The first thing to know about car accident injury-related medical bills is this: Even when it's clear that the other driver is at fault for the accident, they don't have to pay your medical bills as those bills come in. Getting your health care providers paid up front is your responsibility.
Our primary focus here is on how you'll pay your accident-related medical bills in the short term. Will your health insurance pay them? Probably so, and we'll consider several different kinds of health insurance that might cover you, depending on your circumstances. Your auto insurance also might be a source of up front payment. We'll take a look at your potential options.
Who's ultimately responsible for your car accident bills? That's another story. More on that later.
What Insurance Will Pay Your Car Accident Medical Bills Up Front?
You can use your auto insurance or your health insurance (or both) to pay car accident medical bills in the short term. The option you choose will depend on a number of factors, including the law in your state, the kinds of insurance coverage you have, the terms of your insurance policies, and the specifics of your situation. Your options might include:
- no-fault auto insurance
- medical payments insurance (auto insurance)
- private health insurance
- Medicare (public health insurance)
- Medicaid (public health insurance), and
- workers’ compensation insurance (on-the-job health and accident insurance).
Let's take a closer look at each one.
What Happens In No-Fault Car Insurance States?
Many states follow a no-fault auto insurance system for motor vehicle accidents. In a no-fault state, your personal injury protection (PIP) insurance will pay for some or all of your medical bills and lost earnings when you're hurt in a car accident, regardless of who was at fault. Depending on the no-fault state, it might also cover expenses like household replacement services and funeral and burial costs. You must buy the minimum PIP coverage required by your state's law.
So, if you have the state-minimum PIP insurance, how much of your medical bills will be covered? Every state is different, and the amounts vary widely. For example, in Utah, the minimum amount of state-required PIP coverage pays for $3,000 in medical bills. (Utah Code § 31A-22-307 (2024).) In New York, PIP might cover as much as $50,000 in medical costs. (N.Y. Ins. Law § 5102 (2024).)
When you're hurt in a car wreck in a no-fault state, your PIP insurance pays first. In insurance-speak, it's "primary" coverage. Once your medical expenses exceed your PIP limit, health insurance—if you have it—pays the rest of your bills. In this situation, your health insurance is called "secondary" coverage.
Don't have health insurance coverage? Chances are you'll need to pay the bills as they come in, or make arrangements with your providers to hold off until you can settle with the responsible driver. Some health care providers are willing to make deferred payment arrangements when a third party—like another insured driver—will bear the ultimate responsibility for payment. The chances of such an arrangement are better if you're represented by reputable legal counsel who your providers know and feel they can trust.
Do You Have Medical Payments Insurance?
In states that don't have no-fault insurance, you should have the option to buy medical payments insurance (MedPay). Like PIP insurance, MedPay pays regardless of who was to blame for the accident. Unlike PIP, MedPay usually only pays your medical bills. It won't cover lost wages. MedPay per-person limits typically are less than $10,000.
When you're injured in a car accident, MedPay—if you have it—is likely your primary coverage. Any health insurance you have is secondary. MedPay isn't required by law, so if you want it, you'll need to pay an extra premium. The good news? It's usually not expensive.
Using Private Health Insurance to Pay For Car Accident Injury Treatment
Most states are fault-based insurance states, meaning they've not adopted a no-fault insurance system. In fault-based states, people who are injured in a car accident usually look to their health insurance for immediate payment of accident-related bills. Health care providers don't mind this arrangement. They're used to submitting bills to health insurers and they know that in most cases, they'll get hassle-free payment pretty quickly.
Is your health insurance primary or secondary? Have a look at your insurance policy to see when it's primary coverage (meaning it pays first) and when it's secondary coverage (meaning it only pays after other applicable insurance has paid). Many health insurance policies contain language saying that if you have other insurance—like PIP or MedPay, for example—that insurance will be primary. If your policy has that language, then your health coverage will only pay after you've exhausted your available PIP or MedPay.
Deductibles and copays. There can be drawbacks to using your private health insurance. In particular, your coverage is subject to both deductibles and copays, amounts that you must pay out of pocket. A deductible is the amount you have to pay before your insurer has any payment obligation. For example, if your health plan has a $1,000 individual deductible, you must pay $1,000 out of pocket before the insurance company pays any of your bills.
A copay is the amount of a medical bill that you must pay even after you pay your deductible, until you reach your plan's annual out-of-pocket maximum. Suppose your health plan has a 20% copay for doctor and hospital visits, and a $4,000 annual out-of-pocket maximum. You'll be responsible for 20% of those bills until your total out of pocket for the year—deductible and copays—reaches $4,000.
