What is Medical Payments Coverage?

What is Medical Payments Coverage?

What Is Auto Medical Payments (MedPay) Coverage?

Auto Medical Payments (MedPay), also known as medical payments coverage, is a separate coverage on a personal auto policy that helps to cover some of the medical costs from injuries that arise out of automobile related accidents.   It is a “no-fault” coverage, meaning that it will respond to injuries regardless of whether you were at fault or not.

Auto MedPay coverage is optional in most states.   In some states, medical payments, or a variant of it (such as Personal Injury Protection/PIP) is mandatory.

Auto MedPAy responds to various (reasonable and necessary) costs arising out of an auto accident:

  • Funeral Expenses;
  • Dental Care Costs;
  • Chiropractic Treatment;
  • Medical Expenses;
  • Ambulance Bills;
  • Nursing Services.

The coverage trigger is broad. The injuries must arise from an accident with an auto, but you do not have to be in that auto for coverage to apply. If you are hurt due to an accident with an auto while you are walking, standing, sitting, or biking, coverage may still apply. If you are in an automobile, you do not need to be the driver. Coverage also generally applies to passengers.

What Limits Are Available For Automobile Medical Payments (MedPay) Coverage?

The Limits that are available for purchase may vary by state and by insurer. Generally, the limits available are $50,000 or less. If you have multiple vehicles, you can not purchase the coverage on just one vehicle. Coverage must be purchased on all vehicles or no vehicles. The limits usually apply per person.   So, if you purchase a $5,000 limit, and 3 passengers in your car are each injured in a car accident, they may each have up to $5,000 of coverage.

Can I Purchase Automobile Medical Payments (MedPay) Coverage By Itself, Stand Alone?

No. Automobile Medical Payments coverage is only available when you are also purchasing automobile liability coverage. It is not sold on a stand alone basis.

Do Coverage Limits Stack For Automobile Medical Payments (MedPay) Coverage?   What is Limit Stacking?

In more than half of the states, limits of insurance purchased on multiple vehicles can be stacked.   Stacking generally means that the limits available to you across multiple vehicles can be added together.   So, if you purchased Auto MedPay coverage on three vehicles on your policy, with a $5,000 limit on each, you would actually have $15,000 (3 x $5,000) of Auto MedPay coverage limit available to you for covered costs arising out of an accident with an automobile.

What Is Personal Injury Protection (PIP) Coverage?

Personal Injury Protection is a coverage similar to Auto MedPay coverage, that is mandatory in some states. There are 12 states that have mandatory “No-Fault” coverage. Like Auto MedPay coverage, PIP is a No-Fault coverage. In some respects, Personal Injury Protection (PIP) can be broader than MedPay coverage.

PIP coverage may have higher limits available and may also cover lost wages, rehabilitation services, childcare expenses, and other personal household maintenance services if you are unable to perform them due to injuries arising out of a covered accident.

For more information from the Insurance Information Institute on “No-Fault” states, click here.

If I Have Health Insurance and Auto Medical Payments Coverage, Which Coverage Is Primary?

It depends on the state that you live in. In some states your health insurance is specifically primary. In other states your MedPay coverage is specifically primary. And, there are a few where you can choose which is primary. You can easily research your specific state on the internet.

You may, depending upon your state and the wording on your insurance policies, have the ability to use your Auto MedPay coverage as a supplemental policy to pick up coverage for what is not covered by your health insurance.   For example, it might be possible for you to have your Auto MedPay coverage pick up your deductible or co-pay from your health insurance for treatments for injuries arising out of an auto accident. It is also possible that your Auto MedPay coverage might be broader than your health insurance. For example, your Auto MedPay coverage might apply to chiropractic services whereas your health insurance might not cover chiropractic services at all.

Summary:

Auto Medical Payments Coverage, where available, is generally a very good deal and should be purchased.   The coverage has no co-pay or deductible. The coverage applies while you are in a car and while you are a pedestrian. The premium for Auto MedPay is usually quite low, often less than $25 per vehicle. If you do not have health insurance, it is even more important that you purchase Auto Medical Payments Coverage. While the coverage only applies to injuries arising out of an automobile accident, the coverage is so affordable that it merits serious consideration.

Auto Medical Payments (Auto MedPay) and Personal Injury Protection (PIP) coverage provisions can vary by state and by insurer. It is important that you read your actual policy to see what limits, coverages, exclusions, restrictions, and conditions apply. It should be noted that Medical Payments Coverage does not apply to individuals while in the scope and course of employment as such individuals should be covered by Workers Compensation Insurance. This article is general in nature and may not be accurate or complete.   Coverage depends on the state, your policy, and the individual circumstances of the accident.   It is recommended that you discuss any questions you may have about insurance coverages with a Professional Insurance Agent.

Other Enhanced Insurance articles related to Car Insurance Coverage:

What Is a Car Insurance Deductible

What Is Personal Injury Protection Coverage

What Is Underinsured Motorist Protection

What Is Uninsured Motorist Protection

What Is Rental Car Insurance Coverage

What Is GAP Coverage?

How Much Is GAP Insurance?

Collision Insurance Coverage

Property Damage Coverage

Enhanced Insurance is not written by attorneys. If you’re looking for legal advice, you need to contact a lawyer. Further, insurance practices and forms change constantly and are varied from state to state. For definitive answers in your area, contact a local agent.

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For more on Funeral expense coverage >

Jim Ketterson is an insurance expert with more than 25 years of experience in the industry. He has served as a President of an insurance company, an insurance underwriter, and has held various roles in insurance company product management. He has his Chartered Property Casualty Underwriter designation and a MBA in Finance. The information he offers in his posts is general in nature and may not be appropriate, accurate, or applicable in all situations. Before making any important insurance decisions, you should seek the advice of a qualified insurance agent and discuss the particulars of your individual situation. Follow Jim on Twitter @MNinsurancePro

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