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What’s The Role Of Health Insurance After A Car Accident?

by Martha Simmonds
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When you’re hurt in an accident, you may need medical care. Eventually, if your injuries are the fault of another person, you might pursue economic damages from their car insurance company, which would include your medical bills such as doctor’s visits, tests, rehabilitation, and medication. You could also pursue other economic damages like your mental health care, lost income, and for your property damage to your vehicle. 

That would probably require working with a personal injury attorney, and it takes time, so what happens in the meantime? Does your health insurance cover your medical expenses at any point after a car accident?

Below we discuss the role of health insurance following a car accident. 

Will Your Health Insurance Cover Your Injuries?

In general, if you have health insurance and you’re hurt in a car accident, your insurance company will pay for your treatment related to your injuries, with some caveats. 

One is that you’ll need to make sure you understand what’s in-network and out-of-network, but this is true with any treatment you receive. 

Your health care plan might also state explicitly that your coverage is secondary if you’re hurt in a car accident. It might say that there’s other primary insurance in this scenario, which would be your car insurance or the insurance of the other driver. If that’s the case, you are supposed to first turn to whatever car insurance coverage is available to you. 

Then, if your health insurance is secondary, and your treatment costs exceed your coverage from your car insurance, your health insurance would kick in to pay for the rest of your care. 

Whether or not you have to pay anything out of pocket depends on the details of your coverage. 

Which Insurance Pays First?

Sometimes, your car insurance will pay first until your coverage limits are exhausted. The primary or secondary question is what you have to look at here. 

If your health insurance first pays your medical bills, then your insurance company is probably then going to make a claim against the car insurance for the at-fault driver. 

The two types of car insurance that could be primary and kick in first following an accident are your own personal injury protection (PIP) or your medical payments coverage (MedPay). 

These types of coverage usually pay out quickly, and MedPay coverage rarely requires a deductible, while PIP usually does. 

The liability insurance for the other driver, if they’re at fault for an accident, isn’t usually going to pay your medical bills as they come in. The insurance will cover your injuries, but it’s typically more of a reimbursement. 

The Process

The first part of the process for covering bills when you’re injured is making any deductibles or co-pays. 

If you’re using health insurance, the protocols are the same as getting any other treatment for a health issue. If you’re using your car insurance, you have to submit a claim with your company, which you can typically do online. Sometimes a healthcare provider may not require upfront payment if you’re injured. They may provide the services and then later work with you to determine who’s responsible for paying what. 

If you’re the injured claimant and you’re not the at-fault driver, the involved insurance companies might work on getting the party who is at fault to absorb some or all of your costs. You may also be able to recover some of your out-of-pocket expenses, like your co-pays and deductibles, if you include these costs in a car accident settlement agreement. 

Medical Liens

Something else to be aware of with personal injury situations is a medical lien. A medical lien is paid out of a judgment or personal injury settlement. 

Some providers will give care in exchange for a medical lien. Then, the provider is able to recover the costs of the care if a personal injury case is successful. 

Medical liens are also known as hospital liens, and the legally binding contract underlying these is a lien agreement. 

If you’re using a medical lien to cover the costs of your care after an accident, you’re basically receiving medical care on credit. 

However, if you have health insurance, Medicaid, or Medicare, you generally don’t need a medical lien since your health insurance covers the costs of your medical bills. What may happen instead is that your health insurance company could come after your settlement if you receive one to recover what it spent on your care. 

It all becomes complicated, as you can see, so it’s a good idea to at least have a consultation with a personal injury attorney.

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