Medical payments coverage pays for medical-related expenses for you and your passengers, regardless of who is at fault in the accident. You might see this coverage listed as MedPay on your policy documents. Although medical payments coverage is almost always optional, it can provide significant financial protection for what is usually a low cost. Even if you already have medical insurance, medical payments insurance could be indispensable as it can help cover out-of-pocket expenses your medical insurance may leave you with, such as deductibles. Bankrate breaks down the particulars behind medical payments to help you decide if this coverage could bolster your auto insurance policy.

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What is medical payments coverage?

To put it simply, medical payments coverage pays medical bills up to your coverage limit for you and any passengers riding in your vehicle in case of an accident, regardless of who is at fault. It might also pay if you’re hit by a car while walking or biking or if you are injured in an accident in someone else’s car, but generally the at-fault driver’s bodily injury coverage would pay first. Your medical payments coverage may also move with you, like if you are walking or cycling, as well as with your insured vehicles, regardless of who is driving. It carries no deductible or copay.

You might think your bodily injury liability coverage will cover those expenses, but that coverage only steps in to cover injuries sustained by injuries that you cause to others if you’re the driver in an at-fault accident. It does not cover you or any passengers that are family members. While another driver’s bodily injury liability coverage can help if you are injured in an accident that another insured driver caused, determining liability can be time consuming and your medical bills could go unpaid during that time.

With medical payments coverage, you may be able to get faster coverage to help pay any medical bills you or your passengers face after an accident. Your health insurance might pay, but many health care plans have high deductibles and copays that can stretch your finances before the insurance settlement with the at-fault driver is reached.

How does MedPay work on auto insurance?

Medical payments coverage generally kicks in quickly to pay your medical bills, health insurance deductible and copays, up to the policy limits. It also covers other out-of-pocket costs that your health policy might not pay, including ambulance fees, chiropractic, dental, prosthetics and, in a worst-case scenario, funeral expenses.

Unlike liability coverage, the policy limits on medical payments coverage do not refer to the total available coverage limit, but instead to the amount available for each covered injured individual. For example, if you have a $5,000 medical payments limit and you, your spouse and your two children are injured in an auto accident, each of you could collect up to $5,000 in medical payments coverage for a total of $20,000. However, your insurer will not pay the same bills under both your medical payments coverage and liability coverage.

Medical payments coverage can be especially important for drivers without health care insurance. However, medical payments should not be used as a substitute for health coverage. You must carry auto liability coverage in order to purchase medical payments coverage, and you have to be injured in an auto-related accident to use it.

What does MedPay cover?

If you are considering purchasing medical payments coverage, you are probably wondering what protections you will get. Here are some of the coverages that medical payments coverage provides:

  • Medical care: Your medical payments coverage can cover the cost of doctors and hospital expenses.
  • Health care insurance deductibles and copays: A huge benefit of medical payments coverage is that it can pay for out-of-pocket costs that your medical insurance may leave behind. For example, medical payments coverage might cover any co-pays for your doctor visits, plus your health care insurance deductible, up to the policy limit.
  • Emergency medical care: Medical payments coverage does not just step in for checkups after the accident. It can cover the cost of an ambulance trip or emergency medical services, which are often pricey but critical if you or any of your passengers are badly hurt in the accident.
  • Specific diagnostics and treatments: Medical payments coverage also covers services to help you determine the extent of your injuries, like X-rays, or treatments required for you to heal, like surgery and therapy.

You might be tempted to forgo medical payments coverage to save money on your car insurance, but medical payments coverage can go a long way to financially help you or your passengers if any of you gets hurt in a car accident.

How is MedPay different from PIP?

If you live in one of the 12 “no-fault” states (Florida, Hawaii, Kansas, Kentucky, Massachusetts, Michigan, Minnesota, New Jersey, New York, North Dakota, Pennsylvania and Utah), the benefits of medical payments coverage may sound familiar. That is because the coverage is very similar to personal injury protection (PIP) coverage. PIP coverage is generally mandatory in no-fault states.

PIP coverage works similarly to medical payments coverage, paying for medical expenses after an auto accident. But PIP coverage is generally further reaching than medical payments coverage, covering things like wage reimbursement if you have to miss work because of your injuries.

How much does medical payments coverage cost?

The average cost of medical payments coverage is often quite low and the benefits you may receive from just one claim could offer financial peace of mind.

“For example, if your health insurance has a $1,000 deductible, a 20 percent copay and you have a $5,000 medical claim from an accident, with your health insurance you would typically pay $1,800 out of pocket,” says Christy Moulton Perry, director of product management for Great Northwest Insurance Co. “But with your MedPay, you would pay $0 out of pocket. That’s a big difference.”

Despite the compelling arguments in favor of medical payments coverage, nearly one in four State Farm drivers chooses to decline it in states where it is offered, according to company spokesman Kip Diggs. Those who choose to forgo the coverage can either afford to self-insure for the cost of items covered under medical payments coverage or are willing to take on the risk of possible out-of-pocket medical expenses in the event of an accident.

But Perry says a smarter move for many would be to boost coverage from the standard levels of $1,000 to $5,000 up to $10,000 or more. The cost to move from $2,000 to $10,000 in medical payments coverage on a Travelers auto policy is around $10 per year, according to agent Shawn Wainwright of Brown & Brown Insurance in Florida.

“Going up to $50,000 or even $100,000 usually costs very, very little and can be worth it,” Perry says. “I know one case where the driver only had $5,000 [in medical payments coverage] and had a serious accident in which she was disabled for a long time. A year and a half after her accident, her credit had been ruined because she had all of the hospital bills she couldn’t pay. Even though the other car insurance company acknowledged liability, she had to wait for the entire claim to be closed before she could get that recovery.”

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