and stays, rehabilitation costs, and ambulance fees. It typically does not cover lost wages, medical expenses unrelated to the accident, or replacement services for tasks you cannot perform due to injuries.

The amount of MedPay coverage you purchase represents the maximum amount available to each person covered under your policy. MedPay is usually sold in small amounts, ranging from $1,000 to $5,000, and often costs less than $10 per month. When deciding how much coverage you need, consider your existing health insurance plan and its deductibles.

MedPay is supplemental to your regular health insurance, and the rules and regulations regarding primary coverage vary by jurisdiction. It is also important to note that MedPay does not cover lost wages or replacement services, which are covered by personal injury protection (PIP) insurance.

Personal injury protection (PIP)

PIP covers the healthcare costs of both the policyholder and their passengers, even if they don't have health insurance. It also covers medical expenses for pedestrians injured by the policyholder's car. PIP policies have a minimum coverage amount and a per-person maximum coverage limit, which is usually no more than $25,000. If the cost of medical care exceeds the PIP limit, health insurance may cover the additional expenses.

In addition to medical care, PIP often covers lost income, childcare, and funeral expenses related to the accident. For example, in New York, No-Fault (Personal Injury Protection) covers 80% of lost earnings from work, up to a maximum of $2,000 per month for up to three years from the date of the accident.

PIP is required in about a dozen states, including Delaware, Florida, Hawaii, Kansas, Kentucky, Maryland, Massachusetts, Michigan, Minnesota, New Jersey, New York, North Dakota, Oregon, Pennsylvania, Utah, and Puerto Rico. In some other states, it is offered as an optional add-on to insurance policies.

Uninsured/underinsured motorist bodily injury

UMBI coverage is an additional coverage that can be added to your car insurance policy. It provides protection if you or your passengers are injured in an accident caused by an uninsured or underinsured driver. This coverage typically includes medical bills, pain and suffering, and lost wages if you are unable to work due to the accident. It may also cover funeral expenses if a fatality occurs in the crash.

If you are in an accident with an uninsured driver, meaning they have no car insurance, your UMBI coverage will help pay for any medical bills that you or your passengers may have. It ensures that you don't have to pay out of pocket for expenses resulting from the accident. Additionally, UMBI coverage can also protect you if you are in an accident with a driver who has insurance but their policy limits are not sufficient to cover the full extent of your injuries or damages.

Unfortunately, a significant number of drivers on the road are uninsured or underinsured. According to statistics, approximately 13% of drivers nationwide were uninsured in 2019. This means that if you are in an accident with one of these drivers, you could be left footing the bill for your medical expenses and vehicle repairs. UMBI coverage gives you peace of mind knowing that you are protected financially in such situations.

State Requirements for UMBI Coverage:

The requirements for UMBI coverage vary from state to state. In some states, UMBI coverage is mandatory, while in others it is optional. Even if your state doesn't require it, it is highly recommended to add this coverage to your policy for the reasons mentioned above. Check with your insurance provider to understand the specific requirements and options available in your state.

Deductible Considerations:

It's important to note that UMBI coverage typically does not include a deductible, which means you won't have to pay anything out of pocket before your insurance coverage kicks in. This is in contrast to your health insurance, which may have a high deductible, making UMBI coverage even more valuable.

Medical payments adjuster

A medical payments adjuster is a crucial part of the process of claiming medical payments coverage, also known as MedPay, following a car accident. MedPay is an optional coverage type that can be added to an auto insurance policy to help cover medical expenses resulting from a car accident. It is important to note that MedPay is not available in all states and does not cover lost wages or other types of damages besides medical expenses.

When making a MedPay claim, the first step is to contact your insurance company to initiate the process. The medical payments adjuster will then guide you through the necessary steps to ensure that you receive reimbursement for your medical expenses. This typically involves submitting all relevant medical records and bills, as well as possibly signing a release form and providing proof of identification. The adjuster will review the submitted paperwork and make a decision to either reimburse the appropriate party, request additional information, or deny the claim.

The role of the medical payments adjuster is to review and assess the submitted medical records and bills to determine the validity and appropriateness of the claim. They act as the intermediary between the insured individual and the insurance company, facilitating the reimbursement process and ensuring that all necessary documentation is provided.

It is important to understand the limits of MedPay coverage, as it typically has a maximum amount that the insurer will pay per person per accident. Therefore, selecting the appropriate coverage limit is crucial to ensure that your medical expenses are adequately covered. MedPay is designed to cover out-of-pocket expenses that may not be covered by your health insurance or other types of auto insurance. By working closely with the medical payments adjuster and providing the necessary documentation, you can effectively navigate the MedPay reimbursement process and receive financial assistance for your medical expenses following a car accident.

Medical payments coverage limits

Medical payments coverage, or MedPay, is an optional coverage for auto insurance policies in most states. MedPay coverage limits are usually low, ranging from $1,000 to $10,000, with some companies offering up to $25,000, $50,000, or $100,000. The coverage limit you choose will determine your MedPay premium, so a higher limit will increase your auto insurance quote.

MedPay covers the policyholder and their passengers' medical expenses in the event of a car accident, regardless of who is at fault. This includes hospital visits, ambulance fees, nursing services, and dental procedures. It also covers the policyholder if they are injured as a pedestrian or while riding a bicycle.

When choosing your MedPay coverage limit, consider your existing health insurance plan. If you have a high-deductible health plan or one with many out-of-pocket costs, you may want to select a higher MedPay limit. MedPay can help cover your deductible and any remaining medical costs.

It's important to note that MedPay won't cover lost wages if you're forced to miss work due to an accident, and it doesn't apply to injuries caused to other drivers. Additionally, MedPay won't cover trailers or other equipment attached to your car.

Frequently asked questions