Who Pays First in a Car Accident – Health Insurance or Car Insurance?

Last Updated on September 19, 2020

You have health insurance and you have car insurance. If you get injured in a car accident, however, then who’s responsible? Does your car insurance or health insurance provider pay first after a car accident?

Today, we’re explaining everything you need to know about how car insurance and health insurance work after an accident.

Who Pays for Medical Bills After a Car Accident?

First, let’s make one thing clear: generally, the person at fault for the car accident will pay the medical bills of anyone injured in the accident.

If you have car insurance, and you caused the accident, then your car insurance company will cover the medical bills of anyone involved in the accident up to the limits of your policy.

All drivers are required to have bodily injury liability coverage in order to legally drive in most states. This coverage specifically covers the medical bills of other people involved in the collision – assuming you were at fault.

Some states require additional coverage called personal injury protection (PIP). PIP covers your own medical bills regardless of who is at fault.

In other words, all car insurance policies have specific coverage limits for medical expenses. Now, let’s look at how this coverage works.

How Does Auto Insurance Medical Coverage Work?

Your car insurance bodily injury liability coverage will cover medical bills for other people involved in a car accident, assuming the accident was your fault.

Meanwhile, your personal injury protection (PIP) coverage (if you have it) will cover your own medical bills from a car accident, regardless of whether you or the other driver was at fault.

Additionally, bodily injury coverage can cover things beyond medical expenses: it can cover funeral expenses, for example, and lost wages.

Will My Health Insurance Cover Car Accidents?

Some health insurance plans cover car accidents, while other plans specifically do not cover car accidents.

Generally, your car insurance policy will function as your primary health coverage after a car accident. Your medical insurance, meanwhile, will be your secondary coverage. That means your car insurance policy will cover medical expenses up to the limits of your policy, and then your medical insurance can cover any remaining expenses.

You can present your medical insurance to the hospital when seeking treatment for a car accident. However, you should check your policy to make sure it covers car accidents.

You may be able to adjust your insurance policies to designate your health insurance as the primary source of medical coverage after a car accident.

If you’re unsatisfied with your car insurance health insurance coverage limits, then you may want to adjust your insurance coverage to make your health insurance your primary source of coverage after an accident.

If you do choose to use your ordinary medical insurance to cover car accident-related injuries, then all of your same deductibles and co-payments apply.

Will Medicare or Medicaid Cover Car Accident Injuries?

Medicare and Medicaid are state-run health plans. Neither Medicare nor Medicaid, however, can be designated as your primary healthcare coverage after a car accident. They can be named as your secondary coverage.

If you designate your Medicare or Medicaid policy as your secondary coverage, then you can use it when you exceed the limits of your personal injury protection (PIP) coverage after an accident.

Who Pays First?

Your car insurance policy will pay first to cover any medical expenses related to a car accident – assuming you have personal injury protection (PIP).

Once your PIP limits are exhausted, then your health insurance may cover the remaining expenses.

All of the above assumes you were at fault for the accident.

If the other party was at fault in the accident, then the other driver’s liability insurance will pay for any medical expenses not covered by your own insurance. In a no-fault state where PIP coverage is required, for example, your PIP coverage would cover your own medical expenses (regardless of fault). Then, the other driver’s liability coverage would cover the remainder.

Only 12 of 50 States Require Personal Injury Protection, Which Means You May Not Be Covered

Personal injury protection is kind of like health insurance when you’re driving: it covers your own medical expenses after an accident regardless of fault.

However, only 12 states in America require personal injury protection coverage. It’s optional in 30 states and unavailable in eight states.

That means that you may not have any coverage for medical expenses after a car accident. Don’t assume your health insurance will automatically cover medical expenses after an accident. In most states, the legal minimum car insurance will only cover the medical expenses of other people you injure – not yourself. This could leave you paying for enormous medical expenses out of pocket.

You Can’t Double-Dip

There’s one more thing to remember about health insurance and car insurance: you can’t double-dip.

You can’t claim the same event on your car insurance policy on your health insurance policy, for example.

You can, however, claim certain items on your car insurance medical coverage and then claim any additional expenses on your medical insurance. If you’ve exhausted your car insurance PIP coverage, for example, then you can claim the remaining amount on your health insurance. This is not considered double-dipping.

Coordinated or Excess Medical Benefit

There are some exceptions to everything we mentioned above. Some states allow something called a coordinated or excess medical benefit. Under this system, your health insurance is expected to pay first while the car insurance company pays second.

Conclusion – Does Health Insurance or Car Insurance Pay First?

In most cases, your car insurance will pay first for medical expenses following a car accident. Once your car insurance personal injury protection (PIP) coverage is exhausted, however, you may be able to claim remaining expenses under your medical insurance (assuming the collision was your fault). If the collision was not your fault, then the other driver’s liability coverage will cover your medical expenses.