What is MedPay Coverage and How Does it Work?

Key Points:

• MedPay is an optional/supplemental policy meant to fill in gaps in your insurance coverage such as deductibles, co-pays, and other costs not covered by other policies
• MedPay pays out regardless of who caused the accident
• Georgia law does not require that you carry MedPay but it can be extremely helpful if you do not have health insurance or a medical policy with a high deductible
• MedPay can also pay for the medical costs of injured passengers or pedestrians who are not family members covered by your medical policy
• MedPay can be used to pay for funeral costs which are not generally covered by standard auto insurance policies

Table of Contents

What is Med Pay Insurance?

MedPay insurance, also known as medical payments coverage is an optional add-on to auto insurance policies available in most states. It helps pay for medical expenses related to vehicular accidents, regardless of who is at fault.

Who is Covered by a Med Pay Policy?

MedPay can cover expenses for you, your passengers, and any pedestrians that might have been injured in an accident. It can also cover your medical costs if you or a member of your family are riding as a passenger in another vehicle or are injured by a vehicle as a pedestrian, bicyclist, or public transportation rider.

Med Pay is a Supplemental Policy

MedPay is meant to be a way to bridge the coverage gap between your other insurance products. It is supplemental to your health insurance and/or your auto insurance, so it can help pay for out-of-pocket costs such as your deductible, copays, and coinsurance that are not covered by other policies. It can also cover medical expenses that are not covered by your health insurance plan, including funeral costs.

Is MedPay Expensive?

MedPay coverage limits typically range from $1,000 to $25,000, but you can choose higher limits if you wish. MedPay premiums are relatively low, so it can be a good investment, especially if you have a high-deductible health insurance plan or if you have passengers who are not covered by health insurance.

Is MedPay a Requirement in Georgia?

MedPay is offered by most insurance companies in Georgia, but the law in Georgia does not require you to carry such a policy. Some companies may offer it as a standard feature on their auto insurance policies, while others may offer it as an optional add-on at a very reasonable price. Some companies even offer MedPay as a standalone policy. It is important to check with your insurance company to see if and in what ways they offer MedPay to their customers.

Here is a list of some of the major insurance companies that offer MedPay in Georgia:

• Allstate
• American Family
• Farmers
• Geico
• Nationwide
• Progressive
• State Farm

If you are not sure whether or not your insurance company offers MedPay, you can contact them directly or check your policy declarations page. Your policy declarations page will list all of the coverages that you have purchased, including MedPay.

Is a MedPay Policy Worth the Premium?

MedPay can help pay for medical expenses related to vehicular accidents, regardless of who is at fault. It can cover expenses for you, your passengers, and any pedestrians you may injure. It can also cover your expenses if you are riding as a passenger in another vehicle or are injured by a vehicle as a pedestrian, bike rider, or on public transportation.

If you are considering adding MedPay to your auto insurance policy, be sure to weigh the pros and cons carefully. Even at a very low premium rate, MedPay premiums can add up over time, so it is important to make sure that you are getting the most value for your money.

MedPay policies don’t pay for everything, but are useful to fill in the gaps in your normal policies’ coverage such as deductibles and co-pays.

What Services Can be Paid with MedPay?

Your MedPay policy can be applied to the services of all specialists, as long as the services are medically necessary and related to the injuries sustained in the auto accident. This includes specialists such as:

• Cardiologists
• Dermatologists
• Endocrinologists
• Gastroenterologists
• Gynecologists
• Neurologists
• Ophthalmologists
• Orthopedic surgeons
• Otolaryngologists (ear, nose, and throat specialists)
• Psychiatrists
• Rheumatologists
• Urologists

MedPay does not cover cosmetic surgery or elective procedures.

If you are unsure whether MedPay will cover the services of a particular specialist, you should contact your insurance company to inquire.

MedPay will generally cover:

• Doctor visits
• Hospital stays
• Surgery
• X-rays and other medical tests
• Prescription drugs
• Physical therapy
• Dental work
• Ambulance rides and air transportation

Funeral costs are the most common expenses covered by MedPay

• MedPay will only cover funeral expenses if the death is caused by an accident that is covered by MedPay.
• MedPay will typically pay funeral expenses directly to the funeral home, so you will not have to come up with the money out of pocket unexpectedly
• If your MedPay coverage limit is not enough to cover all of your funeral expenses, you may need to pay the difference out of pocket

What is NOT covered by MedPay?

