Have you been injured and do not know how your medical bills will be paid? Don’t panic. This article written by our Georgia accident and injury lawyers will explain your options to pay for medical care.
- Wondering, “how do I pay for medical care” while I wait for my accident case to settle? You have several options: medical insurance, medical payments coverage, or attorney lien care.
- If you have both medical health and automobile medical payments coverage, both policies may pay for some or all of your medical care.
- If you do not have medical insurance, other options exist, such as treatment on a medical or attorney’s liens or personal injury medical funding.
After any Georgia car accident or other injury, you are responsible to pay for your own medical expenses until your case settles or pays you money.
But if this seems very unfair, you are not alone. You have options to get your bills paid after a car accident, even if you do not have medical insurance. Some of the ways you have to get your medical treatment on track and paid for include private medical insurance, government assistance, medical payments coverage, medical liens, attorneys liens or or private medical-legal funding.
Who Pays For Medical Care In Georgia Immediately After an Accident?
In theory, automobile insurance – either yours or the at-fault driver’s insurance — should cover your medical expenses while you recover and settle your case, but this is not how it usually works after a car wreck in Georgia.
In our state, each person hurt in a car wreck is expected to pay for his or her own medical expenses up front. The insurance company for the at-fault driver usually only pays for your medical expenses at the end, one time, when your case settles, but not as you receive your medical care. When your case settles, you will sign a settlement release in exchange for the payment of all of your damages, including your medical bills.
If you are fortunate to have a health care insurance plan, your insurance company will pay for your treatment while you recover. Or, if you have purchased medical payments coverage (MPC), this may pay for a portion your bills as you receive them. But what if you do not have health insurance? Some hospitals and doctors may be willing to treat on a lien (a promise to pay after your case settles), but some will want to bill you immediately. Good personal injury attorneys can often help you locate a doctor or clinic that can treat you on a lien while you recover.
I have no health insurance and need medical treatment. What can I do to keep my bills at bay?
If you are not covered by health insurance and need medical treatment, your attorney may be able to assist you with providers who are willing to treat you on a lien basis. This means you’ll be able to receive the care you need, and the medical providers will be entitled to reimbursement once your claim is settled.
Will the At-Fault Driver’s Insurance Company Pay Medical Bills While You Recover or Wait For Your Settlement?
Unfortunately, no. Eventually, you should receive payment for your medical bills and other expenses from the negligent driver’s insurance company, but not until your case settles. Until that time, it will be your responsibility to seek and pay for medical care.
If You Have Both Health and Auto Insurance – Who Pays?
If you have medical insurance, ambulance companies, hospitals and doctors should bill your health insurance plan. Otherwise, they will bill you personally. Later, after your case settles, your health insurance company may, in some but not all cases, be reimbursed from the settlement for the care that was paid for up-front.
If you have medical payments coverage (MPC) on your Georgia car insurance policy, you may have MPC pay the bills directly, or you may apply the MPC to the hospital and ambulance bills when those bills begin arriving. MPC in Georgia usually only pays a fixed amount, however. This will be limited to the amount of MPC you purchased. Most often this is $5,000 or $10,000, but we have seen medical payments overages as large as $50,000 or more. Be sure to check the amount of MPC your auto insurance policy has.
If you have both medical insurance and MPC, the MPC can be used first to pay up to its limit. After that, your health insurance policy should take over. Ultimately, though, all medical bills are unfortunately your responsibility.
What is Medical Payment Coverage, and how does “med pay” work?
When you have been injured in a Georgia collision you should review your auto insurance policy to check whether your policy includes a rider called medical payments coverage, also known as “med pay” for short. Typical amounts of med-pay coverage are $1,000, $2,000, or $5,000. Some policies can include as much as $10,000, $50,000 or even $100,000 in MPC.
Med-pay coverage works to pay your medical bills up to the limit of the med pay limit. In several ways it can be even better than traditional health care coverage: First, it is not limited to your medical provider network; and secondly, your med pay policy pays immediately and does not include any deductible or co-pay; additionally, med-pay does not have to be repaid or reimbursed at the end, when your case is settled. Med pay should be used to pay medical bills as they arise, but can also be used to repay your health insurance plan, if and when reimbursements are required.
Generally speaking, med-pay coverage pays your bills before health insurance – in other words MPC pays first. In fact, under most health care plans, you are required to exhaust any medical payments coverage under your auto insurance policy before the health insurer pays. Med-Pay coverage, however, is usually fairly limited and once your bills exceed the MPC limit, your health insurer will pay or you will have to find another way to pay for care.
In addition to the above, there may be situations where you actually do not want your med-pay policy to pay for certain care directly, but to to be used to reimburse your health care insurer. For example, a hospital may bill MPC at a full or retail rate, while it may bill a health insurer at a discount. In such cases, it may be best to let your health insurance plan pay the lower rate, and then allow your med-pay to reimburse the health insurance plan later, at the discounted rate. Why would you want to do this? Because of subrogation. If your health care plan is governed by ERISA or another federal program, you may have to reimburse the plan at when your case resolves. The smaller the lien, the less you will have to repay the insurance company.
If you have medical payments coverage, be sure to let your car accident injury attorney know right away. Proper coordination and timing of benefits can make a big difference to how much you are able to keep in your pocket at the end of your injury claim.
