Auto Insurance

What Is Medical Payments Coverage?

Medical payments coverage (MedPay) is an optional coverage that can help reduce your out-of-pocket costs if you’re responsible for an accident and you (or your passengers) suffer injuries. Here’s a look at how this coverage works, what it offers, and why it may be worth considering. 

Medical Payments Coverage

Most drivers are familiar with insurance options such as bodily injury and property damage liability, which cover injuries to other drivers and damages to other vehicles. All but two U.S. states — New Hampshire and Virginia — require these coverages to operate a motor vehicle legally. Medical payments coverage, also called MedPay, is an optional coverage that can supplement standard automobile insurance coverage to help cover medical expenses from an accident.

What Is Medical Payments Insurance?

Medical payments insurance can be added to your existing auto insurance policy to help pay the medical bills of anyone in your car who was injured in an accident, regardless of who was at fault. While standard bodily injury (BI) coverage pays for the cost of medical care for drivers and passengers in the other vehicle if you’re at fault, it does not cover your own medical care or that of your passengers.

Without MedPay, you’re responsible for the cost of your own medical care after an accident, and you may also be liable for the cost of any medicare care needed by your passengers. With MedPay, your insurance activates to help cover this cost after an accident. In addition, this coverage helps pay for your medical bills if you’re injured as a pedestrian rather than as a driver.

While mandatory minimum or basic auto insurance does not usually include medical payments coverage, MedPay is required in Maine, New Hampshire, and Pennsylvania.

Is Medical Payments Insurance Mandatory?

Medical payment insurance is optional coverage, though it is mandatory in Maine, New Hampshire, and Pennsylvania. In Pennsylvania, it is called “medical benefits” coverage. The minimums are:

How Does MedPay Coverage Work?

MedPay coverage helps pay for the healthcare needed if you or your passengers are injured in an accident. The injured parties, such as you or your passengers, submit a claim to the auto insurance company. You may need to include information about the nature of the accident and injuries, as well as your physician’s contact information.

If the claim is approved, your MedPay insurance helps cover the cost of your health insurance plan deductible along with any copayments or coinsurance up to the policy limit. For example, if you carry $5,000 worth of MedPay insurance and are injured in an accident, your coverage pays up to $5,000 for any approved medical expenses. This coverage is on a per-person basis, meaning passengers in your vehicle who are injured could also file a claim for up to $5,000.

Just like other auto insurance coverage types, you pay a premium each month for MedPay insurance, which is added to your total car insurance premium. Generally, there is no deductible for medical payments insurance.

What Does Medical Payments Insurance Cover?

While insurance companies each offer their own version of medical payments insurance, it typically covers the following:

  • General medical care: This includes the cost of doctor visits and hospital expenses, such as surgery.
  • Emergency medical services: This includes ambulance fees, emergency room facility fees, and other related costs.
  • Health insurance deductible and copayments: MedPay can pay for your health insurance deductible and any copayments up to the policy limit.
  • Diagnostics and medical treatments: This includes x-rays and other scans along with prescription drugs and other treatment plans. 
  • Dental care: MedPay can help cover the dental care required if your face and jaw are injured in an accident.
  • Funeral services: Funeral expenses may also be included if you or any of your passengers are killed in an accident.

In general, this coverage extends to:

  • You and family members in your car
  • Others (non-family members) riding in your vehicle.
  • You or family members if hit by a car while walking as pedestrians
  • You or family members if riding in a vehicle that is hit by another car 

So, even if you’re riding as a passenger in a friend’s car, you can use your medical payments coverage to help pay your physician bills.

What Does Medical Payments Insurance Not Cover?

Your medical payments insurance may not apply or may not offer coverage for the following:

  • Driving under the influence: If you are injured while driving under the influence of drugs or alcohol, you may not be covered.
  • Post-accident pain and suffering: Unlike bodily injury coverage, claims for post-accident pain and suffering cannot be made under MedPay.
  • Essential duties compensation: Under bodily injury coverage, you may be covered if you can no longer perform specific work duties after an accident. However, this is not covered by MedPay. 

Of course, your auto insurance medical payments coverage does not help pay for damage to your car or others’ cars or property or injuries to other drivers where you’re at fault. Liability insurance must cover these expenses, as the law requires in many states. Further, medical payments coverage is not a form of health insurance, so you cannot use it to see a physician or for other non-accident-related purposes. 

Read your policy carefully, as other exclusions could include injuries sustained while: 

  • In a motorized vehicle with less than four wheels, such as a scooter
  • On the job
  • If you’re using your vehicle for ridesharing
  • Racing your car

What’s the Difference Between PIP and Medical Payments Coverage?

