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Will Health Insurance Cover Medical Bills From a Car Accident?

Will Health Insurance Cover Medical Bills From a Car Accident?

Generally, insurance coverage should protect you from having to personally cover expenses related to a collision on the road in Philadelphia. However, if you have health insurance along with your legally mandated motor insurance, you may be wondering, Will health insurance cover medical bills from a car accident?

In this post, we unravel the intricacies involved in this question.

Understanding Your Insurance Coverage

In the state of Pennsylvania, every road user must carry motor insurance. (The legally required minimum levels of coverage are set out below). Many motorists also have health insurance that provides for some of the same potential claims as their car insurance. You can’t file two insurance claims for a single loss; so, which policy do you turn to first?

What Does Health Insurance Cover?

Health insurance is designed to cover medical expenses for illnesses and injuries. It is a contract between an individual and an insurance company under which the insured pays a monthly premium and the insurer pays for a portion of covered medical costs in the event of a successful claim.

Health insurance covers medical expenses related to medical conditions regardless of how they occur. So, whether you sustain a broken ankle by getting in a car accident or falling down the stairs at home, health insurance should provide the same level of compensation.

Some employers sponsor health insurance policies for their workers as a benefit, but it’s also possible to purchase health insurance coverage on an individual or family basis.

What Does Motor Insurance Cover?

Motor insurance covers costs related to vehicle collisions and other accidents, including property damage, liabilities, and medical expenses.

Pennsylvania is a no-fault state. This means that you can collect compensation from your own motor insurance company following an accident regardless of who was at fault. It also means that your motor insurance should automatically cover any medical expenses you incur as a result of your accident, and that this coverage should kick in before you have to rely on any form of health insurance.

However, it’s important to remember that no-fault coverage only extends to a certain point. In Pennsylvania, the legally mandated minimum levels of no-fault motor insurance coverage every driver must carry are:

  • Bodily injury liability: $15,000 per person and $30,000 per accident.
  • Property damage liability: $5,000 per accident.
  • First party medical care: $5,000 per accident.
  • Uninsured motorist (UM) and underinsured motorist (UIM) protection: Motorists are not required to purchase these types of coverage in Pennsylvania, but insurance providers must offer them. If you’re not sure whether you have this type of coverage, you should research your policy document (ideally with the help of a road accident attorney).

If you incur medical expenses in excess of the no-fault limits of your policy, you may need to rely on your health insurance coverage.

Limited Tort vs. Full Tort Motor Insurance

Pennsylvania is one of three states that allow motorists a choice between full tort and limited tort insurance coverage.

With a limited tort policy, you won’t be able to sue for noneconomic damages, such as pain and suffering, after a car accident unless the harm you suffer qualifies as “serious injury.” Limited tort policies are more affordable than full tort options, but this limitation means your recovery rights following a successful accident claim will be significantly reduced. This can be a major drawback if you’re facing prolonged discomfort that affects your quality of life.

There are some situations in which it may be possible to sue for noneconomic damages with a limited tort insurance policy, such as if the at-fault driver was under the influence of alcohol or drugs at the time of the accident or they were driving a car registered in another state.

However, only the full tort option gives you and members of your household the unrestricted right to seek compensation for pain and suffering and other types of noneconomic harm arising from road accidents.

Private Health Insurance vs. Medicaid

There are important differences between publicly-funded health insurance (Medicare or Medicaid) and private health insurance when it comes to road accident compensation. These center primarily around quality of coverage; private insurance tends to offer more comprehensive treatment packages and better selections of medical professionals than Medicare or Medicaid.

Some Medicare or Medicaid policyholders choose to supplement gaps in their coverage with private insurance policies. This may allow for better treatment in the event of serious health conditions, such as brain injuries or spinal injuries.

This is a complex area with various considerations to take into account. If you’re not sure about the specifics of your own situation, you should sit down with an attorney who has expert knowledge of cases like yours.

Health Insurance vs. Disability Insurance Following a Road Accident

If you have disability insurance coverage, you may be wondering where it fits into this conversation. Many employers offer long-term disability insurance to their workers as a benefit.

However, disability insurance doesn’t cover medical bills that arise after an accident like a car crash (at least, not directly). Instead, this type of insurance provides you with income replacement over an extended period if an illness or injury prevents you from working.

There are short- and long-term disability insurance policies. Short-term policies typically provide coverage for up to six months, while long-term policies can cover you for a few years or up until you reach retirement age, depending on the terms of your policy.

If you’ve been left unable to work by a car accident and you have a disability insurance policy, you should research the terms of the policy to learn more about your potential entitlements, ideally with the help of a lawyer who specializes in this area.

Frequently Asked Questions (FAQs)

Will my health insurance automatically cover my medical bills if I’m in a car accident?

Pennsylvania’s no-fault rules mean that your motor insurance will cover your health care expenses up to policy limits. Past these limits, any health insurance you have should kick in.

Can I choose between my health insurance and motor insurance for coverage of my medical bills?

Depending on the terms of your policies and the circumstances of your accident, you may have the freedom to choose between motor insurance and health insurance coverage when it comes to paying your medical bills.

What should I do immediately after a car accident to ensure my medical bills are covered?

The first step to take is to notify your motor insurance company of what happened and start the claim-filing process. If you encounter any issues, you should consult with a personal injury lawyer with ample experience of these types of claims.

If I’m unable to work due to a car accident injury, will my health insurance cover my lost wages?

Health insurance primarily covers medical expenses related to injuries or illnesses, such as hospital stays, surgeries, prescriptions, and other medical treatments. It does not compensate for lost earnings. Disability insurance provides wage-replacement benefits; alternatively, you could file a personal injury lawsuit against the at-fault party.

How long do I have to file a claim with my insurance company after an accident?

This varies from one policy to the next, but it’s generally advisable to report an accident as soon as possible after it happens. Waiting too long can potentially complicate the claims process. Always review your insurance policy’s terms and conditions or consult with your insurance agent to understand specific timelines and requirements.

If I was hit by a car as a pedestrian or cyclist, who will pay my medical bills?

In Pennsylvania, if a pedestrian or cyclist is hit by a motor vehicle, the motor vehicle’s insurance typically becomes the primary source of medical benefits. Under the state’s no-fault system, even if the driver of the car is not at fault, their personal injury protection (PIP) insurance will cover the medical expenses of the injured pedestrian or cyclist up to the policy limit. If the costs exceed the PIP limit or if there are other damages like pain and suffering, the injured party might seek additional compensation from the at-fault driver’s liability insurance or through a personal injury lawsuit.

Contact a Philadelphia Road Accident Lawyer Today

The rules and requirements around insurance can be highly complex, particularly if you don’t have a formal background in the area. However, if you’ve been in an accident, it’s critical that you understand how you’re going to fund your recovery. If you’re feeling lost, we can help.

Contact the Cochran Firm in Philadelphia today to start the process of your financial recovery. You can reach us over the phone at 800-969-4400 or via the contact form on our website.