Medical payments (MedPay) and personal injury protection (PIP) are two medical coverages that pay medical expenses resulting from injuries sustained in an auto accident.
Both MedPay and PIP typically cover you, your passengers and other authorized drivers of your car who are injured while in your insured vehicle. Both coverages typically also protect you and your family members if you are injured while riding in someone else’s car or if you’re struck by another vehicle as a pedestrian.
What do MedPay and PIP cover?
MedPay and PIP are similar, but PIP is typically more comprehensive and pays for items such as lost wages that MedPay will not. Both coverages usually come with a benefit for funeral expenses.
Medical payments strictly pay for reasonable medical expenses, such as hospital, dental, nursing and X-ray bills incurred within a specified period of time after your accident (usually the first three years).
PIP typically covers reasonable medical expenses, loss of essential services and lost wages. The exact benefits offered by PIP coverage differ greatly by state, and a deductible and/or co-payment may be due before your benefits start up.
Are MedPay and PIP mandatory medical coverages?
You must buy personal injury protection in these states: Delaware, Florida, Hawaii, Kansas, Kentucky, Maryland, Massachusetts, Michigan, Minnesota, New Jersey, New York, North Dakota, Oregon and Utah. Most, but not all, are no-fault states.
Only one state, Maine, requires drivers to purchase medical payments coverage. New Hampshire does not have a compulsory car insurance law, but if you buy a policy, as most motorists there do, it must include medical payments coverage. Both states’ minimum MedPay limit is $2,000.
Most other states offer PIP and/or medical payment as optional coverages.
What are the recommended limits for medical coverage?
Medical payments and personal injury protection available limits vary significantly from state to state. Some state minimum car insurance requirements mandate that you buy at least the minimum amounts for your state.
If these coverages are optional, experts recommend at least $5,000 for medical payments and $10,000 for PIP.
Consider buying enough MedPay and/or PIP to cover your health insurance deductible. Consider a higher amount if you don’t have health insurance or a policy that doesn’t cover auto accident injuries.
In many states, you can carry MedPay and PIP on your policy if you choose. Depending upon state laws and policy terms, this can be beneficial if you can use your MedPay coverage to pay for your PIP co-payment or deductible. Or your medical payments may kick in after your PIP coverage is exhausted, which is still helpful.
What if I don’t buy MedPay and/or PIP coverage?
If medical payments coverage and/or PIP is optional in your state and you choose to go without, you may pay out-of-pocket for your medical bills when you are at fault in an accident or the at-fault party cannot cover your injuries.
What is the difference between Personal Injury Protection and medical payments coverage?
It’s confusing to many people shopping for auto insurance when they’re offered both personal injury protection (PIP) and medical payments (MedPay) since both deal with medical expenses resulting from auto accidents and without regard to fault.
Depending upon where you live, PIP or MedPay may be required under state car insurance requirements. Typically, you must carry PIP if you live in a no-fault state, and MedPay is optional in most states.
The primary difference between these two coverages is that PIP usually comes with a deductible and has broader benefits than just covering medical bills. In contrast, MedPay doesn’t usually have a deductible (and actually might cover your PIP or health insurance deductible) and only covers medical expenses related to the auto accident.
Both PIP and MedPay:
- Cover certain medical expenses related to injuries up to the amount you’ve chosen to carry. Based on where you live and your insurer’s options, the coverage you can purchase may range from $1,000 to $25,000.
- Covers you, family members and other passengers injured in an accident while riding or driving within your insured vehicle. Plus, you and covered family members are also usually covered if injured while riding in someone else’s car.
What does PIP cover?
PIP usually covers only medical and hospital expenses deemed reasonable and necessary, and you may have a short period to seek treatment and make your PIP claim. Whether a specific medical cost will be covered will be determined by state laws surrounding PIP coverage and the particular terms of your policy.
PIP gives broader coverage than MedPay. Personal injury protection typically comes with benefits that include:
- Necessary and reasonable expenses for medical, hospital, surgical, nursing, dental, ambulance and X-ray services. Essential medications, medical supplies and prosthetic devices may also be covered.
- Rehabilitation
- Loss of income
- Replacement services/disability services (for example, childcare or housework if a parent is disabled due to accident-related injuries)
- Funeral expenses/death benefit
Medical payments coverage only covers medical expenses. It doesn’t offer coverage for lost wages or loss of essential services. Medical payments benefits usually include the following:
- Doctor or hospital visits or stays (including required surgeries)
- X-rays
- EMT/Ambulance expenses
- Professional nursing expenses
- Prostheses expenses
- Dental expenses
- Funeral expenses
Final thoughts: MedPay and PIP
When you have both PIP and MedPay as part of your auto insurance policy, MedPay is usually secondary to your PIP coverages.
If your state doesn’t require either of these medical coverages and you don’t have health insurance, consider adding PIP and/or MedPay when shopping for auto insurance. Reasonably priced coverage for accident-related medical bills, which can get quite expensive quite quickly, is much better than no coverage.
— Michelle Megna contributed to this story.
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