• Medical expenses that exceed your policy’s limit
• Wage reimbursement if you are unable to work due to your injuries
• Child care costs if you are unable to care for your children due to your injuries
• Medical expenses related to an accident that occurred while you were driving under the influence of alcohol or drugs
• Pain and suffering
• Funeral expenses if you are killed in an accident that is not covered by MedPay

It is important to note that MedPay policies may vary from company to company, so it is very important to read your policy carefully to understand what is and is not covered.

What if Medical Costs are Covered by another Party or Insurance Policy?

Other insurance policies will pay up to their limits when you are injured in an accident. MedPay is a secondary policy, meaning that it pays for medical expenses that are not covered by your primary insurance policy or auto insurance. MedPay can also help pay for medical expenses that are not be covered by your health insurance policy, such as dental repairs or funeral expenses.

For example, if you have MedPay coverage with a limit of $10,000 and your health insurance policy has a deductible of $5,000; MedPay would pay the remaining $5,000 of your medical expenses after your health insurance has paid its share.

However, it is important to note that MedPay policies may have different coordination of benefits provisions. You should always contact your MedPay insurance company to find out how your MedPay policy will coordinate with your other insurance policies.

For example, if you have a $2,000 deductible on your health insurance plan and you are involved in a car accident, you can use MedPay to pay your deductible. Once your MedPay benefits are exhausted, your health insurance will begin to pay for your medical expenses.

It is important to note again that MedPay policies may vary from company to company, so it is important to read your individual policy carefully to understand what is and is not covered.

Filing a Med Pay Claim

To be reimbursed for your medical expenses, you will need to submit a claim to your insurance company. You will need to provide documentation of your medical expenses, such as receipts and bills. You may also need to provide a statement from your doctor or other medical provider.

Once your insurance company has received your claim, they will review it and determine whether or not your medical expenses are covered by MedPay. If your claim is approved, your insurance company will reimburse you for your medical expenses, up to your policy limit.

MedPay is Not the Same as Uninsured Motorist Coverage

MedPay is a first-party insurance coverage, meaning that it pays out benefits to you, regardless of who is at fault for the accident. Policies that cover Under Insured Motorist, UIM, or Uninsured Motorist, UM, are third-party insurance coverages, meaning that they only pay out benefits to you if you are injured by an uninsured or underinsured motorist.

What if You are At-Fault?

Most insurance policies expect the at-fault driver’s insurance to be liable for medical expenses. MedPay, on the other hand, can be used to pay for medical expenses and will pay covered expenses regardless of who is at fault. So, if the other driver has insufficient insurance to cover your injuries MedPay may pick up the costs up to the limits detailed on your MedPay policy.

Challenges That Can Come With MedPay Coverage

In considering whether or not to purchase a MedPay policy, you should look carefully at the advantages and disadvantages. The advantages are straightforward and many find having coverage for more contingencies can be comforting. However, listed below are some of the relative disadvantages of maintaining a MedPay policy:

• Limited coverage. MedPay policies have limited coverage limits, typically ranging from $1,000 to $10,000. This may not be enough to cover the cost of serious medical expenses.
• Secondary coverage. MedPay is a secondary coverage, meaning that it will pay for medical expenses after your health insurance policy has reached its limits. This can be a disadvantage if you have a high deductible or co-pays on your health insurance policy.
• Subrogation rights. Your MedPay insurance company may have subrogation rights, which means that they may be able to seek reimbursement from the at-fault party’s insurance company for the medical expenses that they paid. This can be a complex process, and your MedPay insurance company may not be willing to pay the full amount of your medical bills if they believe that you could have recovered more money from the at-fault party’s insurance company. In such situations, it might be helpful for your attorney to step in during the settlement process.
• Cost. MedPay policies can be expensive, especially if you have a high coverage limit. You may be able to find cheaper alternatives, such as increasing your health insurance deductible or purchasing a supplemental health insurance policy.

Deciding whether or not a MedPay policy is right for you will depend upon your individual needs and circumstances. If you are considering purchasing a MedPay policy, be sure to weigh the pros and cons carefully by speaking with your insurance agent, your attorney, or a financial advisor.