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Why Health Insurance Doesn’t Cover Accident Injuries

If you have been in a car accident and have sustained injuries, you might be wondering who will pay for your injuries. Does your health insurance cover your injuries, or your car insurance? Florida is a no-fault state when it comes to car insurance, which means that who pays for your medical bills after an accident in Florida can get a little complicated. 

Our team at Impact Med Zephyrhills discusses what coverage pays for your medical expenses and the importance of seeking care promptly following an accident.

Was Your Accident No-Fault? 

All Florida drivers much purchase no-fault vehicle insurance, commonly referred to as Personal Injury Protection, or PIP. This insurance covers you for less-serious injuries that you might sustain in a car accident. 

Generally, the rule is that each driver will put a claim in with their insurance following an accident even if they are at fault. If you suffer from severe injury, you may be able to bring a claim against the at-fault driver to recover your losses and get medical bills paid. 

Keep Reading> 10 Steps to Recovery After an Accident 

PIP Insurance Is Primary

At the core of Florida’s no-fault coverage, is Personal Injury Protection or PIP. This insurance pays your medical bills whether you caused the accident or not. It generally pays around 80% of your medical bills up to the policy limit stated in your insurance policy. You may also have a deductible that must be met before PIP kicks in. 

PIP insurance is the primary payer for your injuries following a car accident, even if you have health insurance. You must seek care within 14 days of your accident to receive your full PIP benefits. 

The great thing about PIP insurance is that it covers family members that live in your house, not just those who are listed as a driver on your auto policy. 

What PIP Covers

Florida’s no-fault laws dictate what kinds of medical services must be covered by your PIP insurance including:

  • Medical, x-ray, surgical, dental, and rehabilitative care
  • Hospital, ambulance, and nursing services
  • Follow-up care and rehab

Caveats: 

  • The treatment facility must be medically licensed
  • A doctor’s order must be submitted for medical care
  • Acupuncture and manual are NOT covered by PIP 

Med Pay Coverage

Medical payments coverage, called Med Pay, is like PIP. It typically pays for medical and funeral costs, but not living expenses or lost wages. It is often sold as an add-on coverage to PIP or as a less-expensive alternative to PIP. In Florida, Med Pay is considered an optional coverage. 

Health Insurance

Often, if you note that your injuries were sustained in a car accident, your health insurance provider might route the bills to your auto insurance company instead. (Especially if you haven’t exhausted your PIP or Med Pay benefits.)

Think of health insurance as the last resort to pay for your auto accident injuries, followed by paying out of pocket.

Coverage of Additional Bills 

Once you have exhausted your PIP coverage, the next step is supplemental Med Pay coverage (if you have it,) and then your health insurance. If your health insurance doesn’t cover all your bills, you may have to pay for some of your medical expenses out of pocket. 

Therefore, it is often recommended to purchase more than the minimum limit of $10,000 for your PIP insurance. If you have enough PIP to begin with, you won’t have to turn to Med Pay, health insurance, or your bank account to pay for your medical bills. 

Learn More> 5 Benefits of Cash-Pay Clinics 

Seek Medical Care Promptly 

As stated above, it is critical to receive medical treatment within 14 days of an accident to receive full PIP benefits. Don’t take a chance and forgo treatment, even if you feel fine. Your medical bills will be covered by your PIP benefits up to your policy limits, and then other coverage may kick in from there. 

Get medical attention after an accident from our cash-pay clinic at Impact Med Zephyrhills. We’re here to help you heal. Call for an appointment today—813-737-7965!