Should You Use Your Health Insurance for Accident-Related Injuries?

what is accident-related health insurance

What you’ll learn reading this article:

  1. You have several options when it comes to covering medical expenses after an accident, including your own medical insurance, the other driver’s auto insurance company and supplemental health care insurance such as MedPay.
  2. The other driver’s car insurance company will often take longer to agree to cover costs, so understanding the timeline of your medical treatments and your claim is important when weighing the pros and cons of using third-party insurance.
  3. MedPay is a great option as it can cover expenses related to an auto accident no matter who is at fault. 
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After a car accident-related injury, people often wonder whether they should use their own health insurance plan to cover medical expenses. The first thing to determine is just what insurance is available to you. Your own health insurance company is your first option, whether you’ve gotten it through a personal plan or through work or if it’s Medicare or Medicaid.

Secondly, there is the insurance of the person who hit you, often referred to as third-party insurance. Thirdly, there is an option to use medical payment benefits if you’ve paid for the policy.

Using Third-Party Insurance

What is important to know is that the third-party insurance often will not cover payments until the end of your case, meaning it could be a while before it is willing to pay. You may be lucky and be able to settle your claim quickly, or you may end up having to file a lawsuit that could go on for several years.

Additionally, the insurance company might say it will cover the costs and then later decide its client is not at fault and fight you on the payment. This could leave you stuck with a mountain of bills.

Using Your Own Insurance

One of the things you should check for after an accident-related injury is your coverage limits and whether you have any medical payment benefits (or MedPay) in your auto insurance policy. MedPay is an add-on that will pay for medical bills in the event of an automobile accident regardless of who was at fault. Usually, MedPay can be applied to a fair amount of your medical bills and can cover anywhere between $1,000 to $25,000.

Applying Medical Payment Benefits

Using this option if you have it can be a great strategy. You’re already paying for this coverage, and depending on your policy, it can help you to cover a considerable amount of your medical care, lost wages, and other bills. Using it to pay out-of-pocket expenses can be especially smart and keep you from needing to pay yourself.

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MedPay is optional in Indiana, but some states require it. Depending on your state, MedPay will cover a variety of expenses associated with car accident injuries, making it a great addition to your auto insurance policy if your health insurance has gaps.

MedPay may cover medical, dental, surgical and chiropractic care costs following an auto accident, such as:

  • Ambulance fees.
  • Diagnostic tests like X-rays.
  • Prostheses and nursing costs.
  • Treatment costs for injuries sustained from the accident.
  • Treatment costs for injuries sustained by your passengers in the accident.
  • Copays and deductibles.

Many people worry that by applying their medical payment benefits, their insurance rates will go up even if they weren’t liable for the accident. However, if you’re paying for it, you should use it—or else, where is that money going? If you’re already paying for a benefit, you should absolutely make use of it when it makes sense.

Additionally, medical payment benefits can also be used to maximize your net settlement should your case go to trial.

Poynter & Bucheri Accident Recovery—Indianapolis Personal Injury Attorneys

If you or a loved one has been injured physically or mentally by a person, product or company, you need to know your legal rights. Our personal injury attorneys are experienced with cases like yours and can evaluate what your case may be worth. We will ensure that you are protected and compensated for your injuries and losses.

Why pay up to 40% in attorney fees? Our fee is only 25%*, and we fight to win your case or you pay no attorney fees at all. Don’t hesitate—one of our experienced attorneys can assist you right away. Call (800) 265-9881 for a free case review and receive the legal advice you need to move forward.

Video 1 Transcript

Hi. I’m Rich Bucheri from Poynter & Bucheri injury attorneys. Today I want to talk about whether you should use your health insurance for your auto-related injuries.

When we’re talking about using your health insurance, the first thing that we need to do is find out what insurance is available. Typically, you might have some of your own personal health insurance, whether it’s your insurance through work, or maybe you have Medicaid, or maybe you have Medicare.

Then you might also have the third-party’s insurance, which is the person that hits you. They might have some kind of auto insurance coverage.

Well, what I would tell you is don’t rely on using other party’s insurance. Sometimes I get clients that say, “Well, I didn’t use my Medicaid, or I didn’t use my health insurance through work because I didn’t want to make the charges chargeable to them. I instead gave the third party’s insurance information to my treatment provider, and they said that they would run it through.”

Well, typically the other party’s insurance doesn’t pay the bills until the end. You don’t really know whether or not they’re going to make you a satisfactory settlement right away or if you’re going to have to file suit and the case won’t get resolved for years later.

Also, sometimes they might say they’re going to pay the bills, but then once they’ve had a chance to take a look at the case and maybe talk to some witness statements, they decide that they’re not at fault, in which case they don’t pay any of the medical bills. Then you’re stuck with having the bills and collections.

One thing that you should try to do is see if you have any MedPay benefits under your own insurance policy; medical payment benefits pay for medical bills regardless of who was at fault.

They’re usually anywhere between $1,000 to $5,000 to even $10,000 or $25,000 as far as the policy limits go. You can use quite a bit of MedPay to pay your bills. Typically, what I would say is to use it strategically. Try to use it for your out-of-pocket expenses that other insurances aren’t paying so you’re not out of pocket any money.

Finally, the No. 1 thing is you want to make sure your bills get paid. You don’t want to be in a situation where something happens to your personal injury lawsuit and you haven’t submitted any of your bills to insurance and so the bills don’t get paid. Then you’re personally responsible on top of having been the victim of an accident.

Video 2 Transcript

Hi, I’m Rich Bucheri from Poynter & Bucheri. And today I want to talk about the importance of using your medical payments coverage.

So if you’ve been involved in an accident, one of the first things you should do is check your own policy to see if you have any medical payment benefits. And if you are already paying for it, then you should consider using it.

Some people don’t want to use their medical payment benefits because they’re afraid their insurance rates are going to go up even if they weren’t at fault for the accident. But if this is a coverage that you’re paying for, then you’re basically wasting your money if you’re never going to use it. So I would consider using it. And the reason that it’s good is because it pays out regardless of who’s at fault.

And so the way I would use it is, I would use it if you had out-of-pocket expenses, perhaps if you have work insurance and they only pay 80% of your bill and you’re responsible for 20% or you haven’t met your deductible yet, then medical payments coverage is an excellent way to pay for these out-of-pocket medical expenses.

And one other thing is that medical payments coverage can be used to maximize your net settlement. If you hire an attorney, then that can be used to your benefit. So when your insurance company pays for medical payments, they have a right of subrogation against the third party that caused the accident. So basically they can get paid back for what they paid out, but they don’t necessarily get paid back 100%.

If you have an attorney, that amount is reduced by attorney fees and pro-rata expenses. So basically they’re a partner in your lawsuit. And so by doing that, you’re able to get a higher net settlement.