Personal injury protection (PIP) insurance is offered in no-fault states and mandatory for drivers or insurers in more than 20 states. At-fault states offer MedPay instead. When accidents happen in at-fault states, the insurance of the driver determined to be responsible for the accident pays for damages to both parties. In practice, this means that bodily injury coverage pays for any injuries sustained by the driver (and their passengers) not at fault, while MedPay coverage helps offset the healthcare costs for at-fault drivers.

In no-fault states, insurance companies pay for the damages and injuries to their policyholders, regardless of who was at fault. PIP coverage is offered in these states to help offset healthcare costs. However, PIP limits may be defined by the state. For example, insurers in Texas must offer $2,500 in PIP in writing, while PIP coverage in Washington can make up to $10,000 available.

While medical payments coverage and PIP are functionally similar, there are some notable differences. First, PIP usually carries a deductible, while MedPay does not. PIP also has broader coverage than MedPay; drivers can claim both lost wages and childcare costs with PIP but not with MedPay. Finally, MedPay premiums may be less than PIP since it offers less extensive coverage. 

MedPay Coverage vs. Health Insurance

MedPay coverage fulfills the same function as health insurance, but specifically for injuries sustained in a vehicular accident. Despite the similarities, it is worth carrying both medical payments and health insurance.

Health insurance offers broader coverage than MedPay because it applies to any health concerns, not just injuries from an accident. As such, healthcare plans have their own deductibles, copayments, and coinsurance. However, MedPay can help covers these costs when the injury is from an accident so that you do not have to pay out of pocket. In addition, MedPay can help do this for all injured passengers, not just yourself.

In most cases, there may be a longer waiting period for approval of your health insurance claim because it is submitted separately from your auto insurance claim. With MedPay, however, you’re making a single claim from a single insurance company, which can help streamline the process. 

How Much MedPay Coverage Do You Need?

The amount of coverage you need depends on several factors, such as how much you drive. For example, if you’re driving a short distance alone in your vehicle each day — such as to and from work — you may not need much in the way of MedPay insurance. If, however, you regularly drive long distances or drive with other people in the car, such as your spouse and children, it may be worth paying for more coverage. In addition, you may not need medical payments coverage if you have a health insurance plan that features a low deductible and low copays.

For example, if you have a MedPay policy with a maximum of $2,000, this means that any health costs beyond this amount may not be covered by your insurance. If you have a policy with a per-person limit of $5,000, meanwhile, and an at-fault driver injures you, your partner, and your two children, you could claim up to $20,000 through your MedPay plan.

However, remember that your health insurance will not cover any injuries to your passengers if you’re at fault in an accident. You could be held personally liable for those injuries.

Medical Payments Coverage Limits

Medical payments coverage only pays for medical and funeral expenses up to the limits you’ve purchased. For example, imagine you purchased $5,000 in medical payments coverage, but an accident cost you $5,001.00 — you would be responsible for paying for that extra $1. Limits vary significantly by state, policy, and insurer but commonly ranges from $1,000 to $25,000.

How Much Can Medical Payments Car Insurance Cost?

Medical payments coverage costs can vary by location, driving history, and other factors. Costs may range between $5 and $29 per month. Much could depend on the amount of coverage you’re buying. For example, a lower-priced policy may only provide a lower-limit medical payments plan, while you’ll pay more for a higher-limit plan. However, you’ll need to weigh the monthly cost against how much you’ll gain in emergency expenses and peace of mind. 

Other Types of Car Insurance to Consider

Along with MedPay, there are other types of car insurance that can help offset costs after an accident. 

Mandatory Coverage in Most States

  • Bodily injury liability coverage: Mandatory in most states, bodily injury liability coverage pays for the medical bills for those injured in an accident, excluding yourself. It also provides payment for legal representation if you are sued for damages related to the accident.
  • Property damage liability coverage: Property damage liability coverage is mandatory in most states. It pays for damages you cause to another driver’s vehicle (or vehicles), as well as damage to other property such as walls, mailboxes, and other structures.
  • Uninsured motorist coverage: Some states, such as Kansas and Illinois, require uninsured motorist (UM) coverage. This coverage applies if an at-fault driver damages your vehicle or causes injury but does not have insurance coverage or commits a hit-and-run.
  • Underinsured motorist coverage: Some states, such as Maryland and Massachuttes, require underinsured motorist coverage (UIM), which compensates policyholders if an at-fault driver does not have enough liability insurance to cover the costs of damage or injuries. 

Optional Coverages in Most States

  • Collision insurance: This optional coverage helps pay for the cost of vehicle damage even if you’re found to be at fault.
  • Comprehensive insurance: This optional coverage helps pay for damage to your car due to acts of nature such as fire, wind, hail, vandalism, or striking an animal on the road.