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Have you heard of the term “Med Pay” but not sure what it means?

Med Pay is short for medical payment coverage in an automobile insurance policy. Under the Med Pay provision of the policy, a policyholder is generally covered for reasonable medical expenses (including chiropractic) if he or she is in a car accident, regardless of fault. Additionally, Med Pay covers family members who are also in the car at the time of the auto accident. 

However, there are some restrictions. 

First, not every auto insurance policy has Med Pay. So, check with your insurance agent to find out if your policy has a Med Pay provision. Generally, Med Pay provisions have limits of $1,000, $2,000 or $5,000. The cost for additional Med Pay coverage is not excessive. So, it may be worthwhile to increase your coverage. 

Second, you must generally either be a named insured under the policy, be the resident spouse of the named insured, be a family member of the named insured, or be using the vehicle covered under the policy. The best way to determine if you are covered is to ask your insurance agent. 

Third, you must be physically injured in a car that is covered under the policy and must have incurred medical bills. Any payment made under the Med Pay provision generally goes to the health care provider who examined and/or treated you. Sometimes, Med Pay may also cover you for out-of-pocket expenses, such as co-pays and medication. 

Fourth, Med Pay generally pays for “reasonable expenses” incurred for necessary medical treatment. Insurance policies generally do not reimburse for experimental treatment, or treatment that is not recognized within the medical profession in the United States. The cost for said treatment generally depends on the health care providers’ area of practice and the charges should be consistent with the usual charges within the geographical area for similar services. For example, a chiropractor’s charges must be similar to those in his or her geographic area and an acupuncture’s charges must match those of licensed acupuncturists.

Fifth, Med Pay only pays for past or incurred medical and chiropractic treatments. It does not cover for future medical or chiropractic treatment. Similarly, Med Pay does not pay for pain, suffering or inconvenience. If you need future care or wish to recover for pain, suffering and inconvenience, you may need to consult with a personal injury attorney. 

What if you have health insurance? Should you still carry Med Pay on your auto insurance? The simple answer is “yes.” Why?

First, not all health insurance policies cover chiropractic treatment, which is what you may need. Victims of car accidents generally suffer soft tissue injuries. They may also suffer from other types of injuries, such as broken bones, but that is generally in addition to soft tissue injuries. More often, soft tissue injuries require chiropractic treatment, and if your health insurance (such as Kaiser Permanente) does not cover chiropractic treatment, then its benefits may be limited in case you suffer from soft tissues injuries only. 
Second, your choice of a health care provider may be limited because providers may have to be part of a pre-approved network list with your health insurance company. 
Third, your treatment may be delayed if you have to go through your primary care doctor to get a referral for additional treatment. 

Are there situations when you should not use your Med Pay? 

If you are covered by health insurance, submit as many bills as you can to your health insurance first because (unlike Med Pay) you may not have a policy limit on your health insurance. Try not to use Med Pay for emergency care, urgent care, hospital and/or ambulance bills. Submit these bills to your health insurance and keep the Med Pay open for treatments such as chiropractic bills, co-pays and medication. 
Med Pay should not be substituted in place of health insurance, and you should carry Med Pay in addition to health insurance. 
We recommend that you contact your auto insurance agent and ask him or her if you have Med Pay provision on your policy and how the Med Pay works because they are different types of Med Pay provisions which are covered by different insurance companies. 
You may also wish to speak with an attorney. An experienced accident attorney can work with you and your insurance companies to best protect you. So, it is very important to speak with a lawyer following an accident, regardless of the type of insurance you may or may not carry.

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