Medical payments coverage (MedPay): definition, how it works

  • MedPay will cover your medical expenses as a driver, passenger, or pedestrian if you are injured in a car accident.
  • It will also cover passengers traveling in your car.
  • Policy limits are low, but it can be an affordable add-on to your health insurance or PIP coverage.

People who are injured in car accidents are generally responsible for their own medical bills, even if the accident was the fault of another driver. In those cases, the injured person’s health insurance or personal injury protection (PIP) coverage will usually pay the costs.

However, if your PIP or health insurance coverage falls short, medical payments coverage (also known as MedPay) can help cover the additional costs.

What is medical payments coverage?

Medical payments coverage is optional insurance that reimburses you for medical and funeral expenses related to vehicle accidents, regardless of who is at fault.

MedPay protects you and your passengers in the following scenarios:

  • If you or your passengers are injured in your vehicle
  • If you are injured while riding in someone else’s vehicle
  • If you are a pedestrian and are injured by another vehicle
  • If you are injured by a vehicle while bicycling or using public transportation

MedPay complements your health insurance coverage. Because MedPay limits are low, your health insurance will pay most of the costs and MedPay will kick in when you reach your health insurance limits.

Medical Payments Coverage vs. Personal Injury Protection

“No-fault” states require drivers to have personal injury protection (PIP). No-fault insurance covers up to a specified limit for accident-related medical bills, regardless of who is at fault.

In other states, at-fault drivers are liable for the victim’s injuries that occur in a collision. You have the option of filing a lawsuit against the guilty party. However, it can take a long time to prove fault and get reimbursed for your injuries.

Suppose you don’t have health insurance and you reach the maximum of your PIP coverage. In that case, you can use MedPay to fill the gap, according to Jason Turchin, a personal injury and accident attorney with the Law Offices of Jason Turchin in Florida. Here are some of the main differences between MedPay and PIP coverage:

Bodily injury liability insurance covers the medical expenses of passengers in another car where you are at fault.

What does medical payments coverage include?

Your MedPay insurance will go where you go, whether you’re a pedestrian, driver or passenger. You are also covered outside of the US. Here are several of the expenses that MedPay will cover:

  • Medical services: MedPay will cover hospital or doctor visits, EMT and ambulance fees, nursing care, and any other medical services related to the accident.
  • Health Insurance Copay or Deductibles: If your health insurance deductibles or copays are high, consider getting MedPay. It will cover the rest of the cost of copays or deductibles if you need to use your health insurance.
  • Deals: MedPay will cover everything from dental procedures to prosthetics, surgeries and medications related to injuries from the accident.
  • Funeral expenses: If someone dies in an accident, MedPay will cover the funeral expenses.

What does MedPay not cover?

MedPay will cover you in many car accident cases, no matter where you are. But there are several cases in which medical payment coverage is not applicable. These include:

  • If you exceed your coverage limits: If you max out your health insurance, PIP, and MedPay coverage, you’ll have to pay the rest out of pocket.
  • Loss of wages: MedPay will not cover lost earnings if you are out of work due to an accident.
  • Other drivers: MedPay does not cover injuries you cause to other drivers and their passengers.
  • Injuries not related to car accidents: MedPay will only cover injuries related to the accident, not other health problems that previously existed.
  • Childcare costs: If you are not home and unable to care for your child, MedPay will not cover child care costs.

Do I need medical payments coverage?

Only two states require MedPay coverage: Maine and New Hampshire. Twelve states require PIP. MedPay and PIP are optional for the rest, according to Insurance.com.

“Medical payment coverage may not be necessary if you have health insurance, as it usually covers the balance after PIP,” says Turchin. However, MedPay guarantees that 100% of your medical treatment is covered, meaning you’ll get treatment quickly, even if you’re at fault for an accident, Turchin says.

Even if it’s not required, you may want to consider MedPay in certain circumstances. For example, if your deductibles and copays for your health insurance are high, it may be worth having MedPay. It may also make sense to purchase MedPay coverage if you frequently use your vehicle to transport non-relatives. For example, if you drive for a rideshare company like Uber or Lyft, having MedPay coverage may help.

How much medical payments coverage do I need?

MedPay has lower limits because it acts as supplemental coverage to your health insurance or PIP. The limits can be as low as $2,500 or as high as $10,000, according to Insurance.com.

Medpay can cost as little as $2 per month, while PIP typically starts at $50 per month, according to Insurify.

The amount of MedPay coverage you must purchase will depend on how much you already have in health insurance or PIP. You may only need a couple thousand dollars in MedPay coverage if you have low health insurance deductibles and copays. If you have high deductibles and copays, consider getting more MedPay coverage.

MedPay may not be required for drivers with sufficient health insurance or PIP coverage. But remember, in many states, an at-fault driver is not responsible for your medical bills. Having MedPay can give you peace of mind that your expenses are fully covered in the event you have an accident.

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