Does Health Insurance Cover Car Accidents?

Car accidents can cost a lot of money, so many people wonder if their health insurance will pay the bills. The answer depends on your policies and the circumstances of the accident. This guide will help you understand how health insurance works for car accidents and what to do when filing a claim.

Health Insurance and Car Accidents

Health insurance covers medical bills for injuries, including those from car accidents. But will your health insurance be the primary or secondary payer? Auto insurance and state laws determine that. Some policies have exclusions or require using other options like personal injury protection (PIP) first.

Will Health Insurance Pay for Car Accident Injuries?

Health insurance may cover car accident injuries, but:

• Policy Exclusions: Some health insurance plans exclude auto accident injuries or require specific endorsements.
• Deductibles and Copays: Even if health insurance covers accident-related expenses, you may still have to pay deductibles and copays.
• In-Network vs. Out-of-Network Care: Your insurer only covers if the medical providers are in-network.

When Health Insurance Covers Car Accident Injuries

• You don’t have auto insurance with medical coverage (like PIP or MedPay).
• Your auto insurance has run out.
• The at-fault driver’s liability insurance doesn’t cover all your medical bills.

When Health Insurance Won’t Cover Car Accident Injuries

• Your policy excludes auto accident injuries.
• Another insurance policy (like PIP) has to be paid first.
• The accident was work-related and required workers’ comp.

Auto Insurance vs. Health Insurance: 

Auto insurance policies usually have medical payment coverage (MedPay) or personal injury protection (PIP), which pays for medical expenses after a car accident. The order of payment depends on your policy and state laws.

• Personal Injury Protection (PIP) is required in no-fault states. It covers medical expenses regardless of who was at fault and pays before health insurance.
• Medical Payments Coverage (MedPay): An optional addition to auto insurance, MedPay helps pay medical bills regardless of fault and may work with health insurance.
• Health Insurance: If your auto policy doesn’t have PIP or MedPay or those are exhausted, health insurance will pay the rest.

Subrogation: Can Your Health Insurance Sue You?

Subrogation is a process where your health insurer sues the at-fault driver’s insurance after they pay your medical bills.

How Subrogation Works:

1. Your health insurance pays your medical bills upfront.
2. Your health insurer may claim a portion if you get a settlement from the at-fault driver’s insurance.
3. Not paying could result in legal consequences or higher premiums.

What to Do If You Get a Subrogation Letter

• Consult a lawyer before responding to a subrogation request.
• Make sure your medical bills are covered before agreeing to pay them back.
• Negotiate the repayment amount if possible.

How to Submit Medical Bills After a Car Accident

Filing a claim correctly is key to getting paid quickly and avoiding disputes.

How to Send Medical Bills to Auto Insurance:

1. Notify Your Auto Insurance Company: Report the accident and confirm your medical coverage options.
2. Use PIP or MedPay First: If applicable, these will pay your medical bills before your health insurance. 3. Submit to Health Insurance: If your auto insurance has expired, file with your company.
3. Keep Records: Keep copies of all medical bills, insurance correspondence, and payment receipts.
4. Appeal Denied Claims: If insurance denies a claim, review the policy and consider appealing.

When to Get a Lawyer for Insurance Disputes

Insurance claims can be complicated, especially when multiple policies are involved. You may need a lawyer in the following situations:

• Your health insurance won’t cover accident-related medical expenses.
• The at-fault driver’s insurance disputes liability or won’t pay.
• You get a subrogation letter demanding reimbursement.
• Your settlement offer doesn’t cover all your medical bills.

Does insurance cover you when it’s your fault?

Yes, insurance will cover you even if you were at fault, but it’s different types of coverage. Liability covers others, PIP or MedPay covers you, and collision covers your vehicle, but deductibles apply. However, standard health insurance will still require coordination with auto insurance to cover medical. 

Final Thoughts: 

Knowing how medical insurance works with auto insurance can help you avoid being surprised after a car accident. Talk to an insurance pro or attorney if you’re unsure about your coverage or have disputes. Review your policy and consider PIP or MedPay to cover the unexpected.