PIP vs. MedPay Insurance Coverage

By Insurance.com Posted : 09/16/2004

If you live in a state that is considered "no fault," you are required to purchase either Personal Injury Protection (PIP) or Medical Payments (MedPay) insurance coverage. PIP and MedPay cover the medical bills of you and the passengers in your car, in the event of an accident. They are both designed for "immediate and short-term care," so if you have health insurance coverage as well as either one of these, MedPay or PIP will be used first if you file a claim.

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If you have MedPay as part of your car insurance policy, there are a couple steps to follow when filing a claim. You must first pay for your treatment upfront and obtain a receipt from the doctor or hospital. Then you will send that receipt to your insurance company and wait for the reimbursement check. If you use MedPay for medical expenses, inform the doctor or hospital that your auto insurance will pay for the rest of the treatment.

Some insurance companies allow the policyholder to decide which coverage to use, be it MedPay or health insurance. In no-fault states, such as Pennsylvania or New York, MedPay or PIP is the primary coverage when you're injured in a car accident. If you live in a state without no-fault insurance, but have MedPay or PIP on your car insurance policy, be sure to use it first to pay for medical expenses, because some health insurers might deny coverage unless you exhaust all/any MedPay or PIP benefits.

"No-fault" State
If you live in a no-fault state, there is no reason to buy both MedPay and PIP. This is because PIP provides insurance coverage that is equal and beyond MedPay. Keep in mind, though, PIP has a 20% deductible, where as MedPay has none.

MedPay covers reasonable and necessary expenses for medical, surgical, dental, and chiropractic treatment. It also covers hospitalization, ambulance services, X-rays, nursing services, prosthetic devices and funeral services. If you have health insurance or belong to an HMO, your probably don't need it. Also, it is no substitute for broader health insurance, and few companies are willing to sell more than $25,000 worth of MedPay coverage - something to keep in mind when deciding on what to get.

PIP covers the same services as MedPay, but also many more. It also covers psychiatric, physical, occupational therapy and rehabilitation, and any other professional health services. In addition, PIP covers lost wages, reasonable costs other than medical and work-loss expenses, and a small death benefit. It's best to check your policy for exact details on what PIP covers for you.

Having both MedPay and PIP is considered duplicate insurance coverage in many situations. MedPay is more "valuable" in situations where you're driving with someone who is not family, because even if they don't have health insurance, they are still considered covered. MedPay can also help off-set the deductible that comes along with PIP.

If you're interested in quotes for all kinds of insurance, including car and health (along with life, home and more), visit Insurance.com where you can get multiple quotes from leading insurance companies.

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