Medical Payments Coverage
What Is Medical Payments Coverage?
Medical payments coverage is an auto insurance add-on that pays for injuries resulting from any vehicular accident. Also known as MedPay, this can pay for your medical bills whether you’re a driver, passenger or pedestrian. It also covers injuries of your passengers.
Medical payments coverage applies regardless of who is at fault. Understanding how it works can help you determine if you should get this optional add-on for your auto insurance policy.
Understanding Medical Payments Coverage
Medical payments coverage can financially protect you in a variety of accidents involving vehicles. If you’re a driver, passenger or pedestrian and whether you’re at-fault or not, MedPay will cover your medical payments, including doctor visits, treatments needed due to the accident and even health insurance deductibles.
If personal injury protection (PIP) coverage is required in your state, you may not need MedPay. MedPay comes with its own limitations and does not cover all costs involved in an accident. Before purchasing medical payments coverage, it’s important to evaluate whether it’s worth the extra cost.
What Does Medical Payments Coverage Include and Not Include?
In general, medical payments coverage pays for the treatment of any injuries sustained in any auto accident. While it helps with a variety of medical bills, it does not pay for other typical costs involved in an auto accident. Below is a list of what MedPay does and does not cover:
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- CoveredNot Covered
- 1.Health insurance deductibles and copaysLost wages
- 2.Doctor and hospital visits or staysReplacement services (childcare expenses, etc.)
- 3.Surgeries or dental procedures needed as a result of the accidentMedical treatment not related to the accident
- 4.Prosthetic devicesInjuries sustained by the other party
- 5.Chiropractic servicesLegal expenses
- 6.Funeral expensesProperty damage
- 7.Ambulance feesSurvivor’s loss
How Does Medical Payments Coverage Work?
The way to claim a payout from your medical payments coverage will depend on your insurer, as it depends on whether they consider it as primary or secondary coverage and whether you live in a no-fault state.
- If MedPay is considered primary coverage: You pay for your medical bill or health insurance deductible upfront and apply for reimbursement from your MedPay insurer afterward.
- If MedPay is considered secondary coverage: Your health insurance or PIP coverage — if you have either — will pay out first. Deductibles and copays, along with any costs that go over their respective limit, will be covered by MedPay.
- If you live in a no-fault state: Your PIP coverage is considered primary, while MedPay is secondary. This means that your MedPay coverage will pay for anything over your PIP coverage limit if you happen to have both.
MedPay, PIP and Bodily Injury: What’s the Difference?
- Both MedPay and PIP coverage pay for your medical bills: PIP coverage is more comprehensive — as it covers other costs related to auto accidents — but MedPay can fill in gaps in health insurance coverage if you don’t have PIP.
- Bodily injury coverage only covers third-party injuries: If you’re at fault in an accident, bodily injury coverage is what pays for the medical bills or lost wages of any third party involved.
- Bodily injury coverage is required by almost every state: MedPay and PIP are not: Almost all states require some level of bodily injury coverage. PIP is only mandatory in no-fault states and MedPay is optional in nearly every state.
MedPay, personal injury protection (PIP) coverage and bodily injury coverage are three types of coverages that are often confused with one another. Understanding the difference between the three can ensure you get the coverage you need.
While both medical payments coverage and PIP coverage pay for physical injuries that you sustain in an accident, regardless of who is at fault, PIP coverage is more comprehensive. In addition to medical care, it also covers lost wages, essential services like childcare, and survivors’ loss — none of which are included in medical payments coverage. MedPay also has lower liability limits than PIP coverage, as it is meant only to supplement other coverages in your policy.
In contrast, bodily injury coverage only covers third parties involved in an auto accident where you are at fault. This means that if you get into or cause an accident, your bodily injury coverage is responsible for paying for any third-party medical bills. None of your own injuries will be covered by bodily injury coverage.
Between the three coverages, only bodily injury is required in almost every state. PIP coverage is mandatory in states that require no-fault insurance but is optional in others, while MedPay is optional in all but a few states.
Is Medical Payments Coverage Necessary?
With national health spending projected to grow at an average rate of 5.4% per year. Having MedPay helps protect you from rising healthcare costs because it closes the gap and covers services that some health insurance policies may not. If you don’t live in a no-fault state, have PIP coverage or health insurance that covers injuries after an accident, MedPay might be worth considering.
When Will You Need Medical Payments Coverage?
Medical payments coverage can kick in in a variety of situations and help you save on a number of medical costs. MedPay can cover you when:
- You get into an accident as a pedestrian: If you’re casually walking down the street and you get into an accident with a car or a bike, all injuries sustained will be covered by MedPay up to your limit.