Subrogation and reimbursement. Check the fine print in your health insurance policy. It gives your insurance company a right of subrogation or reimbursement for any amounts it pays on your behalf. What does this mean? In a nutshell, if you get compensation (what the law calls "damages") from an at-fault driver, you're legally obligated to pay your health insurer back out of the proceeds.
Note, importantly, that this is a legally-enforceable obligation. If you don't repay your health insurance company after you receive a settlement or a jury verdict, the insurer can come after you for the money. That's a headache you don't need.
If you have health insurance, do you need PIP or MedPay? In a no-fault state, yes, you'll need PIP insurance. It isn't optional, so you must buy enough to satisfy state law. Keep in mind that PIP covers more than just medical bills. In most no-fault states, PIP will take care of some portion of your lost wages, and will also cover at least part of funeral and burial costs.
You can also use PIP and MedPay to reimburse yourself for any health insurance deductible and copays that come out of your pocket. This will be especially helpful if you have a high deductible health plan, with a deductible of $1,500 or more.
Can I Use Medicare or Medicaid for the Treatment of Car Accident Injuries?
If you're on Medicare and you get into a car accident, as with private health insurance, Medicare will pay your medical bills as they come in. Medicaid is a federal funding program that assists states in providing public health insurance to low-income residents. If you receive health insurance through a state Medicaid-funded program and get into a car accident, that state program will pay your medical bills.
Federal and state laws provide for subrogation and reimbursement, just as with private health insurance. In other words, Medicare and any state program affiliated with Medicaid will usually be entitled to reimbursement for bills paid related to your car accident injuries. Unlike private health insurance, this legal obligation carries with it the force of possible federal or state penalties. Failing to reimburse the government for accident-related bills can be costly.
Does Workers’ Compensation Apply to Car Accident Injuries?
If you get hurt in a work-related car accident, your employer’s workers’ compensation insurer will pay all of your medical bills. When you're hurt on the job, workers' compensation is a type of health and accident insurance. But unlike private health insurance, you're not required to pay any money toward your medical bills. There are no deductibles or copays. Many states require the workers’ compensation insurer to reimburse you for transportation expenses (mileage, tolls, and parking) for all of your travel to and from your medical appointments.
Who Ultimately Pays Your Medical Bills?
The answer depends on whether the at-fault driver had any (or enough) auto insurance to pay for your losses. If that driver had no insurance—and no other assets you can look to for payment—then whoever first paid your bills as they came in will be left holding the bag. If the other driver was insured, at least some of your bills ultimately will be paid by their insurance company.
Other Driver Was Uninsured
When the other driver is uninsured and has no other assets you can look to for recovery, your payment options have run their course. Barring extraordinary circumstances, whoever paid your medical bills in the first place will be stuck with them. Think long and hard before you pursue an uninsured driver with a lawsuit or other collection activity. Odds are you're simply throwing good money after bad.
Other Driver Was Insured
If the responsible driver has auto liability insurance to pay for your some or all of your medical bills, you can file an insurance claim (called a "third-party claim") with their auto insurer. You also have the option to file a lawsuit against the driver if their insurance company refuses to offer you a fair settlement.
The Process for Getting Your Medical Bills Paid After a Car Accident
A typical medical bill payment process might go something like this after a car accident.
- Get medical care. You receive necessary medical care for your car accident injuries—at the ER, from your primary care doctor, or from another provider.
- Submit the bills to your health insurance provider. If you're using your health insurance (public, private, or workers' compensation) at this stage, the same procedure applies as with any other kind of medical care you receive under your plan. Your health care provider submits their bills to the insurer. You pay any applicable deductible or copay as required under the terms of your health coverage.
- Submit the bills to your auto insurer. If you're using your auto coverage (PIP or MedPay) to pay your medical bills as they come in, follow the insurance company's claim submission process. You can probably submit bills online or through a claims app.
- Insurance companies will negotiate over payment. When another insured driver is to blame, the insurance company or payor that first paid your bills will negotiate with the driver's auto insurance company over reimbursement. You (or more likely, your lawyer) will want to be in on those negotiations to make sure that your interests are protected. Be sure that all providers and payors who are legally entitled to reimbursement get what's coming to them.
Getting Help After a Car Accident
Getting your medical bills paid is a key consideration in the days and weeks after a car accident, especially when you were seriously hurt. It's a safe bet that additional problems and issues will arise. You don't need these headaches while you're being treated and trying to recover from your injuries. This is one of those times when it makes sense to have a car accident lawyer on your side.
Whether you're running into problems with the car insurance company, another insurer, or you just want to make sure that you position your car accident claim for the best result, it makes sense to discuss your situation with an experienced attorney. Here's how to find a lawyer who's right for you and your case.