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Do you need PIP or MedPay coverage?

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.

Living in a "no-fault" state?

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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