Drivers living in “no-fault” states are required
to buy either Personal Injury Protection (PIP) or Medical Payments
(MedPay) coverage. PIP and MedPay cover the medical bills of you and
the passengers in your vehicle after a crash, regardless of who's at
fault.
Having both MedPay and health insurance can be confusing for the policyholder.
If you have MedPay as part of your auto insurance,
filing a claim requires several steps. You would first have to pay for
your treatment up front, get a receipt from the doctor or hospital,
send that receipt to the insurance company, and wait for your
reimbursement check. If you use MedPay to cover medical expenses, tell
the doctor or hospital your car insurance will pay for the treatment.
Some
insurance companies let the policyholder decide which coverage (MedPay
or health insurance) to use. Your health care provider might want you
to use MedPay first, if you were injured in an auto accident.
MedPay
or PIP is designed for "immediate and short-term care" and is generally
used first. Once your MedPay or PIP limits are exceeded, your health
insurance then kicks in.
In no-fault states such as
Pennsylvania and New York, your MedPay or PIP is the primary medical
coverage when you're injured in an auto accident.
If you
live in a state without no-fault insurance, and have MedPay or PIP on
your auto policy, use it first to pay medical expenses related to auto
accidents. Your health insurer might deny coverage, until you have
exhausted any MedPay or PIP benefits.
If
you live in a "no-fault" state, there's little reason to buy both
MedPay and PIP: That's because PIP provides coverage equal to and
beyond MedPay (although PIP often has a 20 percent deductible and
MedPay has none).
MedPay generally covers reasonable and
necessary expenses for medical, surgical, dental and chiropractic
treatment. It also covers hospitalization, ambulance services, X-rays,
nursing services, prosthetic devices and funeral services.
PIP,
on the other hand, covers the same services as MedPay. PIP also covers
psychiatric, physical, occupational therapy and rehabilitation, plus
any other professional health services. (Check your policy for exact
details.) In addition, PIP covers lost wages, reasonable costs other
than medical and work-loss expenses, and a small death benefit.
In
many situations, having both MedPay and PIP is duplication of coverage.
There are certain situations in which MedPay can be valuable, such as
when you're driving with someone who's not in your family. MedPay
covers everyone in the vehicle at the time of the accident, so your
friends will have medical coverage even if they don’t have health
insurance. MedPay can help offset the deductible that comes with PIP.
If you have health insurance or belong to an HMO, you probably don’t need MedPay.
Also,
MedPay is no substitute for broader health insurance. Few companies are
willing to sell more than $25,000 worth of MedPay coverage.
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