What is MedPay?

Key Highlights:

• What is MedPay? The MedPay stands for Medical Payments Coverage and is an add-on to your auto insurance medical payments coverage.
• MedPay insurance will cover your accident medical expenses regardless of fault.
• There is no deductible or copay, and it provides fast payments.
• It is optional auto insurance coverage in most states, and the limit varies from $1,000 to $10,000.
• MedPay insurance will pay your medical expenses before Medicare for accident-related care. 

It can help you with your medical bills after a car accident; it helps regardless of fault / no-fault coverage.

I am Robert Tatum, a lawyer from the firm of Tatum & Atkinson Law Firm. For the past six years, we have provided legal services to our clients in Virginia concerning their MedPay insurance coverage.

What Is MedPay, and Why Was It Created?

Medical bills after a car accident are coming long before the fault is determined and the insurer is selected. The main idea behind MedPay insurance is to bridge this gap, as it allows you to get paid for your accident medical expenses immediately. without any fault determination and without a no deductible or copay required by a health insurance after an accident plan. 

There are millions of people being admitted to emergency rooms every year because of motor vehicle crashes, according to NHTSA. MedPay insurance typically covers the insured person, his/her family members, and passengers.

MedPay Coverage; MedPay Non-Coverage

Medical Payments Coverage is intended for the accident medical expenses in case of an accident: 

• Transport via ambulance and visits to the emergency room; 
• Staying at the hospital and undergoing surgeries
• Diagnostic procedures (X-rays, MRIs)
•  Subsequent therapy and rehab
• Funeral expenses, if any, are in the policy. 

However, there are specific items that MedPay insurance does not cover, including medical bills for other persons in the other car, property damage, loss of income, and pain and suffering.

MedPay Versus Other Coverages

MedPay vs PIP is likely to be easily confused with other coverages that have something to do with medical expenses: coverage what it pays for pays regardless of fault / no-fault coverage? 

Limits, Deductibles, and the Claims Process

Auto insurance medical payments coverage has low limits. In most cases, you will be allowed by insurers to set coverage limits ($1,000-$10,000); all other expenses fall upon you personally. In comparison with health insurance after an accident, MedPay insurance does not have any no deductible or copay; it pays all covered expenses from the very first dollar up to your limit. 

You should send the bills directly to your auto insurer and make a claim for the reimbursement of covered expenses. 

Tip for consumers: As MedPay has no deductible or copay, it may provide coverage for your first medical bills after a car accident immediately after an accident, before the other types of claims are completed.

How MedPay Interacts With Health Insurance, Medicare, Medicaid, and Workers’ Comp

With multiple coverages, the coordination of benefits determines which will pay first. With private health insurance after an accident, MedPay can be primary or secondary, according to the state and specific insurance. In the case of Medicare, the sequence is fixed by federal law. 

Auto insurance coverage, no-fault, and MedPay coverage are considered primary, while Medicare is a secondary payer for accident medical expenses. 

Medicare Secondary Payer / conditional payment rules state that if an auto insurance company does not pay timely, then a conditional payment can be issued, but this payment should be returned when the claim is settled. 

In general, Medicaid payer of last resort and is usually the last payer, usually followed by workers’ compensation for workplace injuries. If the insurance company can recover payments after settling a lawsuit, then it is known as subrogation/reimbursement.

Is MedPay a Good Deal? Questions To Answer Prior to Purchase

MedPay insurance is relatively cheap and useful for those with high-deductible health plan insurance policies and people who tend to ride in their vehicles with passengers. However, MedPay does not suit everyone, and some questions need to be answered prior to buying the policy: 

• How much is my deductible on my health insurance after an accident, and would MedPay help cover that amount?
• How much liability insurance can I purchase, and what will be the price?
• Is my state a no-fault state that requires personal injury protection (PIP), which would duplicate MedPay?
•  Are there any funerals covered by my policy, and which people are covered?
• Is my insurance company able to make a claim for subrogation/reimbursement from a settlement in my state? 

