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Understanding Medical Payments Coverage (Coverage F)?

What Is Homeowners Insurance Medical Payments Coverage?

Homeowner’s medical payments coverage, also called Coverage F or MedPay insurance, helps cover medical expenses incurred if a guest is accidentally injured at your home. Medical payments home insurance is an optional coverage on your policy, though it is often included by default. It is designed to help offset the cost of medical care for injured parties, regardless of who’s at fault for the injury. 

Coverage limits typically range from $1,000 to $5,000 and cover accidents that happen in your home, on your property, and in some cases even outside the home. Learn about what is covered by home insurance medical payments, how this coverage works, and how you can purchase Coverage F for your policy if it is not already included.

How Does Homeowners Medical Payments Coverage Work?

Medical payments insurance works by covering the costs of minor injuries sustained in your home up to your policy’s claim limit. Unlike personal liability insurance, coverage amounts are lower, ranging from $1,000 to $5,000.

For example, suppose you’re cooking dinner with friends at your home, and one friend suffers a deep cut from a kitchen knife. After taking them to the emergency room, they receive stitches and are then referred to a physical therapist for follow-up. 

Since the injury happened in your home, you can make an insurance claim with your provider for these expenses. Things like ER visits, medically necessary treatments, and physical therapy would be covered. If the total costs of treatment are $3,200 and you have a coverage limit of $4,000, your MedPay insurance would cover the entire bill. If your limit is $1,000, your coverage pays the first $1,000, leaving a balance of $2,200 for you to cover out of pocket, or for the injured party to cover with their own health insurance. You may also be able to use your personal liability insurance to cover the balance if you are determined to be at fault for the injury.

What Does Homeowners Medical Payments Insurance Cover?

Medical payments insurance can help offset the costs of a visitor’s medical bills if they are injured at your home. For example, if you have friends over for a party and someone hits their head by slipping on the stone patio in your backyard, you can submit a claim to your home insurance provider. If the claim is approved, your coverage pays eligible medical bills for your friend up to your coverage limit, which usually ranges from $1,000 to $5,000.

Common coverages for this insurance type include:

  • Ambulance services
  • Visits to the ER
  • Hospital care
  • Surgery
  • X-rays
  • Physical therapy

In some cases, your coverage may also extend outside the home. For example, if you accidentally cause injury to someone away from your home, or your dog bites and injures someone, you may be covered. Coverage may also extend to injuries caused by employees of your home, such as care providers who accidentally hurt a visitor. However, residents of the home are not covered under this insurance, and it does not apply to intentional acts of harm.

What Does Homeowners Medical Payments Insurance Not Cover?

Residents of the home — including you, your spouse, your children, and your roommates — are not covered under homeowner’s medical payments coverage. There are also other exclusions to medical payments coverage, such as:

  • Intentional injuries: If you or someone at your home causes an intentional injury, Coverage F does not apply. For example, if a disagreement escalates into a fight and someone is injured, medical payments coverage is not applicable in that situation.
  • Business-related injuries: If you’re operating a business out of your home and someone is injured as a result of your business services, medical payments insurance is not applicable. This is because customers are not considered guests — in this case, business liability coverage policies would apply.
  • Infectious disease injuries: Infectious diseases passed to guests by members of your household or other guests fall outside the scope of Coverage F. This includes influenza, COVID-19, or any other illness.
  • Controlled-substance use: In cases where guests are using controlled substances such as alcohol and injuries occur, medical payments coverage does not apply.

Home Insurance Medical Payments Insurance vs. Health Insurance

While home insurance medical payments and health insurance both offer coverage for medical expenses, they do so in different ways. Health insurance policies are designed to cover you and your family in the event of medical issues, including injuries or accidents that occur in your home. If you are injured in your home (or anywhere else) and seek medical attention, your physician will submit insurance claims on your behalf. You would pay any applicable deductibles, coinsurance, and copayments before your insurance company covers the remaining eligible balance.

Home insurance medical payments, meanwhile, cover other people injured in your home. As a result, injuries sustained by you and your family in your own home are covered under health insurance, not MedPay. However, MedPay coverage does not come with deductibles, coinsurance, and copayments.

Home Insurance Medical Payments Insurance vs. Personal Liability Insurance

Personal liability insurance, also called Coverage E, covers medical bills for guests injured at your home if you are liable for the injury. This coverage also includes property damage, such as if you or a member of your household causes damage to someone else’s property. For example, if you’re playing catch in the backyard and accidentally send the ball through your neighbor’s window, your personal liability insurance may cover the damages. In addition, personal liability insurance can help cover your legal defense if the neighbors bring a lawsuit against you or your family.

