Does Health Insurance Cover Car Accident Injuries?

Key Takeaways

• Health insurance may cover your car accident injuries in some situations.
• Auto no-fault insurance can be coordinated with your health insurance, which means you can select your health insurance to cover your medical losses first.
• If you are on Medicare, a new law allows you to opt out of PIP coverage if you have Medicare Part A and B and other drivers in your household have no-fault PIP or private health insurance that meets requirements.
• Matz Injury Law can help you explore options to secure compensation for losses over and above these limits.

After being hit by a driver in Michigan, the aftermath of a car accident can leave you feeling anxious and uncertain.

This situation becomes even more challenging when you start receiving medical bills and realize that your health insurance may not cover all treatments. The fear of mounting debt and the frustration of dealing with insurance companies that might try to minimize your claims can add to your emotional and physical burden. Every delay in getting the compensation you need feels like another hurdle, making an already difficult situation even more daunting.

In times like these, contacting a Michigan car accident attorney can make a significant difference. An experienced attorney at Matz Injury Law can guide you through the complexities of insurance claims and help you understand your rights and options. We will advocate on your behalf to secure the compensation you deserve.

Can I Use Health Insurance to Cover Auto Accident Injuries?

Yes, in most situations, you can use your health insurance to cover expenses for injuries from an accident. However, some policies exclude car accident injuries from coverage, so check your policy to see if that applies to you. For many people, qualified health insurance plays a significant role in covering the medical care they need after suffering car accident injuries.

In situations where bills exceed personal injury protection (PIP) medical benefits coverage, health insurance could be critical to covering injury expenses after a car crash.

When Might Health Insurance Not Cover Car Accident Injuries?

In some situations, health insurance might not cover your injuries. Some examples include:

• Auto accident exclusions: Some medical insurance policies have a specific auto accident exclusion that eliminates coverage for medical care you need after a car crash.
• Secondary payer provisions: This clause in a medical insurance policy means the insurer will only pay on a secondary basis for accidents. That means it will only pay after no-fault auto insurance pays out first.
• Coverage exclusions or limitations: Some health insurance plans will exclude vital medical services or treatment after a car accident injury if they are routinely covered by no-fault insurance.
• Loss of job: If you can no longer do your job because of your accident-related injuries and you lose your job as a result, you also lose your job-provided medical insurance coverage.

Keep in mind that there are some types of losses that your health insurance will not cover beyond your medical injuries. Most often, health insurance will not cover losses outside of health-related injuries, including:

• Wage loss
• Long-term care
• Vehicle modifications

Also note that there are some people, especially those who are on Medicare, who may not have to carry no-fault insurance. If no family members in your household drive, and you are on Medicare, you may be able to opt out of coverage. If you are on Medicaid, you may be able to lower your PIP coverage, but you cannot opt out as you can with Medicare.

Coordinating Health Insurance With Auto Insurance After an Accident

Under Michigan auto insurance law, you can coordinate your medical coverage with your auto insurance policy. This process lets you set up coverage so that your health insurance is the primary payer after a vehicle accident. That means your health insurance covers your medical losses first.

This can be beneficial because health insurance has a different cap, giving you more room to seek compensation for other losses under your PIP plan. You can coordinate your health insurance and car insurance with your insurance agent.

What Are the Drawbacks to Coordinating Health Insurance?

Coordinating coverage of Michigan no-fault insurance and health insurance benefits is optional. If you choose uncoordinated benefits, your Michigan no-fault insurance pays first for your medical care. While coordinated health insurance benefits tend to be less expensive, they have several drawbacks.

For example, with coordinated benefits, if you have an HMO or similar type of managed health insurance plan, you must exhaust all of those benefits before the no-fault insurer pays for any medical expenses you incur from seeking care outside your plan. In these cases, you lose control over who you seek care from.

With uncoordinated auto insurance coverage, you can receive treatment whenever you want to do so and for any services that you believe are reasonably necessary for rates that are considered reasonable. This gives you more options for treatment.

Another factor to consider is Medicare’s limitations. While Medicare covers many of the costs you may have, there are some specific types of expenses that Medicare does not cover, but your PIP insurance may cover, including:

• Guardianship or conservator services
• Long-term care and custodial care that results from the car accident
• Wage losses
• Vehicle modifications
• Massage therapy
• Case management services
• Residential treatment programs

Why Clients Choose Matz Injury Law

An experienced Michigan law firm that can help you navigate your PIP medical coverage and your health insurance policy limitations is critical in a case like this. When you choose to work with Matz Injury Law, you gain insight, support, and an advocate dedicated to you throughout your case. You will always work directly with your lawyer.

Matz Injury Law is an experienced Southfield firm that has recovered millions of dollars for clients throughout our long history. That includes a recent $3.45 million settlement in Genesee County when a truck crossed the center line in a roadway, resulting in three deaths and severe injuries to a four-year-old. We understand the Michigan insurance system and can guide you through it while you work on recovering.

Testimonials

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“Wow! What an amazing attorney, Mr. Steven Matz. His guidance & expertise set my family’s mind at ease & we are all forever grateful for such a wonderful person. Thanks again, Mr. Steven Matz. I wish I could give him 10 stars!” — Natasha S. 

Related Resources

• Why is My Policy Limit Less Than My Car Accident Settlement?: Filing a car accident settlement when coverage levels are insufficient to meet your needs creates a challenging outcome. Learn more about what you can do if your settlement exceeds your available policy limit.
• Michigan Personal Injury Protection Guide: Understanding Michigan PIP medical coverage requirements and your PIP benefits can be challenging. This guide breaks down everything you need to know about PIP coverage.
• If I Have Medicare, Can I Opt Out of PIP Insurance?: If you have Medicare, you need to know when and if you should opt out of PIP coverage. Under the state’s no-fault law, you may be required to maintain PIP coverage unless you have Medicare and meet specific requirements.

Unsure About Your Coverage? Our Attorneys Are Ready to Help

Call Matz Injury Law now at 1-866-22Not33 for immediate help, or fill out our online contact form to schedule a free consultation.