In no-fault states, PIP is mandatory and covers medical bills, lost wages and rehabilitation after an accident regardless of fault. In at-fault states, MedPay is the available option — it covers medical bills only, also regardless of fault. In a handful of states, both are available. For a full breakdown of how PIP works, see what is PIP insurance and do you need it.
PIP vs. MedPay: What's the Difference
Updated: June 8, 2026
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Key Takeaways
PIP is required in no-fault states and covers medical bills, lost wages and rehabilitation. MedPay is optional in at-fault states and covers medical bills only, not lost income.
Both PIP and MedPay pay with no deductible or copay, meaning they cover what your health insurance makes you pay out of pocket first. That is their primary value for drivers who already have health coverage.
In at-fault states, MedPay typically adds $5 to $30 per month to your premium and can pay your health insurance deductible and copays immediately after an accident without waiting for a fault determination.
PIP vs. MedPay: What's the Difference
MONEYGEEK EXPERT TIP
Most drivers assume their health insurance covers car accident injuries and that PIP or MedPay is redundant. The distinction: health insurance has a deductible and copays; PIP and MedPay have neither. After a crash, PIP or MedPay pays the ER visit first, with no out-of-pocket cost to the patient. That is the gap they fill.
Drivers in at-fault states deciding whether to add MedPay, drivers in no-fault states assessing whether state minimums are sufficient, and drivers in states where both are available deciding whether to stack should read the sections below. For context on related coverage, see what is uninsured motorist insurance and do you need it.
PIP vs. MedPay: What Each Covers
PIP and MedPay both cover your medical bills after an accident regardless of fault, but PIP goes further, covering lost wages, rehabilitation and household services in most no-fault states.
PIP Covers
Medical bills after an accident (regardless of fault)- Lost wages during recovery
- Rehabilitation and therapy costs
- Death benefits (in most states)
- Household services during recovery (in some states: childcare, cleaning)
MedPay Covers
- Medical bills after an accident (regardless of fault)
- Dental injury treatment
- Funeral expenses (in most cases)
What MedPay Does Not Cover (That PIP Does)
Lost wages- Rehabilitation beyond acute care
- Household services during recovery
DISCLAIMER
Coverage details vary by state and insurer. In no-fault states, PIP is required at state minimums.
Which States Require PIP and Where MedPay Applies
In no-fault states, PIP is mandatory at state-defined minimums. In at-fault states, MedPay is an optional add-on. A subset of states makes both available, and stacking rules vary. Kentucky and New Jersey offer a choice between no-fault and at-fault coverage. Pennsylvania uses "first party benefits" as the legal term for its PIP-equivalent coverage rather than "PIP." Verify current statutory requirements with your state insurance department before purchasing, as state rules are subject to legislative change.
State | Fault System | PIP Required | MedPay Available | Both Available |
|---|---|---|---|---|
Alabama | At-Fault | No | Yes | No |
Alaska | At-Fault | No | Yes | No |
Arizona | At-Fault | No | Yes | No |
Arkansas | At-Fault | No | Yes | No |
California | At-Fault | No | Yes | No |
Colorado | At-Fault | No | Yes | No |
Connecticut | At-Fault | No | Yes | No |
Delaware | No-Fault | Yes | No | No |
District of Columbia | No-Fault | Yes | No | No |
Florida | No-Fault | Yes | No | No |
Georgia | At-Fault | No | Yes | No |
Hawaii | No-Fault | Yes | No | No |
Idaho | At-Fault | No | Yes | No |
Illinois | At-Fault | No | Yes | No |
Indiana | At-Fault | No | Yes | No |
Iowa | At-Fault | No | Yes | No |
Kansas | No-Fault | Yes | No | No |
Kentucky | Choice No-Fault | Optional (Choice No-Fault — verify with KY DOI) | Yes | Yes |
Louisiana | At-Fault | No | Yes | No |
Maine | At-Fault | Yes (MedPay required) | Yes (Required) | No |
Maryland | At-Fault | No | Yes | No |
Massachusetts | No-Fault | Yes | No | No |
Michigan | No-Fault | Yes | No | No |
Minnesota | No-Fault | Yes | No | No |
Mississippi | At-Fault | No | Yes | No |
Missouri | At-Fault | No | Yes | No |
Montana | At-Fault | No | Yes | No |
Nebraska | At-Fault | No | Yes | No |
Nevada | At-Fault | No | Yes | No |
New Hampshire | At-Fault | No | Yes (Required) | No |
New Jersey | Choice No-Fault | Yes (Choice No-Fault — verify with NJ DOI) | Yes | Yes |
New Mexico | At-Fault | No | Yes | No |
New York | No-Fault | Yes | No | No |
North Carolina | At-Fault | No | Yes | No |
North Dakota | No-Fault | Yes | No | No |
Ohio | At-Fault | No | Yes | No |
Oklahoma | At-Fault | No | Yes | No |
Oregon | At-Fault | Yes | Yes | No |
Pennsylvania | Choice No-Fault | Yes (First Party Benefits — verify with PA DOI) | Yes | Yes |
Rhode Island | At-Fault | No | Yes | No |
South Carolina | At-Fault | No | Yes | No |
South Dakota | At-Fault | No | Yes | No |
Tennessee | At-Fault | No | Yes | No |
Texas | At-Fault | No | Yes | No |
Utah | No-Fault | Yes | No | No |
Vermont | At-Fault | No | Yes | No |
Virginia | At-Fault | No | Yes | No |
Washington | No-Fault | Yes | No | No |
West Virginia | At-Fault | No | Yes | No |
Wisconsin | At-Fault | No | Yes | No |
Wyoming | At-Fault | No | Yes | No |
DISCLAIMER
State rules confirmed from state insurance department sources as of 2025. Kentucky, New Jersey and Pennsylvania operate choice no-fault systems — verify current statutory PIP requirements with each state's insurance department before purchasing.
