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    Does Health Insurance Cover a Car Accident?

    5 mins

    Your health insurance will likely cover your medical costs associated with a car accident. Personal injury protection (PIP) and MedPay are also car insurance coverages commonly used to help pay medical expenses. These along with liability coverage can help mitigate the flow of out-of-pocket expenses regardless of who is at fault. Hospitals are required to treat your injuries regardless of your insurance but will certainly seek reimbursement, so it’s best to be prepared. 

    Below you’ll find out what these options mean for you and how to better protect yourself and others should an accident occur.

    On This Page:

    • Will My Health Insurance Cover a Car Accident?

    • What if You Live in a No-Fault State and Have PIP Coverage?

    • What Is MedPay?

    • Are There Out-of-Pocket Expenses?

    • FAQ’s

    Will My Health Insurance Cover a Car Accident?

    Your health insurance should cover the costs of your injuries caused by a car accident. Consider whether you live in one of 12 no-fault states: Florida, Hawaii, Kansas, Kentucky, Massachusetts, Michigan, Minnesota, New Jersey, New York, North Dakota, Pennsylvania, and Utah. A no-fault state is one in which an insurance company will pay for your medical bills from your own policy regardless of who caused the accident.  

    Keep in mind that your health insurance may make a distinction between what is “primary” and what is “secondary” coverage. Primary coverage is the insurance that is used first for initial costs while secondary coverage is what is used to handle any remaining debt. 

    An example of this would be someone who has a $15,000 medical bill and a $10,000 PIP coverage. The PIP insurance would cover the first $10,000 of medical expenses as the primary coverage. Your health insurance would be the secondary insurer that pays the balance. PIP policies can be issued with different limits depending on state requirements and the individual needs of the policyholder.

    Now, if you live in a fault, or tort state, then the at-fault driver's insurance will be responsible for covering the injured party's medical bills, typically through their liability insurance. This includes hospital bills and prescriptions. It can also help pay for lost wages. Liability insurance is a common component of most auto insurance policies. Understand that every policy has a limit on what it will cover, meaning you will need to pay out-of-pocket if that limit has been reached and more money is owed unless you have MedPay.

    What Is MedPay?

    MedPay is a type of insurance that is typically offered as an add-on to car insurance policies, which can help cover the cost of medical care for you and your passengers after an accident. 

    MedPay can help pay:

    • Hospital stays 

    • Deductibles

    • Copays

    • Ambulance rides/EMT fees

    • Surgery

    • Funeral expenses if someone is killed in an accident

    Once you have MedPay, it will provide coverage up to the limit you have selected. This coverage can be used regardless of who is at fault for an accident, and it can help to ease the financial burden of medical expenses.

    What if You Live in a No-Fault State and Have PIP Coverage?

    If you live in a no-fault state and have PIP coverage, you and your passengers will be covered for any of your medical expenses that result from a car accident, regardless of who was at fault. In fact, your medical insurance won’t need to be brought in until your PIP is spent. 

    PIP coverage can help to pay for: 

    • Hospitalization

    • Surgery 

    • Rehabilitation

    • Medication

    • Prosthesis

    • Lost wages

    • Childcare

    Are There Out-Of-Pocket Expenses?

    Out-of-pocket expenses depend on the type of insurance you carry. Each type of policy serves a different purpose and can often be used in tandem to reduce personal costs. Often it’s worth consulting with your insurance advisor to see how to best design your coverage. 

    Medical Insurance

    Out-of-pocket expenses include deductibles, copays, and coinsurance. Your deductible is the amount you pay towards medical expenses before your insurance kicks in. The average deductible for an individual in 2020 was $4,364 and $8,439 for a family. Copays are a set fee that will be charged upfront every time you have a doctor's appointment or medical service performed. 

    For example, you may be expected to pay $25 or $50 (or more) for a routine office visit. Coinsurance is an additional percentage owed for healthcare after you’ve paid your deductible and up to your out-of-pocket maximum.

    PIP

    PIP does not typically have large deductibles. The average deductible in 2020 was $250 and in most PIP states is zero. On rare occasions, PIP can also have coinsurance costs. 

    MedPay

    MedPay has no deductible and no coinsurance costs.

    Health Insurance and Car Accident FAQs

    Is MedPay Worth It?

    This depends entirely on your situation. If you don’t have health insurance, yes it’s worth buying MedPay. First, MedPay can help cover medical costs for you and your passengers. It is also extremely inexpensive with pricing as low as $10 a month. 

    Additionally, MedPay can help cover the costs of deductibles and copays. It can also help cover funeral costs and nursing services. It is especially helpful if you don’t have good health insurance or your policy has high deductibles and other out-of-pocket expenses.

    Will Having PIP Raise My Premiums?

    PIP is required in 12 at-fault states and has a cost just like liability coverage has a cost. Filing a personal injury protection (PIP) claim will not necessarily cause your premiums to go up unless you’re at fault.

    Make Sure You Have the Right Coverage

    Health insurance can help you cover the medical expenses after a car accident. You can use your PIP and MedPay first, possibly eliminating the need to resort to your health insurance. You will also need to have liability car insurance to cover the medical expenses of others you’ve injured. With the right combination of coverage, you can protect yourself and your family from exorbitant medical bills.

    SmartFinancial
    SmartFinancial
    SmartFinancial is a leading insurance marketplace serving the needs of insurance customers across all 50 states.
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