Jane Dotson
Excess medical auto insurance, also known as coordinated or excess coverage, is a type of insurance policy that covers medical and funeral expenses resulting from a car accident. In the event of an accident, the individual's health insurance is primarily responsible for paying the medical bills, with the auto insurer covering any remaining costs or expenses not covered by the health insurance policy. This type of coverage is available in most states as an optional add-on, but in some states, it is mandatory. Excess medical auto insurance ensures that individuals are protected financially in the event of a car accident, providing peace of mind and reducing potential out-of-pocket expenses.
| Characteristics | Values |
|---|---|
| Type of insurance | Excess medical coverage, also known as coordinated coverage |
| When it applies | After a car accident, or if you are injured as a pedestrian or cyclist |
| What it covers | Medical and funeral expenses, including EMT and ambulance fees, hospital visits and stays, nursing services, dental procedures, and injuries sustained as a pedestrian or cyclist |
| Who it covers | The policyholder, family members driving the car, and passengers |
| How it works | It acts as secondary coverage, meaning your health insurer pays for most medical bills, and MedPay covers deductibles or copays |
| Cost | Between $2 to $37 per month, depending on the desired coverage amount |
| Coverage limits | Typically $1,000, $2,000, $5,000, $10,000, or $25,000 |
| Where it's available | Most states, but not required in all; required in Maine and Pennsylvania |
What You'll Learn
Coordinated vs uncoordinated coverage
In Michigan, drivers have the option to choose between coordinated and uncoordinated No-Fault insurance benefits. This is also referred to as excess coverage.
Coordinated Coverage
If you have coordinated coverage, your health insurance is the primary payer for car accident-related medical expenses. Your No-Fault auto insurance will only pay for accident-related medical care, treatment, and services if they are not covered by your health insurance provider. In return for this, drivers receive a reduced auto insurance premium.
However, some health insurance policies will not pay for medical expenses related to car accidents if there is No-Fault coverage. In these cases, the auto insurer will pay first.
Uncoordinated Coverage
If you have uncoordinated coverage, your No-Fault auto insurance is the primary payer for car accident-related medical expenses. This means that your auto insurer will pay for all accident-related medical care, treatment, and services, even if they are covered by your health insurance provider.
Uncoordinated coverage is more expensive but provides more flexibility in choosing a doctor and does not run the risk of exhausting health insurance benefits.
Recommendations
Most people in Michigan have coordinated coverage as it is cheaper. However, some attorneys recommend uncoordinated coverage as it provides more comprehensive protection in the event of a car accident.
It is also recommended that drivers choose unlimited No-Fault PIP (personal injury protection) medical benefits coverage in their uncoordinated auto insurance policy. This is because No-Fault provides coverage for all "reasonably necessary" medical care and treatment, whereas health insurance plans may fail to cover the treatment, care, and services needed by car accident victims.
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Primary medical benefits
Excess medical auto insurance, also known as coordinated or uncoordinated coverage, is a type of insurance policy that covers medical expenses resulting from a car accident. While it is not available in all states, it is an optional form of auto insurance in most.
Now, let's discuss primary medical benefits in detail:
- Auto Accident Exclusions: If your health insurance policy includes any type of auto accident exclusion, it is advisable to elect primary medical coverage on your auto insurance policy. This ensures that your medical expenses related to a car accident are covered.
- HMO Restrictions: If you have coverage through a Health Maintenance Organization (HMO), electing primary medical benefits can expedite your treatment and provide a wider choice of doctors and specialists. HMOs often have restrictions and delays in treatment, so primary medical benefits can help you access faster and more flexible care.
- ERISA Plan Concerns: If your health insurance is a self-funded ERISA plan, electing primary medical coverage on your auto insurance is recommended. Self-funded ERISA plans have been associated with claiming liens against auto accident negligence cases, which can impact your settlement.
