What Is MedPay and Why Does It Matter After an Accident?
Medical Payments coverage, commonly called MedPay, is an optional add-on to your auto insurance policy in Illinois. It pays for medical expenses after a car accident regardless of who was at fault. If you have it, it can be one of the most valuable coverages on your policy. If you do not have it, you should consider adding it.
MedPay fills a critical gap in the weeks and months after an accident. While you wait for the at-fault driver’s insurance to settle your claim, MedPay pays your medical bills now. No fault determination required. No waiting months for a settlement.
How MedPay Works in Illinois
Illinois is a fault-based state for car accidents. The at-fault driver is responsible for paying damages. But getting compensation from the at-fault driver’s insurer takes time. Sometimes months. Sometimes years if a lawsuit is necessary.
MedPay works differently. You file a claim with your own insurance company. They pay your medical bills up to your policy limit. It is straightforward and fast.
Key Features of MedPay
- No-fault coverage: Pays regardless of who caused the accident
- Covers the policyholder: You are covered whether you are driving, riding as a passenger, or even hit as a pedestrian or cyclist
- Covers passengers: Passengers in your vehicle are also covered
- No deductible: MedPay typically has no deductible
- No copay: You do not pay copays or coinsurance
- Quick payment: Claims are usually paid within weeks
What MedPay Covers
MedPay covers reasonable and necessary medical expenses resulting from a car accident. This includes:
- Emergency room visits
- Ambulance transportation
- Hospital stays
- Surgery
- Doctor visits
- X-rays, MRIs, and other diagnostic imaging
- Physical therapy
- Chiropractic treatment
- Dental work for injuries sustained in the accident
- Prescription medications
- Prosthetic devices
- Funeral expenses (in the case of a fatal accident)
What MedPay Does Not Cover
- Lost wages
- Pain and suffering
- Property damage
- Long-term nursing care (in most policies)
MedPay is strictly for medical expenses. Other damages must be recovered through the at-fault driver’s liability insurance or through a personal injury lawsuit.
MedPay Coverage Limits
MedPay limits in Illinois typically range from $1,000 to $25,000, though some policies offer higher amounts. Common limits include:
- $1,000
- $2,000
- $5,000
- $10,000
- $25,000
The limit applies per person, per accident. If you have $10,000 in MedPay coverage and three people are injured in your vehicle, each person can receive up to $10,000 in medical expense coverage.
The cost of MedPay is surprisingly low. Adding $5,000 in MedPay coverage typically costs $10 to $30 per year, depending on your insurer and location. For $10,000 in coverage, expect $20 to $50 per year. Given the cost of even a single ER visit in Chicago, this is an excellent value.
MedPay vs. Health Insurance
You might wonder why MedPay matters if you already have health insurance. There are several important differences:
No Deductible or Copay
Health insurance requires you to pay deductibles and copays before full coverage kicks in. Many health plans have deductibles of $2,000 to $5,000 or more. MedPay has no deductible. It pays from dollar one.
No Network Restrictions
Health insurance limits you to in-network providers for full coverage. After an accident, you may be taken to whatever hospital is closest, which may be out of network. MedPay does not have network restrictions.
No Prior Authorization
Health insurance often requires prior authorization for MRIs, specialist visits, and certain treatments. MedPay generally does not. This speeds up your treatment.
Covers Health Insurance Gaps
MedPay can pay your health insurance deductible, copays, and coinsurance. This makes it a valuable supplement even when you have good health insurance.
Works If You Have No Health Insurance
If you do not have health insurance, MedPay may be your only coverage for accident-related medical expenses. It ensures you can get treatment without worrying about how to pay.
MedPay vs. Personal Injury Protection (PIP)
Some states require Personal Injury Protection (PIP) coverage, which is broader than MedPay. Illinois does not require PIP. But some Illinois policies may offer PIP-like coverage.
The key difference: PIP typically covers lost wages and other non-medical expenses in addition to medical bills. MedPay only covers medical expenses. In Illinois, MedPay is the standard optional medical coverage available on auto policies.
How MedPay Interacts with Your Personal Injury Claim
MedPay does not replace your personal injury claim against the at-fault driver. It supplements it. Here is how they work together:
MedPay Pays Now, the At-Fault Driver Pays Later
MedPay covers your immediate medical expenses while your personal injury claim is being processed. This means you can get treatment without worrying about out-of-pocket costs or waiting for a settlement.
Subrogation and MedPay
Your auto insurer may have a subrogation right on MedPay payments. This means they may seek reimbursement from the at-fault driver’s insurer. In some cases, they may also seek reimbursement from your settlement.
However, Illinois law limits MedPay subrogation in some circumstances. An experienced attorney can help you navigate this to maximize your net recovery.
MedPay Does Not Reduce Your Claim
Receiving MedPay benefits does not reduce the amount you can claim from the at-fault driver. You are still entitled to full compensation for all your damages. MedPay simply helps bridge the financial gap while your claim is pending.
Filing a MedPay Claim
Filing a MedPay claim is simpler than filing a liability claim. Here are the basic steps:
- Report the accident to your insurer. Let them know you want to use your MedPay coverage.
- Provide medical records and bills. Submit documentation of your accident-related treatment.
- Your insurer reviews and pays. The insurer verifies the expenses are accident-related and pays up to your policy limit.
Most MedPay claims are processed within two to four weeks. Some insurers pay on a rolling basis as new bills come in.
Common Issues with MedPay Claims
Insurer Disputes What Is “Accident-Related”
Your insurer may argue that certain treatment is not related to the accident, especially if you have pre-existing conditions. Thorough medical documentation linking your treatment to the accident is essential.
Reaching the Policy Limit
If your medical bills exceed your MedPay limit, the coverage runs out. Remaining bills must be covered by health insurance, the at-fault driver’s liability insurance, or out of pocket. This is why higher MedPay limits are worth the small additional cost.
Coordination with Other Coverage
When you have both MedPay and health insurance, there can be questions about which pays first. In most cases, MedPay is primary for accident-related injuries. This means MedPay pays first, and health insurance covers what MedPay does not.
Who Should Carry MedPay?
Short answer: everyone. MedPay is affordable and provides real protection. But it is especially important for:
- People without health insurance: MedPay may be your only medical coverage after an accident
- People with high-deductible health plans: MedPay covers the deductible
- Families: MedPay covers all passengers in your vehicle
- People with long commutes: More time on Chicago roads means higher accident risk
- Rideshare passengers: If you regularly ride in Ubers or Lyfts, your own MedPay can provide backup coverage
Review Your Auto Policy Today
Pull out your auto insurance declarations page and check whether you have MedPay coverage. If you do not, call your agent and add it. The cost is minimal compared to the protection it provides.
Already Injured? Make Sure You Use All Available Coverage
If you were hurt in a car accident, truck accident, or motorcycle accident in Chicago, make sure you are using every source of coverage available to you, including MedPay. An attorney can help you coordinate your insurance benefits and maximize your total recovery. Learn more about uninsured and underinsured motorist coverage that may also apply to your case.
Call Phillips Law Offices at (312) 346-4262 or contact us online at /contact/ for a free consultation.