Medical payments coverage

In plain English: medical payments coverage, often called MedPay, is an optional US car insurance coverage that pays reasonable medical costs for you and your passengers after an accident, regardless of who was at fault, up to a fairly small limit.

What it pays for

• Ambulance and emergency room bills
• Doctor visits, X-rays and scans
• Hospital stays and surgery
• Physical therapy and follow-up treatment
• Your health insurance deductibles and co-pays, in many policies
• Funeral costs, under some policies

It usually covers you and your household when you're in your own car, someone else's car, or hit as a pedestrian or cyclist, and passengers in your car. Check the definitions in your policy for exactly who's included.

MedPay vs PIP

In no-fault states, personal injury protection (PIP) is usually required and does more. PIP typically covers medical bills plus a portion of lost wages and some household services. MedPay covers medical bills only. Some states offer MedPay alongside PIP; others don't offer it at all. Outside the US, the nearest equivalents are the no-fault accident benefits systems in Canadian provinces. The UK has no real equivalent, because NHS treatment is free at the point of use and injury costs are recovered from the at-fault driver.

Why it's useful even if the other driver was at fault

A claim against the at-fault driver's insurer can take months or years. Medical bills don't wait. MedPay pays quickly without anyone deciding fault, and it can fill gaps left by health insurance. Because limits are often modest, it tends to help most with early bills and out-of-pocket costs.

Reimbursement and subrogation

If MedPay pays your bills and you later settle with the at-fault driver, your insurer may be entitled to be repaid from that settlement, depending on your policy and state law. Some states restrict or forbid this. Before you settle, ask your insurer for a written statement of any amount it claims, and check whether a reduction for your legal costs applies.

How to claim

1. Tell your own insurer about the accident and ask to open a MedPay claim.
2. Send itemised bills and any health insurance explanation of benefits forms.
3. Keep copies of everything you send and note the claim number.

Next: no-fault benefits and PIP · first-party claims · out-of-pocket expenses.

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