If you have suffered injuries as a result of a car accident, you may be wondering whether your health insurance will cover your medical bills. The general rule is that you are responsible for paying your own medical bills (or making sure they get paid), but medical costs arising from car accident injuries tend to get paid from different sources, depending on liability for the accident and the timing of the medical treatment. Read on for the details.
How Do Deductibles Work?
Most insurance policies (including health insurance and "collision" car insurance policies) include a "deductible," which is the amount that the policyholder (you) must pay to cover the insured loss before the insurance kicks in to cover the rest of the costs.
So, if you have been injured in a car accident, and you want to use your health insurance coverage to pay for your medical treatment (at least at the outset), you will be responsible for the deductible. You will likely not be required to pay the deductible immediately, as the greater concern is that healthcare providers treat your injuries and give you the best care possible. After services have been rendered, however, you should expect to receive a bill detailing your responsibility for the deductible. Any costs beyond the deductible amount should be covered by your health insurance.
It's important to note that, if you end up filing a personal injury lawsuit, chances are your lawyer will make sure you get reimbursed for any health insurance deductible you paid, as part of your damages.
Whose Car Insurance Pays?
If your car accident was caused by the other driver, then the liability (bodily injury) coverage of their car insurance policy should cover your medical expenses, up to policy limits of course. In this situation, you could file a third-party claim directly with the other driver's carrier, or open a claim with your own car insurance company, and let the two insurers sort it out. Learn more about how car insurance affects a car accident case.
If you live in one of the states that follow a no-fault car insurance system (Florida, Hawaii, Kansas, Kentucky, Massachusetts, Michigan, Minnesota, New Jersey, New York, North Dakota, Pennsylvania, Utah, and Washington, D.C.), then it's usually a little more simple. Your car insurance policy will pay for your medical bills, regardless of who was at fault for the car accident. You can only step outside the no-fault system and file a claim or lawsuit against the at-fault driver if your case meets the threshold for doing so in your state -- meaning your injuries are "serious" according to statutory definition, or your medical bills exceed a certain amount.
Additionally, many car insurance policies also include an option known as “med pay” coverage, which pays medical expenses for you and any passenger in your vehicle after a car accident, regardless of who was at-fault, though coverage limits are typically pretty low.
The "Umbrella" of Health Insurance
Typically, once available car insurance coverage has been exhausted, your medical costs will be billed to your health insurance, and your health insurance will pay your medical bills. Your health insurance will later be reimbursed from any settlement you obtain. (more on this in the next section).
If you don’t have health insurance and no other resources are available, you will have to pay for your medical treatment out-of-pocket. In that situation, it's probably time to talk with a personal injury attorney about your options for getting compensation from the driver who caused your accident.
Liens and Reimbursement
If you receive a personal injury settlement or jury award over your car accident injuries, it's important to keep in mind that your health insurer is entitled to make a claim against those proceeds and be reimbursed for funds paid out on your behalf. This right of reimbursement belongs to your insurer and is rooted in the principle that you cannot recover twice for the same damages. If your insurer paid your medical bills for you, then you cannot also receive compensation from the defendant for the same medical bills. Learn more: What if there are liens on my car accident claim?