When to Choose PIP, MedPay, or Neither
PIP is already mandatory in no-fault states, so the question is whether the state minimum is enough. Minimum PIP often starts at $10,000 and may not cover a serious injury's full costs.
MedPay at $5 to $30 per month (per Insurance.com) covers your health insurance deductible and copays immediately after an accident, before any fault determination. The clearest use case: drivers with high-deductible health plans who would otherwise owe $1,000 to $5,000 out of pocket for post-accident care before their health coverage starts. The IRS defines an HDHP as a plan with a minimum deductible of $1,600 for self-only coverage or $3,200 for family coverage in 2024 (IRS Rev. Proc. 2023-23), meaning many insured drivers face significant out-of-pocket exposure before health benefits begin.
In states where both PIP and MedPay are available, stacking — adding MedPay on top of PIP — can cover gaps in the state minimum. Some states prohibit stacking; confirm with your insurer before purchasing. For context on related coverage, see uninsured motorist bodily injury.
MONEYGEEK EXPERT TIP
A driver with comprehensive health coverage, a low deductible, strong income protection and residence in an at-fault state may not need MedPay. In that profile, MedPay adds cost with limited incremental protection. For that specific situation, skipping MedPay is reasonable.
Frequently Asked Questions About PIP vs. MedPay
PIP and MedPay both cover medical bills after an accident regardless of fault, but PIP goes further. PIP covers lost wages during recovery, rehabilitation and therapy costs, death benefits, and in some states household services such as childcare and cleaning. MedPay covers medical bills, dental injury treatment and funeral expenses, but not lost income or rehabilitation beyond acute care. PIP is required in no-fault states; MedPay is an optional add-on in at-fault states. MedPay typically adds $5 to $30 per month to your premium, according to Insurance.com data.
PIP is required in no-fault states. States with mandatory PIP include Delaware, Florida, Hawaii, Kansas, Massachusetts, Michigan, Minnesota, New York, North Dakota, Oregon, Utah and Washington. Kentucky, New Jersey and Pennsylvania operate choice no-fault systems — drivers in these states may elect no-fault or at-fault coverage, and PIP requirements vary accordingly. Verify current statutory requirements with your state insurance department before purchasing, as these rules are subject to legislative change. Pennsylvania requires first-party benefits rather than full PIP. Maine and New Hampshire require MedPay rather than PIP.
In some states, both PIP and MedPay are available and can be stacked on the same policy. Stacking means adding MedPay on top of your PIP coverage to fill gaps left by the state minimum. Some states prohibit stacking, so confirm your state's rules with your insurer or state insurance department before purchasing both coverages.
PIP and MedPay both pay with no deductible or copay, meaning they cover what your health insurance requires you to pay out of pocket first. After a crash, PIP or MedPay pays the ER visit immediately, with no out-of-pocket cost to the patient, before any fault determination. Health insurance has a deductible and copays that still apply; PIP and MedPay do not. That is their primary value for drivers who already have health coverage.
MedPay typically adds $5 to $30 per month to your premium, according to Insurance.com data. The exact cost varies by state, insurer and the coverage limit you select. In states where MedPay is required, such as Maine and New Hampshire, the cost is built into the standard policy. Verify current rates with your insurer, as costs vary by driver profile.
MedPay can still add value even with good health insurance, because it covers your deductible and copays immediately after an accident with no out-of-pocket cost and no wait for a fault determination. The strongest use case is drivers with high-deductible health plans (HDHPs). The IRS defines an HDHP as a plan with a minimum deductible of $1,600 for self-only coverage or $3,200 for family coverage in 2024 (IRS Rev. Proc. 2023-23), meaning affected drivers could owe $1,600 to $3,200 or more before health coverage begins. Drivers with low deductibles, strong income protection and residence in an at-fault state will see the least incremental benefit from MedPay.
State availability data sourced from state insurance department filings. MedPay cost estimates sourced from Insurance.com industry data. HDHP deductible thresholds sourced from IRS Rev. Proc. 2023-23. Kentucky, New Jersey and Pennsylvania PIP status reflects choice no-fault systems as of 2025 — verify current requirements with each state's insurance department.
About Mark Fitzpatrick
Mark Fitzpatrick, a licensed Property and Casualty (P&C) Insurance Producer in Connecticut, is MoneyGeek's resident insurance expert. He has spent nearly a decade analyzing the market, first at LendingTree and now at MoneyGeek, where he produces original research on hundreds of carriers and millions of rates across auto, home, renters, health and life insurance.
He covers economics and insurance at MoneyGeek, and his work has been featured in The Washington Post, The New York Times and NPR, among other outlets.
Like all MoneyGeek analysts, he draws on independent cost and consumer experience data. No insurance company partnership influences his recommendations.
Mark holds a B.A. from Boston College and an M.A. in Economics and International Relations from Johns Hopkins University. He started his career in financial risk management at State Street and is also a five-time “Jeopardy!” champion.