Using Health Insurance for Car Accident Injuries

The interplay of your health insurance and car insurance coverage after a car accident.

Updated by , J.D.
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  • If you're injured in a car accident, understanding your options for getting your medical care paid for can become a tricky proposition, especially if a number of different insurance policies are in play. Here's what to know at the outset:

    • Your health insurance will likely cover your car accident injuries, but if you have other car insurance-specific options (like MedPay or PIP coverage), those might save you money and hassle.
    • Your health insurer probably has a right to get back any money paid to treat your car accident injuries, if you end up getting money from the at-fault driver's insurer, or from some other source.
    • Exactly how much ultimate responsibility a particular party or insurance carrier has can depend on who was at fault for the car accident, and the types of car insurance coverage in place.

    Let's take a closer look at some key issues related to health insurance and car accident injuries.

    Does Health Insurance Cover Car Accident Injuries?

    In a word, yes. If you have health insurance and you're injured in a car accident, your health insurer will usually pay for treatment related to your accident injuries, but there's usually a catch or three:

    • Depending on the details of your health insurance, there might be in-network or out-of-network distinctions when it comes to care providers, or similar restrictions on what's covered.
    • Your health plan might also explicitly state that your health insurance is "secondary" if you're injured in a car accident and there's other ("primary") insurance (i.e. your own car insurance coverage or the other driver's) available to cover your injuries. When that's the case, you would turn first to the available car insurance coverage, and if the cost to treat your car accident injuries exceeds the amount of that coverage, your health insurance would kick in and pay for the remainder of your care.
    • Certain kinds of treatment you receive in connection with your car accident injuries might not be covered under your health insurance, including alternative forms of treatment.

    But the bottom line is that if you ever need to use your health insurance to pay for treatment of your car accident injuries (no other insurance is available, in other words) you usually can.

    And just a quick note that while your health insurance will cover medical treatment for almost any kind of injury or illness, no matter the cause (including car accidents), it probably goes without saying that it doesn't work both ways. Regardless of the details of your car insurance coverage, you can't use that insurance to pay for health care that's unrelated to a vehicle accident.

    What If I'm Injured After an Accident But I Don't Have Health Insurance?

    Don't delay getting necessary medical treatment after a car accident, even if you don't have health insurance. Depending on the law in your state, hospitals and other care providers may be legally required to present certain options to uninsured patients, including interest-free payment plans and discounted charges for treatment, depending on the specifics of the law.

    For car accident injuries in particular, some health care providers will treat the patient now and postpone getting paid until any car insurance claim or injury lawsuit is resolved. This kind of arrangement is often called a "medical lien." Learn more about health care provider claims on personal injury settlements.

    Will I Need to Pay Anything Out of Pocket?

    It depends on the details of your coverage, but chances are you'll need to pay a deductible and/or some kind of co-pay (or a series of deductibles or co-pays over the course of your care) if you use your health insurance plan to pay for treatment of your car accident injuries. This is a big reason why, if you've got car insurance coverage that will pay your medical bills quickly (and without a deductible), health insurance might not be your best option when it comes to paying for medical treatment for your car accident injuries. We'll get into more detail on that in the following sections.

    If you don't have health insurance or car insurance, don't let that stop you from seeking necessary medical attention after a car accident. As touched on above, laws in your state may require health care providers to work with you on a payment plan, and you may be entitled to receive care at a reduced rate. And if you contact a car accident attorney shortly after your crash, the firm might be able to put you in touch with health care providers who will agree to be paid out of any settlement you receive.

    Who Pays First? Auto Insurance or Health Insurance?

    Car insurance typically pays for treatment of car accident injuries until the available coverage limits are exhausted, and then your health insurance usually kicks in to pay for what's left.

    As we touched on above, the "primary" or "secondary" question might be answered by the fine print of the different policies in place. If, for whatever reason, your health insurance coverage paid your medical bills first, the health insurer will turn around and make a claim against the car insurance company that insures the at-fault driver.

