What is medical payments coverage on home insurance?

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A standard homeowners insurance policy usually provides coverage for things like fire and storm damage, theft and vandalism. But it also typically includes protection for medical expenses incurred by visitors if they get hurt on your property, regardless of whose fault it was. This is called medical payments coverage (MedPay coverage).

You’re probably wondering: Do I need medical payments coverage, and if so how much medical payments coverage do I need? Here, find out the facts and learn what’s involved with medical payments coverage claims.

Key Takeaways

Medical payments coverage is part of a standard homeowners insurance policy that can help cover the costs of minor medical expenses related to an injury of a guest that occurs on your property.
Medical payments coverage usually covers expenses related to medical attention, ambulance services, hospital stays, medical tests, surgery, physical therapy and more.
Injuries incurred by a resident of your home or your pets, general suffering or pain, damage to your property, and accidents that happen outside your home are usually not covered by medical payments coverage.
Most policies pay out a minimum of $1,000 per injured person, but experts recommend extending this coverage to $5,000 per person or higher.
You or the injured party can submit their medical bills to your insurance company for coverage/reimbursement.

What is medical payments coverage, or MedPay, and how does it work?

Medical payments to others coverage, also known as Coverage F or “MedPay,” is a component within a standard homeowners insurance policy that can help cover the costs of minor medical expenses related to an injury of a guest that happens on your property. This “no-fault” coverage kicks in whether you (the policyholder) have been found liable for the injury or not.

“It works by reimbursing you, the policyholder, or the injured party directly, for expenses paid out for the injured’s medical bills derived from the injury,” explains Mark Friedlander, director of Corporate Communications for the Insurance Information Institute in St. Johns, Florida.

For instance, if your neighbor visits your home, slips on a wet spot in the kitchen, and fractures his elbow, your medical payments coverage would pay for his treatment up to the amount specified in your policy.

Landy Liu, manager of Insurance Products for Better.com in New York City, says this portion of your policy is designed to resolve smaller claims so that they don’t escalate into lawsuits.

“Medical payments coverage has low limits, typically between $1,000 and $5,000, which is usually enough to amend a situation that calls for immediate medical attention,” says Liu.

What is covered under MedPay coverage for homeowners insurance?

Medical payments coverage commonly covers the following:

Medical attention
Ambulance services
Emergency room services
Hospital stays
X-rays and other medical tests
Surgery
Physical therapy
Nursing
Prosthetic devices
Dental services
Funeral services

“It will cover any necessary medical expenses that occur within three years from the date of an accident,” notes David Griffin Jr. senior vice president of Holyoke, Massachusetts-based The Dowd Agencies, LLC.

What is not covered under medical payments coverage?

Friedlander cautions that medical payments to others, however, usually does not cover the following:

Injuries suffered by a resident of the home or your pets
General pain or suffering
Damage to your property
Accidents that occur outside of your home or its boundaries
Communicable diseases, such as a guest contracting COVID-19 while visiting your home
Controlled substances
Acts of war

“Medical payments coverage does not apply to anyone who lives in the home, either as a dependent or a tenant. It also doesn’t apply if the injury is expected or intentional, for example as a result of a fight,” Griffin says.

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How much medical payments coverage do I need?

In a standard homeowners insurance policy, medical payments coverage usually pays at least $1,000 per injured person. You can opt to extend this coverage to a larger amount if believe you could benefit from additional protection.

“There is minimal difference in the premium you’ll pay if you increase the coverage to a $5,000 limit versus a $1,000 limit, so we recommend taking a higher limit,” advises Friedlander. “Some insurers offer a limit as high as $25,000 for MedPay; ask your insurance agent if higher limits are available.”

What is the cost of medical payments coverage?

The portion of your premium that goes toward MedPay is minuscule. That’s why many experts recommend increasing your medical payments coverage limit.

“For example, on a Florida standard homeowners policy that has dwelling coverage of $400,000, the annual premium for MedPay is just $10 for a $5,000 limit,” Friedlander adds.

What states require MedPay?

Medical payments coverage for a homeowners insurance policy is not required in any state, although it is usually automatically included in a standard policy at a minimum limit (such as $1,000).

“However, the car insurance equivalent, also known as MedPay, is required in New Hampshire, Pennsylvania, and Maine,” says Griffin. This auto insurance coverage pays the medical expenses of anyone within your vehicle at the time the accident occurs, even if the accident was your fault.

How does a MedPay claim work?

Submitting a claim or requesting reimbursement for medical payments coverage is relatively simple.

“If someone has been injured at your home, such as a friend or neighbor, they can submit their medical bills to your insurance company,” says Liu. “This way, the bills can be paid quickly and without a liability claim being filed against you.”

Or, you or your guest can pay for your guest’s injuries out of pocket, and then you can submit a claim to your insurance company for reimbursement. The Insurance Information Institute recommends following these steps if you need to file a claim:

Take pictures of where the accident took place.
Document how the accident occurred and gather contact details for the injured party.
Obtain receipts for any expenses incurred.
Contact your insurance agent or carrier to file the claim.

Fortunately, your policy’s deductible doesn’t apply to claims submitted for MedPay coverage.

Frequently asked questions

What is the difference between bodily injury and medical expenses?

Bodily injury usually refers to coverage in an automobile insurance policy, not a homeowners insurance policy. David Griffin Jr. with The Dowd Agencies, LLC, explains that bodily injury covers more than just medical care/expenses and can include reimbursement for lost wages, legal fees, funeral costs, and pain and suffering. These items are typically not covered by medical payments coverage in a homeowners insurance policy.

Medical expenses, on the other hand, also known as medical payments (MedPay) coverage, is included in a homeowners insurance policy as well as an auto insurance policy. For the former, it covers the cost of minor injuries suffered on your property by a guest, no matter who is at fault for the injury.

Do I need medical payments coverage on my auto insurance?

MedPay coverage for auto insurance is only required in three states: New Hampshire, Pennsylvania, and Maine. Experts recommend having this coverage in place at the highest coverage limit you can afford.

What is the medical payments coverage limit?

This limit is the threshold up to which your insurance company will pay out an eligible claim. Coverage limits typically span from $1,000 to $5,000, but you can purchase extra coverage for a small increase in your premium – up to a $25,000 limit if your insurer allows it. Because the cost of extra medical payments coverage is nominal, experts recommend getting the highest end of the coverage.

Does medical payments coverage replace health insurance?

No. Medical payments coverage is not a form of health insurance and does not replace a health insurance policy.

How does medical payments coverage work with renters insurance?

No. Medical payments coverage is not a form of health insurance and does not replace a health

Medical payments coverage for renters insurance is comparable to similar coverage for homeowners insurance. If someone is injured on the property you rent and seeks medical attention, this coverage will pay for medical treatment, no matter who is at fault. Your renters insurance policy will cover the expenses caused by the injury up to the limits defined in your policy – usually $1,000 to $5,000.

The biggest difference with renters insurance medical payments coverage is that it only applies to injuries that happen inside the rental unit.

Erik Martin

Contributing Researcher

Erik J. Martin is a Chicago area-based freelance writer whose articles have been published by AARP The Magazine, The Motley Fool, The Costco Connection, USAA, US Chamber of Commerce, Bankrate, The Chicago Tribune, and other publications. He often writes on topics related to insurance, real estate, personal finance, business, technology, health care, and entertainment. Erik also hosts a podcast and publishes several blogs, including Martinspiration.com and Cineversegroup.com.