What does medical payments coverage do?

Medical payments (MedPay) coverage pays reasonable and necessary medical and/or funeral expenses for you and others injured or killed in an auto accident while riding in or driving your insured vehicle. Medical payments coverage applies, according to the terms and conditions of the policy, regardless of who is at fault. 

Parties typically covered by MedPay (may vary by state and policy terms) include:

  • Policyholder
  • Policyholder’s relatives in the same household
  • Passengers
  • Other authorized drivers of your insured vehicle
  • Policyholder and family members if they are injured while riding in someone else’s car
  • Policyholder and family members if struck by another vehicle when a pedestrian or on a bicycle (in some states).

MedPay benefits normally include all reasonable:

  • Hospital, surgical, and chiropractor expenses,
  • X-ray expenses
  • Dental expenses,
  • Professional nursing expenses,
  • Prosthetic expenses, and
  • Funeral expenses.

Medical payments coverage is often limited to medical expenses incurred within a specified period of time after your accident (typically the first three years).

Is medical payments coverage mandatory

A few states do require medical payment coverage. In a majority of states, medical payments coverage is optional, though some states do require it to be offered but allow drivers to reject it in writing.

What happens if I don’t have medical payments coverage?

If medical payments coverage is optional in your state and you choose to go without, you may end up paying out-of-pocket for your medical bills when you are at fault in an accident or the at-fault party cannot cover your injuries.

If you have adequate health insurance and your state doesn’t require this coverage, then medical payments coverage may be unnecessary. However, if your health plan requires a deductible, medical payments coverage may be able to help pay it. This coverage may also pay for other items not covered by your health insurance, such as nursing services, dental expenses and funeral expenses.

How do medical payments work with car insurance?

If you have been injured in an automobile accident and want to make a claim against your medical payments coverage, contact your insurance company and first report the accident and injuries and find out how to proceed with your claim.

In general, medical payments coverage pays for medical expenses for you and your passengers injured in an accident. There may also be coverage if a vehicle hits you while walking. Medical payments coverage applies regardless of who is at fault. If you do not have medical payment coverage but have Personal Injury Protection (PIP) instead, then you, others in your car and pedestrians you hit will typically be covered, within the specified limits, for medical, hospital and funeral expenses.

Specific personal injury car insurance limits and coverages vary by state. If you are injured and need to place a PIP claim, contact your agent on how to do so since in many no-fault states there are very specific ways to place this type of claim for medical bills.

If you are injured due to the fault of another driver, you can make a claim against the at-fault party’s Bodily Injury Liability coverage. Claims for bodily injury may be for medical bills, loss of income or pain and suffering.

When making a claim for medical expenses — whether it is through MedPay, PIP or someone else’s bodily injury liability coverage — make sure that you have evidence of injuries and documentation of your medical expenses.

What is the difference between bodily injury car insurance and medical payments car insurance?

The difference is that Bodily Injury insurance covers others that you are responsible for while medical payment covers your own injuries that you sustained in a car accident.

Bodily Injury (BI) liability coverage normally pays for injuries to others when you are legally liable for an accident involving your automobile. Your insurance company will pay for injuries up to the limits of your policy and provide legal representation if you get sued. In some no-fault states bodily injury insurance is limited —  typically just paying for serious injury or death because your own personal injury protection (PIP) would be used for less serious injuries.

Medical payments is an optional coverage that you would purchase to cover your own medical expenses arising from a car accident. This coverage pays for medical expenses for bodily injury up to the limit of your policy.

MedPay covers your medical expenses, plus those of your family members or passengers, regardless of fault. It applies whether you are in your automobile or someone else’s or if you are hit by an automobile while walking or bicycling.

— Michelle Megna contributed to this story.

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Contributing Writer

Shivani Gite is a personal finance and insurance writer with a degree in journalism and mass communication. She is passionate about making insurance topics easy to understand for people and helping them make better financial decisions. When not writing, you can find her reading a book or watching anime.