    So, what kinds of car insurance might cover your car accident injuries? The two main options at the outset of a car accident claim are:

    • Your own personal injury protection (PIP) or medical payments (MedPay) car insurance coverage can be used to pay the medical bills that come in as your car accident injuries are being treated. This coverage typically pays out pretty quickly, and while PIP may require you to pay a deductible, MedPay coverage rarely does.
    • The other driver's liability car insurance (which applies if they're found at fault for the accident) isn't usually an option for paying your medical bills as they come in. This insurance will cover your injuries, but any claim or settlement acts as more of a reimbursement.

    Do I Still Need MedPay/PIP If I Have Health Insurance?

    You might not need medpay or PIP if you already have health insurance (unless your state requires you to have one of those coverages), but there are benefits to having both medpay/PIP and health insurance. They can work in tandem to the extent that medpay/PIP can often be used to pay any deductibles or copays required by your health insurance.

    But perhaps the biggest reason for carrying both medpay/PIP and health insurance is that medpay and PIP coverage can be used to pay the accident-related medical bills of other people beyond just the policyholder, often including family members and passengers who don't have their own car insurance coverage.

    How Medical Bills Are Paid After a Car Accident

    In most cases, car accident injury bills will follow a basic pattern of payment responsibility. The first piece of the pie will involve any co-pays or deductibles in place on the insurance policy in question, depending on whether you use your health insurance policy (assuming you have health coverage) or available car insurance.

    In the typical situation:

    • you get injured in a car accident
    • you get medical care for those injuries
    • if you're using health insurance, you follow the same protocol that you would if you were getting medical treatment for an illness or any other health issue. That means you will have to pay the usual deductible or co-pay under your health plan.
    • if you're using car insurance, you follow the insurance company's claim submission process (often available online). Get tips on making a PIP or MedPay claim after a car accident.

    Hospitals, ambulances and doctor's offices may not require upfront payment from injured parties. Instead, they may provide necessary services and then work with the patient (you) and any involved insurance companies to determine who needs to pay what amount.

    So, for example, if you're taken from the accident scene to the ER via ambulance, don't be surprised if a few weeks later you receive a hefty bill from the ambulance company (or your local city/county). This bill (which could amount to thousands of dollars) will typically include a section asking whether you have health insurance. If you do have health coverage, you'll be asked to provide policy/plan details in space provided and mail the bill back (without paying it). The ambulance company (or city/county) will then deal with your health plan to get payment.

    Recovering Expenses From the At-Fault Driver

    If the injured claimant is not the at-fault driver, the insurance companies involved may work behind the scenes to get the at-fault party's policies to absorb some or all of the costs. Injured drivers and passengers can also sometimes recover some or all of their out-of-pocket expenses (deductibles, co-pays) by making reimbursement of those costs a component of any car accident settlement agreement with the at-fault driver and/or their insurance carrier.

    Dealing With Insurance Company Delays or Claim Denials

    If a key issue like fault for the car accident (liability) is being disputed by the other driver's insurance company, it might be a while before you receive a fair settlement. In that situation (and really any time you don't have your own medpay or PIP coverage) you'll likely use your own health insurance coverage to pay for treatment for your car accident injuries. The same goes for situations in which the car insurance company (your own or the other driver's) is trying to deny your claim. Learn more about what to do if your car insurance claim is denied.

    Getting Help After a Car Accident

    If you've been injured in a car accident and you've got questions about the insurance coverage picture—or if you just want to put your car accident case in the hands of a skilled legal professional—it might be a good idea to discuss your situation with an experienced lawyer.

    Not only will a lawyer know how to navigate the murk of the insurance realm, they'll also make sure you recover compensation for the full spectrum your losses ("damages"). That means not just your medical bills but also your lost income, other out-of-pocket losses, and your mental and physical pain and suffering. Learn more about how an attorney can help with a car accident case.

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