The State Department of Insurance and the National Association of Insurance Commissioners provide consumer guides and other information resources.

MedPay in Virginia Auto Insurance Policies

Virginia is a traditional fault state, as opposed to a no-fault state; it does not apply personal injury protection (PIP). MedPay is the alternative auto insurance medical payments coverage that Virginia motorists may include in their auto insurance coverage policy as described above. The exact terms of coordination of benefits and subrogation/reimbursement depend on the terms of the particular policy and Virginia laws.

Knowing Your Coverage and Seeking Assistance Where Needed

MedPay insurance is a minor but powerful auto insurance coverage that will come in handy if you find yourself in:

• an accident
• quick payment regardless of fault / no-fault coverage, and 
• no deductible or copay. 

The best way to know what your Medical Payments Coverage is all about is before you require it, when you can compare coverage limits ($1,000-$10,000) and match them up with the other insurance coverages you have. 

In case there is a dispute on auto insurance coverage during or after an accident, a rejected claim, payment demands, or MedPay being involved in an injury claim altogether, then you should consider talking with an experienced personal injury lawyer. Tatum & Atkinson Law Firm is a personal injury law firm based in North Carolina and Virginia, and we would be happy to assist you with your coverage matters.

For a free consultation regarding an insurance or personal injury issue, call us at (800) 529-0804.

FAQs: What is MedPay?

Is MedPay the same as health insurance?

No. MedPay only covers injuries sustained in an accident, has no deductible or copay, and processes claims promptly up to a certain limit; health insurance after an accident covers all causes of injury but comes with deductibles, copays, and networks. The two can coexist as follows: MedPay pays out first for any accident medical expenses, or picks up the tab on deductibles and copays left unpaid by your health insurance after an accident.

Does MedPay cover me if I am hurt as a pedestrian or in someone else’s car?

Generally speaking, yes. MedPay insurance usually covers the individual rather than the vehicle in question, meaning you might be covered when struck while walking or biking, or when involved in an accident as a passenger in a car that is not insured by you. Details depend on your individual plan, so you need to make sure of that yourself.

Will using MedPay raise my insurance premium?

Making a MedPay claim does not automatically lead to increased premiums, as MedPay does not depend on any findings of liability. On the other hand, insurance companies consider various factors when determining your rates, which means that the process varies from company to company. If you are worried about that, check with your insurer first.

Can I have both MedPay and PIP?

That’s correct. If both options are available, personal injury protection (PIP) is the main coverage, while MedPay is supplementary; it helps cover the personal injury protection (PIP) deductible or pays medical bills after a car accident, after the personal injury protection (PIP) limits have been used up. MedPay insurance coverage is independent in the absence of no-fault laws, and personal injury protection (PIP) is simply not offered in such states.

Does MedPay cover passengers who have their own insurance?

Indeed. Your MedPay covers the cost of accident medical expenses for anyone riding in your car at the time of an accident, irrespective of whether he or she has health insurance after an accident or auto insurance coverage.

How much MedPay should I buy?

There’s no easy answer here, but an effective approach would be to choose your MedPay limit in accordance with your high-deductible health plan deductible. This way, an accident won’t leave you paying that sum yourself.

Do I need a lawyer to use MedPay?

No, generally speaking. Most often, people settle a MedPay claim by themselves, dealing directly with their insurer. The involvement of legal assistance is needed in case there are disputes regarding a claim denial, subrogation/reimbursement issues after the settlement, or when Medical Payments Coverage is involved in a complicated personal injury claim involving multiple insurers.

About the Author

Robert Tatum

Robert Tatum is the founding attorney at Tatum & Atkinson. He is licensed to practice in all North Carolina state and federal courts and before the U.S. Supreme Court. He earned his J.D. from the University of North Carolina School of Law in 2002 and his B.S. from the University of Virginia in 1999. His practice focuses on personal injury law. Connect with him on LinkedIn.