- You get into an accident in someone else's car: If you’re a passenger in a friend or family’s car and you get into an auto accident, MedPay can cover the cost of treating your injuries.
- You have a family member that gets into an auto accident: MedPay covers family members listed on your policy, too. If they get into any type of auto accident, you can reimburse the medical bill through your MedPay coverage.
Where Will You Need MedPay?
MedPay is an optional add-on in almost every state and is only required in three states: Maine, New Hampshire and Pennsylvania. Maine requires at least $2,000 in MedPay coverage, New Hampshire requires at least $1,000 in coverage and Pennsylvania requires a minimum of $5,000 in coverage.
Examples of Medical Payment Coverage
Examining how medical payments coverage works in real life and when it's applicable can help you determine if this coverage is right for you.
Let's say you get into a vehicular accident and have no health insurance or personal injury protection coverage to pay for your medical bills. In this case, your MedPay coverage would kick in and help pay for immediate medical or funeral expenses. This coverage applies regardless of who is at fault and whether you’re a driver, passenger or pedestrian.
If you do have health insurance, MedPay will pay for your deductible and copay.
If you live in a no-fault state and have low PIP coverage limits, MedPay could act as your secondary coverage and supplement your PIP coverage where it's lacking. For instance, if you have a $10,000 PIP coverage limit, but your medical bills hit $15,000, MedPay will cover the gap.
However, MedPay coverage limits are typically low and are only likely to cover a limited amount of your medical bills. It will also not cover any lost wages, so if you’re unable to work, MedPay will not compensate you.
How Much Medical Payments Coverage Costs
Adding MedPay to your policy will cost, on average, an additional $5 for a limit of $2,000. However, limits can be anywhere from $1,000 up to $25,000, depending on the insurer. Keep in mind that your premium cost will also depend on a number of factors unique to you, such as your age, location, gender and more.
MoneyGeek gathered quotes from three different insurers in various states for a 40-year-old male with a clean driving record and a 2010 Toyota Camry LE. The policy included 100/300/100 in liability limits and comprehensive and collision coverage with a $1,000 deductible. Policies with MedPay had a $2,000 limit.
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- Allstate (Texas)Progressive (California)Nationwide (Nevada)
- 1.No Medical Payments$50 per month$97 per month$127 per month
- 2.Medical Payments$53 per month$104 per month$132 per month
- 3.% Increase Due to MedPay Payments6%7%4%
Note that these rates are simply averages and can change based on your unique circumstance. To find the cheapest auto insurance rates for you, make sure to compare auto insurance quotes from at least three different providers.
Medical Payments Coverage FAQs
Understanding how medical payments coverage can benefit you can be difficult. Below are a few frequently asked questions to help you understand MedPay coverage better so you can determine if it’s right for your needs.
Determining whether medical payments coverage is right for you, MoneyGeek reached out to insurance experts to get their thoughts on what factors you should consider.
- How can a driver determine if adding medical payments coverage is right for them?
- Should medical payments coverage be added if a driver already has personal injury protection (PIP) coverage? Why or why not?
Co-founder and President of Dundas Life
CEO of The Annuity Expert
Insurance Agent at Farmers Insurance
Medical payments coverage is just one of many different types of coverage you can include in your auto insurance policy. Learn more about auto insurance to determine the coverages that are best for your needs.
- Liability Car Insurance: What It Covers and How Much It Costs: Understanding liability insurance, which consists of bodily injury and property damage coverage, can help you determine the right limits for your needs.
- What Is Full Coverage Auto Insurance?: Full coverage auto insurance, which includes comprehensive and collision insurance, provides more financial protection after an accident than liability coverage.
- What Is PIP Car Insurance and Do You Need It?: Learn more about personal injury protection (PIP) coverage and determine if it’s required in your state.
- How Much Car Insurance Do You Really Need?: Buying the most expensive auto insurance is not always the best idea. Learning how to assess what you need can help you save on your monthly premiums.
- How Car Insurance Works: What's Included in Your Policy and How to Use It: Knowing the fundamentals of car insurance is essential before purchasing a policy. This way, you can determine what and how much coverage you need.
About the Author
- Centers for Medicare and Medicaid Services. "NHE Fact Sheet." Accessed November 18, 2021.
- Maine.gov. "Insurance Required by Law." Accessed November 17, 2021.
- Pennsylvania Insurance Department. "Automobile Insurance Guide." Accessed November 17, 2021.
- State of New Hampshire Insurance Department. "Your Guide to Understanding Auto Insurance In The Granite State." Accessed November 17, 2021.