There are many types of insurance that will cover medical expenses after a car accident, whether or not you were the one driving. Bodily injury liability or personal injury protection (PIP) insurance is required in almost every state, which means that you should be financially protected if you are injured in a car accident, but health insurance coverage will also cover medical expenses from a car accident.
While both your health insurance and your car insurance would potentially pay for medical bills, it is a good idea to have both types of coverage in place.
Depending on your state, your insurance carrier, and the severity of your injuries, there could be significant differences in who pays first or how much they will pay for your medical expenses.
Does health insurance cover car accidents?
Yes, health insurance will pay for medical expenses after a car accident, according to the limits of your health insurance policy. For example, if you have a high-deductible plan that requires you to pay the first $8,000 of your medical expenses out-of-pocket, you will be held responsible for that $8,000 deductible, even if you weren’t at fault for the accident.
However, there are several types of car insurance that are designed to help you pay your medical costs, including your deductibles, copays, and out-of-network expenses, that should be billed first, before your health insurance coverage. Some of those car insurance coverages are:
Personal injury protection (PIP)
Also known as no-fault coverage, PIP coverage is a type of car insurance that helps cover medical expenses for you and your passengers in the event of an accident, regardless of fault. PIP coverage is required by law in 16 states and territories and offers coverage for:
Medical expenses due to the accident
Lost income when you can’t return to work after an accident
Child care expenses due to the accident
If PIP is required in your state, it’s already in your policy. States that require PIP coverage often have laws in place that limit your ability to sue an at-fault driver for damages, so it is important to know the laws in your state to make sure you have enough coverage to pay your expenses in the event of an accident.
Also known as medical expense coverage, MedPay is a type of car insurance that helps cover some medical expenses for yourself and your passengers, regardless of fault. MedPay is an optional coverage that is only available in states that don’t require PIP coverage.
This coverage is typically sold in smaller amounts, sometimes as little as $2,000 in coverage, to help pay for deductibles, copays, and other medical expenses, including:
Doctor, hospital, and chiropractic services
Surgery, X-rays, and prosthetic implants
Professional nursing services
In our previous example of a driver with an $8,000 high deductible health insurance plan, this individual could buy $8,000 or more worth of MedPay coverage and the hospital or doctor could bill the car insurance company directly for those medical expenses.
Liability coverage and uninsured motorist coverage
If you are at fault for an accident, your bodily injury liability coverage will pay for the other driver’s medical expenses. Keep in mind that you will be held legally liable for all of their medical expenses associated with the accident, so it is important to carry the highest level of liability coverage that you can afford.
If the other driver was at fault and you end up submitting the claims through your health insurance, your coverage will pay for your medical expenses according to the limits of your policy.
Once the car insurance claim has been filed and liability has been determined, your health insurance company will take the other driver to court to have their expenses reimbursed under the other driver’s liability coverage. This process is called subrogation.
But what if the other driver didn’t have insurance? You can take them to court, but it could be years in the legal system before a settlement is reached. However, if you have uninsured motorist coverage (UM) your car insurance will pay for your medical expenses up to the limits of your policy. Your UM coverage is set at the same limits as your bodily injury liability coverage, which means having higher levels of bodily injury liability coverage will also increase your UM coverage levels.
Should you get PIP or MedPay if you have health insurance?
PIP and MedPay can be helpful even if you have health insurance. If your medical expenses are less than the amount of PIP or MedPay coverage you have on your car insurance policy, you can bill your car insurance directly and avoid having to file a claim through your health insurance at all.
If your medical expenses are more than the amount of PIP or MedPay coverage you have on your policy, you can file a claim through your health insurance for your medical expenses and use your PIP or MedPay coverage to pay for deductibles, copays, and out-of-network expenses, like lab tests or anesthesia.
Who pays first: Car insurance or health insurance?
In most cases, your car insurance will pay first. Drivers who have PIP, MedPay, and other coverages can provide their car insurance information to the medical facility and have them billed directly.
You can also give both your health insurance and your car insurance information to the doctor or hospital and they can bill them both. In this case, they would list your car insurance as primary and your health insurance as secondary.
Do I have to pay my health insurance back after a car accident?
If you receive a settlement after a car accident, the health insurance company may be entitled to some or all of the money to reimburse them for their costs. This depends on a number of factors, including what your health insurance policy says and how much your health insurance paid out in expenses due to the accident.