Does Health Insurance Cover Car Accidents?
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Health insurance can cover car accidents but is typically secondary to auto insurance. If you have it in your auto policy, personal injury protection or medical payments coverage usually pays first — health insurance would then pay for any remaining medical expenses. However, order of payment can vary by policy and your health insurance provider may pay first in some cases.
Different types of coverage step in depending on the accident and who was at fault. Keep reading to learn what coverage you’ll need to ensure your medical costs are paid.
Can You Use Health Insurance in a Car Accident?
Your health insurance provider may provide coverage for medical costs incurred as a direct result of a car accident. Eligible expenses typically include broken bones, burns, emergency transportation and care, diagnostic tests and rehabilitation.
If you have personal injury protection or medical payments coverage in your auto policy, you will need to exhaust these benefits first. The remaining medical costs, if any, are picked up by your health insurance provider.
The order of who pays first can vary by the health insurance company. A health insurance contract for Cigna or Kaiser Permanente, for example, may specify that they are not liable for services that are payable by an automobile insurance policy. On the other hand, Blue Cross Blue Shield of Michigan states that health insurance coverage will be primary and auto insurance coverage secondary.
Be sure to double-check with your auto and health insurance provider to determine who pays first in a car accident.
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What Type of Insurance Should You Use In A Car Accident With Injuries?
Different types of coverage can step in depending on your auto policy, health insurance policy and who was responsible for the car accident.
Medical Payments Coverage or Personal Injury Protection
If you have it, medical payments coverage or personal injury protection in your auto insurance policy will cover your medical expenses. While similar, personal injury protection is not optional in some states and offers slightly more coverage than medical payments coverage:
- Medical payments coverage (Medpay)
- Optional coverage
- Medical expenses
- Funeral costs
- Typically no deductible
- Personal injury protection (PIP)
- Same coverage as Medpay, plus loss of income
- Required in some states
- Deductible may apply
Other Driver’s Auto Liability Coverage
If the other driver was responsible for the car accident, you could file a liability claim against their insurance company to get reimbursed for your medical expenses.
However, fault is not always 100% depending on the accident and your state. Both drivers may be at fault for the accident and would pay the other driver’s medical costs in proportion to their percentage of fault. For example, if the other driver was determined 70% liable for the accident, they would pay for 70% of your medical expenses and you would pay for 30% of their costs.
Uninsured/Underinsured Motorist Bodily Injury Coverage
If the liable driver in the car accident is uninsured or does not have enough coverage, uninsured/underinsured motorist bodily injury (UM/UIM BI) coverage will step in if you have it.
Underinsured motorist bodily injury coverage covers the same types of expenses, but functions a little differently. UIM BI coverage pays for the difference between your UIM limits and the other driver’s liability limits. For example, say the liable driver has $20,000 in liability coverage, you have $30,000 in UIM coverage and your medical costs total $30,000. After exhausting the liable driver’s $20,000 liability limit, your UIM insurance will cover the remaining $10,000.
Note: If you have medical payments or personal injury protection, UM/UIM BI coverage may be redundant and unnecessary.
If you do not have Medpay/PIP or UM/UIM BI coverage in your auto policy, health insurance will pay for your medical bills. However, you will typically need to pay a deductible before your healthcare coverage kicks in. Deductibles typically don’t apply with UM/UIM BI or Medpay but may apply with PIP.
In some cases, your health insurance company may pay for your immediate medical care expenses — even if you have medical coverage in your auto policy. When this happens, your health insurance may seek reimbursement from your auto insurance company in a process called subrogation.
Can You Use Health Insurance if You Don’t Have PIP or Medpay?
If you do not have first-party medical benefits in your auto insurance policy, your health plan should cover motor vehicle-related medical expenses.
You Can Still Receive Care if You Have Zero Coverage
If you have neither medical coverage in your auto insurance policy nor health insurance, you can still receive emergency medical care. According to the Patient Advocate Foundation, hospitals and emergency rooms must administer emergency care even if you are uninsured.
You are still responsible for bearing these costs and paying them out of pocket. In many cases, the medical facility will work out a payment plan so you do not have to make a single lump-sum payment upfront.
Should You Consider PIP or Medpay If You Have Health Insurance?
If you do not have health insurance, then Medpay/PIP could be an affordable coverage alternative for car accident injuries.
Consumers should also remember that Medpay does not charge a deductible unlike health insurance — you can claim full coverage up to the limits without incurring an out-of-pocket cost. PIP deductibles may apply.
If you live in the following 12 states, you are required to carry PIP even if you have health insurance:
Who Pays First for Medical Bills After a Car Accident?
Depending on the accident and your coverage plans, the other driver’s auto policy or your auto policy’s first-party medical benefits or your health insurance plan may pay first for medical expenses that arise after a car accident.
Car Accident Scenario
Who Pays First?
Other driver was liable for the car accident and has auto insurance
Other driver’s auto liability insurance
Other driver was liable for the car accident but is uninsured
Uninsured motorist coverage
Other driver was liable for the car accident and has car insurance but the limits are not enough to cover your medical costs
Other driver’s auto liability insurance, up to its limits; your underinsured motorist coverage pays the difference
You were partially or fully responsible for causing the car accident
Medical payments or personal injury protection
Your auto insurance coverage will cover your medical expenses but your limits are too low.
Your auto insurance, up to its limits; health insurance pays the difference
Medicare and Medicaid
If you have Medicare or Medicaid, then your auto policy’s first-party benefits or the other driver’s liability coverage would cover your medical expenses after a car accident. Similarly, Medicaid is a secondary payer and only steps in after you’ve exhausted the limits in your auto insurance policy. This includes your Medpay/PIP coverage or the at-fault driver’s liability insurance.
How Do I Submit Medical Bills to Car Insurance?
Submitting medical documentation is part of the broader process of filing a car insurance claim. Assuming you have Medpay/PIP in your auto policy, you can typically get your medical costs covered in one of two ways:
- Pay the medical facility directly and send copies of your receipts or bills to your auto insurer for reimbursement.
- Provide your auto insurance information to the medical facility so they can bill your auto insurer directly.
If you’re filing a liability claim against the other driver, you should save copies of all your bills and receipts so you can submit them to their insurance company for reimbursement.
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For a couple of extra dollars per month, you can add medical payments coverage to your auto policy. Just enter your zip code below or call 855.214.2291 and SmartFinancial will send you your free car insurance quotes.