- Medicare and Medicaid: If you have Medicare, Medicaid, Veterans Administration Benefits, or a county health plan, it is advisable to have primary medical PIP on your auto insurance. This helps avoid "super liens" that government benefit providers may have against your personal injury case, protecting your potential compensation.
- Blue Cross Blue Shield Coverage: If you have traditional Blue Cross and full coverage on your auto insurance, there could be a "double dip" situation. To avoid this, consider having primary auto insurance coverage in addition to your health insurance.
- Coordinated Policy Limitations: Many people choose coordinated benefits to save money on their auto insurance premiums if they already have health insurance. However, in the event that you lose your health insurance coverage or encounter one of the situations mentioned above, it is crucial to contact your auto insurer and switch to primary medical coverage.
In conclusion, primary medical benefits provide valuable protection in the event of a car accident, ensuring that your medical expenses are covered regardless of the limitations of your health insurance policy. It grants you greater flexibility in choosing your medical providers and can expedite your treatment, which is crucial for your well-being and recovery.
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MedPay coverage
MedPay covers a range of expenses, including:
- Ambulance and EMT fees
- Hospital visits and stays
- Nursing services and care
- Dental procedures
- Prosthetics and other medical equipment
- Funeral expenses
MedPay is particularly useful if your health insurance policy does not cover car accidents or has high deductibles and copays. It can also be beneficial if you do not have health insurance, as it can provide financial security and help cover medical expenses after an accident.
In some states, MedPay is similar to Personal Injury Protection (PIP) coverage, which is mandatory in no-fault states. PIP coverage generally offers more comprehensive protection than MedPay, including wage reimbursement and coverage for psychiatric and rehabilitative care. In some cases, having both MedPay and PIP can be advantageous, as MedPay can help cover expenses that exceed PIP limits.
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Personal injury protection
In addition to medical costs, PIP covers:
- Rehabilitation therapy
- Lost income resulting from the accident
- Replacement of necessary services, such as family care or household maintenance, if the injured person is not an income producer
- Funeral, burial, or cremation expenses
- Lost income for your surviving dependents if you pass away in an accident
PIP is subject to claim limits, so if your medical bills exceed your PIP limits, you may need additional coverage. While PIP provides comprehensive coverage, it doesn't cover everything. For example, it won't cover the other driver's injuries in a collision or any injuries sustained while committing a crime.
The cost of PIP varies depending on your location, the amount of coverage, and your driving history. It's recommended to compare quotes from multiple insurers to get the best rate.
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No-fault insurance
In a no-fault insurance claim, you submit your claim to your own insurance company, which then pays for certain financial losses related to your injuries from the accident. This streamlines the process as you don't have to prove who was at fault. However, you are still not guaranteed a settlement, and the types of compensation you can collect are limited. No-fault insurance typically covers hospital and medical expenses, lost income, replacement services (such as childcare or cleaning), and funeral costs. It does not cover pain and suffering damages or property damage, which would be covered by collision insurance or the other driver's liability policy.
In Michigan, for example, drivers have the option of "coordinated" or "excess" medical benefits, where health insurance pays first, and the auto insurer covers the remainder. Alternatively, drivers can choose primary medical benefits, where the auto insurance company pays medical benefits directly.
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Frequently asked questions
Excess medical auto insurance, also known as coordinated coverage, is a type of insurance policy that requires the policyholder to use their health insurance first in the event of an auto accident. The auto insurer is then responsible for paying for any care that is not covered or that exceeds the health insurance coverage.
Excess medical auto insurance can provide a reduction in your auto insurance premium as the health insurance is the primary coverage. It also ensures that any medical expenses not covered by health insurance will be paid by the auto insurer.
In no-fault states, such as Michigan, the auto insurer is typically responsible for paying no-fault benefits, even if the policyholder has health insurance. However, with excess coverage, the health insurance is still the primary coverage, and the auto insurer covers any excess or uncovered expenses.