In contrast, MedPay insurance covers injuries that occur on your property no matter who is at fault. It also does not extend to property damage. Coverage limits are also different. While MedPay limits range from $1,000 to $5,000, personal liability coverages range from $100,000 to $300,000 or more, depending on your policy type.

Both types of coverages are often included in homeowner’s and renter’s policies by default, and which is used depends on the exact scenario leading to the visitor’s injury.

See It In Action

For example, suppose you’re playing a game of pickup football in the backyard. You throw the ball to your friend who reaches to catch it, but they run into the wall of your home, dislocating their shoulder in the process. In this case, MedPay insurance helps cover the cost of medical care regardless of who is to blame for the accident.

However, a different situation would be if you’ve recently done yard work and failed to warn your friend about holes in your yard. If he breaks his leg when he runs to make the catch and also sends the football through the neighbor’s window, your personal liability coverage may apply given your responsibility for the injury and the damage to someone else’s property.

How Does Homeowners Medical Payments Insurance Work for Condos and Rental Property Owners?

For condos and rental property owners, medical payments insurance can help cover medical bills if guests on the property are injured under certain circumstances.

For example, suppose a rental unit is vacant and potential tenants accidentally injures themselves while viewing the property. In that case, Coverage F can help pay for medical bills and avoid issues of legal liability. In some cases, guests of tenants may be accidentally injured due to slips or falls, and the landlord’s MedPay insurance covers the cost. This could occur if the landlord is responsible for clearing walkways of ice or snow but fails to do so and a guest falls and injures themselves.

How Does Medical Payments Insurance Work for Renters?

For renters, medical payments insurance works the same way as for homeowners. It’s an optional coverage that may be purchased to cover the costs of accidental injuries sustained while guests are in the rental unit. This means that if you have guests over and they trip over a rug in the living room and injures themselves, Coverage F would apply.

There is a caveat, however — Unlike homeowners’ MedPay insurance, renters’ Coverage F does not apply to injuries sustained outside the home, apartment, or unit itself, such as on shared walkways or backyards.

How Much Does Medical Payments Insurance Cost?

The cost of MedPay insurance varies according to your insurer, your policy’s details, your home state, your home’s value, and how much coverage you want. Most standard home insurance policies include medical payments coverage, so the cost of MedPay is wrapped into the monthly premium for homeowners insurance.

For a home insurance policy with $300,000 in dwelling coverage, the average homeowner pays between $1,500 and $2,800 per month, though your policy may cost less or more depending on where you live.

Most insurers offer MedPay coverage in amounts varying from $1,000 to $5,000. Opting for more MedPay coverage can increase your monthly homeowners insurance premium.

How Much Medical Payments Coverage Do You Need?

Medical payments insurance may help reduce the risk of legal action if someone is injured on your property. If their injuries are minor and your insurance covers the total cost of their medical bills, they may have no reason to pursue legal action.

As a result, it may be worthwhile to purchase as much coverage as possible — typically up to $5,000 — from your insurance provider.

How To Get Medical Payments Coverage

A standard home insurance policy should include MedPay, so to get medical payments to others coverage, take the following steps for getting homeowners insurance:

  1. Determine which coverage types you need for your home. HO-3 homeowners insurance, the most common policy type, includes insurance for your house, detached structures, personal property, liability, additional living expenses, and medical payments to others.
  2. Decide on your coverage amount, including medical payments coverage. MedPay usually covers small amounts ranging from $1,000 to $5,000.
  3. Choose a deductible for your insurance policy.
  4. Compare quotes from various homeowners insurance providers to select an insurer.

Before purchasing any policy, make sure you’ve done your homework and gathered information about your house’s history, building materials, roof condition, and heating and cooling system. Knowing as much as you can about your house will help you pick an appropriate insurance policy.

Putting It All Together

When you purchase a homeowners insurance policy, your plan should include Coverage F, which helps pay for medical expenses if a guest is hurt on your property. Coverage F, also known as medical payments to others insurance, or MedPay, usually covers only small amounts up to around $5,000.

If someone who is not insured under your homeowners policy sustains an ankle sprain or another minor injury on your property, MedPay can help pay for the hospital visit, X-ray, and medical care needed to evaluate and treat the injury. Costlier incidents and injuries would fall under liability coverage rather than MedPay.