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Understanding Coverage: Part 4 – MedPay

Medical Payments coverage1 (MedPay) may cover your own medical expenses or those of your passengers after a covered auto accident.

What does MedPay cover?

MedPay, also known as medical expense insurance, may be a coverage option on your auto policy. MedPay helps cover medical expenses you and your passengers may have incurred from an auto accident, regardless of who was at fault. MedPay can also cover you and your family members should you be struck and injured by an auto as a pedestrian. Some examples of what can be covered by MedPay insurance coverage are: 

  • Health insurance deductibles and co-pays 
  • Doctor visits
  • Hospital visits or stays
  • Ambulance fees
  • Funeral expenses
  • Surgery, X-rays and dental procedures2

This type of no-fault coverage helps reimburse you for out-of-pocket medical expenses without having to determine liability for an accident. It’s important to understand that this differs from MedPay insurance on a homeowners insurance policy, as that’s a type of third-party coverage and can’t be paid to you or your family members. 

Do you need MedPay coverage?

In most states where it’s offered, MedPay is optional, so you might not be legally required to carry it. If you reject medical payments coverage, you may be required to complete a form to confirm you’re rejecting it. Whether or not you choose to carry MedPay insurance can depend on what your personal needs and health insurance circumstances are. For example, if you have a high-deductible health insurance plan, it may be best to carry enough medical payments coverage to handle the deductible if you or your family members are injured in an accident. If you don’t have health insurance, you should strongly consider carrying medical payments coverage with a higher limit to give you peace of mind and help avoid the financial burden of high medical expenses.

What are the limits of medical payments coverage?

When adding MedPay to your auto policy, you choose a coverage limit, which will determine how your premium will be impacted. A typical personal auto policy will have medical payments coverage options anywhere from $1,000 to $100,000. For the states that require medical payments coverage, the minimum limit required may be higher than $1,000. The limit you choose is the maximum limit for each person injured in any one accident. 

How do I get reimbursed for a medical payments coverage claim?

To get reimbursed for a medical payments claim, you can work with your claim handler to guide you through the process. Medical records and bills will likely need to be provided by you or the provider. The claim handler will review the documents submitted and provide reimbursement as coverage and policy limits apply. 

MedPay vs. PIP

PIP (personal injury protection)1 is another type of auto insurance coverage that can help pay for medical expenses. PIP is typically considered to be a more comprehensive coverage, as it extends beyond what MedPay insurance covers. PIP can be used for medical expenses and also costs such as lost income if you’re unable to work due to injury, rehabilitation, psychiatric treatment, physical or occupational therapy, and more. Like MedPay, PIP is required in some states and not required in others, so be sure to discuss with your insurance provider which coverage(s) are available or required in your state.

Because MedPay varies by state, it’s important to understand what type of coverage is available to you, and whether you need to carry it. You can reach out to an Amica representative if you are unsure about your options. A representative can explain the type of MedPay insurance requirements in your state. This can save you a lot of time researching, and give you peace of mind that you have the coverage you need.

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1 Coverage may vary by state and policy.
2 In some states, MedPay insurance may also cover wage loss.

Your Policy, Policy Declarations or Amended Declarations in effect on the date of loss is the primary source of reference for your coverage, coverage limits and deductible amounts.

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