Will Insurance Pay for Medical Bills After an Accident?
Last Updated on August 9, 2020
If you were in an accident and have medical bills, then those medical bills need to be paid. Does insurance pay for medical bills after a car accident?
Who pays for car insurance after an accident? Does your car insurance or health insurance provider cover your medical bills first?
Today, we’re explaining everything you need to know about who pays for medical bills after an accident.
You Pay Your Own Medical Bills, But the Negligent Driver’s Insurance Company Will Reimburse You
If you are injured in a car accident that is not your fault, the other driver is responsible for paying your medical bills.
However, the other driver will not pay for your medical bills immediately. The other driver will not reimburse you after every medical visit, nor will the other driver pay your medical bills on an ongoing basis.
Instead, you pay your medical bills today, then eventually reach a settlement with the other driver (or the other driver’s insurance company) to cover all of the medical bills paid from the accident to today.
Typically, you wait until after you have finished all medical treatments and have been discharged by doctors before asking for a settlement with the other driver’s insurance company. Depending on the severity of your injuries, it could take months or even years before you are fully discharged. Your doctors will require payment during this timeframe. You pay your medical bills today, and then receive reimbursement for those medical bills in the future.
Your Health Insurance or Medical Payment Coverage Will Cover Medical Bills
If you have health insurance or medical payment coverage (MedPay), then you can use either of these coverages to pay for your medical bills after an accident – regardless of who is at fault.
Health insurance works as it normally does. You provide your insurance information to the clinic, and billing goes through your insurance.
Medical payment coverage, meanwhile, is a type of optional car insurance coverage. It works very similar to health insurance: it covers any medical bills after a covered incident. MedPay can be used on its own. Or, you can use it in conjunction with your health insurance, in which case MedPay can even cover your normal health insurance co-pays and deductibles.
Car Accident Injuries in No-Fault States
Most states in America work under tort law systems, where the at-fault driver pays for the other driver’s medical bills. 13 states, however, are ‘no-fault’ states. In these states, your own auto insurance company will pay for some or all of your medical bills after an accident regardless of who was at fault.
After your medical bills exceed the state’s ‘no-fault’ limit, you are responsible for paying them out of pocket. Or, you can use your health insurance to cover the remaining amounts.
Additionally, if your car accident injuries exceed a certain amount, or if your injuries are considered serious, then you’ll be able to file a personal injury claim against the at-fault driver. In this case, the at-fault driver may be required to cover any medical bills beyond your state’s no-fault limit.
Car Accident Injuries and Medicare or Medicaid
If you are on Medicare, Medicaid, or any other state-run insurance program, then your medical bills will be processed as if you had health insurance.
In other words, Medicare or Medicaid will cover your medical bills today, just like they would if you had health insurance.
Auto Insurance Policies Pay First (Before Your Health Insurance Pays)
The auto insurance company of the at-fault driver is required to pay for certain medical bills after a car accident. Your insurance policy has bodily injury liability coverage, for example, which covers the medical bills, lost wages, and other expenses incurred by anyone you injured.
In most situations, the auto insurance policy is considered the primary insurance. The first medical bills are supposed to be charged against your auto insurance policy.
If your car insurance personal injury liability limits are exceeded, then your health insurance may be able to cover the rest. Your health insurance policy is your second line of insurance.
In some situations, your health insurance coverage may be used first. If you are injured in an accident and taken to hospital in an ambulance, for example, then the hospital may charge your health insurance provider immediately. In this case, your health insurance company will turn around and make a claim against the car insurance company of the at-fault driver.
Insurance Companies Work Behind the Scenes to Cover Medical Costs
Car accidents can be tricky. Sometimes, one driver is 51% at-fault and the other driver is 49% at-fault. Medical bills can add up. An injured person may require weeks, months, or years of treatment.
For all of these reasons, the insurance companies will work behind the scenes to negotiate a settlement. This activity can take place without your knowledge.
Your health insurance company might contact your auto insurance company, for example. Or, the other driver’s insurance company might contact your insurance company.
Please remember that car insurance companies are interested in their own bottom line. Insurance companies are for-profit businesses: not charities. The goal of the insurance company is to pay you as little as legally possible for your claim while still fulfilling the terms of your insurance contract. With that goal in mind, the insurance company will push for a fast settlement to close your case as quickly as possible.
If you feel your insurance company has taken advantage of you, then you may wish to hire a lawyer.
Insurers May Require Reimbursement After a Settlement
Your insurer may require you to pay back your medical bills after a settlement.
Let’s say you required $35,000 of medical treatment after an accident. Your insurance company paid the hospital $35,000 in medical bills. Then, as part of your lawsuit with the at-fault driver, you are awarded $35,000 in compensation.
At this point, your insurance company will contact you to recover this amount. You didn’t make or lose any money: the compensation is simply being transferred from the at-fault party to the party that paid.
Should You Use Your Health Insurance to Pay Medical Bills After an Accident?
If you were in an accident and have medical bills to cover, then you can decide whether or not to pay those medical bills through your health insurance.
Let’s say you get a bill in the mail for $3,000 from the ambulance after the car accident. You can attach your health insurance information and send it back. Or, you can pay the bill out of pocket.
Which option is best? Does it really matter which option you choose if the auto insurance company of the at-fault driver is eventually paying?
Generally, it’s in your best interest to use your health insurance to cover any medical expenses after an accident.
There are four main benefits:
- Upfront Payment: When you provide your health insurance information, it ensures your medical bills will get paid right away. You don’t have to dip into your savings. The bills get sent to your insurance company, and your insurance company pays.
- Payment Will Await Settlement of the Case: If you do have to reimburse your health benefit plan, then the plan will await the settlement of the case before reimbursement is required. In other words, you can hold off on payment until a final decision is reached – say if the other driver is required to pay you.
- It’s Cheaper: If you pay out of pocket for health care, then you may be paying more than your insurance company is paying. Your insurance company has deals in place with healthcare providers (i.e. ‘participating providers’) to pay less than what you would pay the hospital directly. If you do have to reimburse your health benefit plan, then the reimbursements will be cheaper than your out of pocket payments.
- Reimbursement is Negotiable: Finally, if you pay your medical bills through a self-funded health benefit plan and you have to reimburse that plan, then you may be able to negotiate the reimbursement amount. If you withdrew $5,000 from that plan for treatment, for example, then you may only be required to reimburse $3,500. Reimbursements are negotiable.
Final Word on Medical Bills and Car Accidents
Car accidents can be complicated, and serious injuries make car accidents much more complicated.
Generally, the at-fault driver’s insurance company will pay for your medical bills, although your own insurance company or health insurance company may cover these medical bills first.
To ensure a fair settlement and smooth claims process, consider speaking with an attorney specializing in car accident injury claims.