What Is Medical Payments Coverage?

Medical payments coverage (MedPay) helps pay for car accident injuries. Read more to find out how medical payments works.
Ambulance speeding to crash covered by medical payments coverage

If you get into an accident, medical payments coverage (MedPay) helps cover medical bills. It protects you from paying extra costs out of pocket that your health plan doesn’t cover.

This article will help explain the basics of MedPay, including:

  • Defining the coverage and how it works in car insurance policies
  • What it covers and doesn’t cover
  • Whether or not you need to buy coverage
  • How much coverage to buy
  • How much it costs
  • Tips for choosing coverage limits
  • Answers to frequently asked questions

Definition of Medical Payments Coverage

Medical payments coverage, or “MedPay,” helps drivers and passengers pay for medical bills from an accident. It is part of an auto policy. But it’s also for other situations such as being hit by a car as a pedestrian. MedPay kicks in regardless of who is liable for the accident.

Most states don’t require MedPay. Per the Insurance Information Institute (III), only Maine, Wisconsin, and New Hampshire require MedPay in some way. In Wisconsin’s case, insurers must offer it to you, but you can reject it. It’s a different type of coverage than personal injury protection (PIP) and health insurance.

Medical Payments vs. Personal Injury Protection

Personal injury protection (PIP) may seem very similar to MedPay, but there are key differences.

  • Sometimes PIP is optional, and other times it’s mandatory. This depends on each state’s policies.
  • PIP is usually available in “no-fault” states. MedPay, alternately, is available in states that don’t identify as “no-fault” states.
  • PIP covers lost wages and possible child care if applicable. MedPay will not pay for these costs.

These are the major differences between MedPay and PIP. They are both very similar as they each pay for injuries you or your passengers sustain.

What Medical Payments Covers

Medical payments (MedPay) protects you from many of the costs related to a car accident. You’ll get coverage for the following:

  • Ambulance and EMT fees
  • Doctor and clinic visits
  • Surgeries
  • Hospital visits/stays
  • Exams such as X-Rays
  • Nursing
  • Prosthetic limbs
  • Health co-pays and deductibles
  • Funeral costs

If you have health insurance, MedPay will cover the extra costs that the former can’t pay for. Your health deductibles are also part of the coverage. This helps you avoid paying any money out of pocket for health costs.

What It Doesn’t Cover

MedPay protects you from a wide range of costs, but some things aren’t covered:

  • Damage to any property regardless of liability
  • Any medical bills that go over your coverage limit

Keep in mind that if your limits are too low, you’ll have to pay out of pocket for any extra medical bills. It’s best to buy as you can to avoid any extra costs.

Do I Need MedPay?

This coverage is optional in most states. These are the only states that require MedPay in some way:

  • Maine – minimum limit of $2,000
  • Wisconsin (must be offered to you but you can refuse it) – minimum limit of $1,000
  • New Hampshire – minimum limit of $1,000 (only a requirement if you buy auto insurance)

These states only require a certain amount of coverage. But the minimum amount may not be enough. Buying as much coverage as possible prevents paying out of pocket for costs and health deductibles.

Potential Risks of Not Having Coverage

While the policy is only mandatory in two states, it is still a good idea to carry it anyway. If you don’t have MedPay, you will need to pay your health deductibles. Also, if your health plan does not cover all the bills, you will need to pay out of pocket.

Not having health insurance only magnifies the issues with not having MedPay. You would need to cover all expenses yourself, which depending on the accident could be very expensive.

Benefits of Having MedPay

Buying MedPay is a smart choice in many cases. If you don’t have health insurance, MedPay protects you against many expenses.

Additionally, if you have health insurance and your deductibles are high, MedPay will be very helpful.

How Much MedPay Coverage Do I Need?

It’s hard to predict how much coverage you need to be safe from paying out of pocket. Normally, insurance agents and companies recommend buying as much coverage as possible. Be aware that MedPay may not be available in your state.

MedPay Isn’t Available in Some States

Some states don’t make MedPay available. It’s available in the states that aren’t classified as no-fault. In short, a no-fault state requires drivers to pay for their own expenses through their insurance instead of relying on the liability of other drivers.

These states follow no-fault insurance regulations:

If you live in a state that is not on this list, MedPay will be readily available to purchase. Every large insurance company carries MedPay if it’s available in your state.

Cost of Medical Payments Coverage

The exact cost of MedPay will depend on a variety of rate factors. The cost also is dependent on how much you’d like to buy. Here are some of the rate factors that may impact the cost:

  • Driving record
  • Area of residence
  • Marital status
  • Type of car
  • Car mileage

The list above doesn’t represent all the factors that can impact your insurance rates. At times the cost of insurance will vary from company to company. It’s a smart idea to assess the insurance market and compare quotes to find the best deal and save money.

Choosing MedPay Limits

Limits are the maximum amount of money the insurance company will use to cover your expenses in an accident. Choosing limits can be difficult because it is hard to predict how much an accident could cost.

When you’re selecting limits for MedPay, think about how much it would cost right after an accident. In other words, consider the immediate costs. These could include ambulance fees, emergency room visits, tests, and other costs.

It is also important to keep health insurance in mind when setting limits. Think about how much your health insurance will cover. Then you can add MedPay as extra coverage.

Tips for Filing MedPay Claims

There can be some complications when filing medical payment claims. If you also have personal injury protection (PIP), it’s considered the “primary” coverage. MedPay and PIP will usually kick in before your health insurance if you have it.

Frequently Asked Questions

Q: Who pays my medical bills first after an accident?

A: This answer varies on the situation you are in. It’s best to check state policies to see which pays first. If you have health insurance, it will cover the expenses that your MedPay can’t and vice versa. It’s key to choose limits that you think will cover most of your costs to avoid needing your health insurance to pay for any expenses.

Q: Which states offer MedPay?

A: MedPay is available in all states that don’t classify themselves as “no-fault” states. Earlier on there is a list of all “no-fault” states. If you live in a state that doesn’t fall under that category, you may add MedPay to your car insurance policy.

Q: What if the other driver has liability insurance?

A: If you sustain injuries in an accident that another driver causes, liability may help pay for your medical costs. The bodily injury part of the policy will surely help cover any medical costs you or your passengers have. These could be:

  • Hospital and emergency room bills
  • Funeral costs
  • Lost wages and essential services
  • Long-term medical costs
  • Pain and suffering due to the accident

The other driver having liability protection will help cover some of the expenses MedPay covers and more.

Q: How much are deductibles with medical payments coverage?

A: There are no deductibles or co-pays with MedPay. This is contrary to most other forms of insurance. You only pay for the premium the insurance company charges for insurance.

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