How Traditional or “Regular” Health Insurance Pays Your Bills After a Georgia Car Accident
Your regular medical insurance plan will cover a car accident, just as it covers any other health problem you may have. Many people worry about using their health insurance after a crash that was not their fault, however, this is exactly why you have health insurance. Use it.
Why Should I Use My Health Insurance if an Accident Was Not My Fault?
Some of our clients have told us that they don’t want to use their own health insurance to pay for care after an accident because “it was not my fault.” This can often be a mistake. The most basic reason to use your medical insurance is so that you are not paying medical bills from your own pocket or savings. Another reason is that if you get your care on an attorney’s lien, you often end up re-paying more than you would pay if you used your health insurance. This is money you could keep for yourself when your case settles.
Will my personal health insurance company reject the medical expenses from my injury?
Your personal health insurance will typically not reject paying for your care after a car accident injury, as long as the medical provider takes your insurance. You should contact the medical provider first to determine if your health insurance is accepted.
Should I pay for my medical bills?
We typically pay our client’s medical expenses out of the available recovery funds. However, if your medical expenses are beginning to mount, you should attempt to pay them or make a payment arrangement with the provider until your case has settled.
I am still experiencing pain and need more medical treatment to heal. Will the insurance company pay more if they already paid?
This depends on whether additional insurance is available or whether the case has been completely resolved. In some instances, there may be other insurance money to claim under another policy, or the insurance may have paid, but your attorney has also filed a lawsuit against another party on your behalf. But, if your case has been completely resolved, by law, you are more than likely prohibited from asserting another claim for the same injuries if you signed a release for the settlement of your claim. This is why it is extremely important to continue your recommended course of treatment and let your providers and case managers know if you are still experiencing pain before your case resolves.
What If a Hospital or Medical Office Refuses to Bill My Medical Insurance?
We have seen cases where a hospital or medical office may refuse to bill health insurance after a car accident. This is improper. Should you encounter this, insist that the bills be sent to your health insurance plan, contact or submit the bills directly to your medical insurance carrier, or contact a Georgia personal injury lawyer.
Do I Have To Repay My Health Insurance Plan?
Sometimes – but not always! Another thing to know about your health insurance, is that if your plan pays for medical care after an accident, it may have a lien against your settlement to recover its payments. Not all heath care liens are enforceable, however, so be certain to review your plan to determine whether the plan is subject to the Georgia “made whole” doctrine or is underwritten by a federal program with strong lien rights. If you are not sure, consult with an attorney. Plans that are subject to the Georgia made whole doctrine may not have to be repaid.
Medicaid, Medicare or Tricare May Pay Your Bills After a Car Wreck – If You Are Eligible
Certain government health insurance plans such as medicare, medicaid, Peachcare, or Tricare may pay your, or a child or other family member’s medical bills after a car accident. If you are on one of these plans, tell the hospital and your doctor’s offices, and have the bills paid by your government payer. You will be required to reimburse the plan when your case settles, but it is usually only a relatively small percentage of the overall bills. It is far better to receive the treatment you need than to worry about the amount that may need to be repaid at the end of your case, known as insurance subrogation. A good personal injury lawyer can negotiate with the plan to, hopefully, significantly reduce the amount owed.
If You Cannot Pay Your Medical Bills
If you can’t cover these costs, it can be possible to work out a plan to make payments with your health care provider to place a hold on your account, which will keep your provider from calling collection agencies as long as you agree to pay when your injury claim is settled.
What is an Attorneys Lien or Doctor’s Lien?
When you need more care after the ambulance ride and emergency room visit, or hospitalization, how do you pay for it without insurance? Some doctors, chiropractors and therapy clinics may be willing to provide medical treatment on a lien. This is a promise that they will be paid after your case settles. Many experienced personal injury lawyers and firms (our firm included) have knowledge of which doctors and medical offices in your part of Atlanta or area in Georgia provide medical care on a lien basis. Treatment on a lien usually involves signing a written document that is a promise to pay later. We recommend that all medical liens be reviewed by an attorney before you sign.
Medical Funding Companies may help pay for your care and treatment
Some companies exist that may pay for your medical care after an injury when you have a valid case and no other options. A medical funding company will usually want to know that you are represented by an attorney and have a good chance of recovering a settlement or verdict. These companies will usually require you to sign a lien and some charge interest on their services. It is important to know the fine print before seeking or accepting medical funding. That said, however, it is usually far better to get the medical care you need, than to hurt your case or your health by not receiving proper medical care, making it possible to prove your injuries when it comes time to settle your injury claim.
What to do if the medical billing department contacts you for payment
If you have a Georgia car accident lawyer, let the attorney or legal assistant know immediately – before you pay the bill. Otherwise, you can can attempt to handle this on your own by contacting the hospital or doctor and explaining that you have an injury claim, and ask that they stop trying to collect until you receive your settlement. Doing nothing at all may result in your bills being turned over to a collection agency, that may attack or damage your credit and hounding you for payment.
Although it is not something you will hear about in TV advertisements, on of the biggest benefits of hiring a personal injury lawyer can be protecting your credit and working out arrangements that allow you to receive important and necessary medical care now, in return for paying for the treatment later at the time of your settlement.
After a personal injury claim is settled, are insurance companies still responsible for paying bills that come in after settlement? More bills came in after my payout – how does this work?
Generally, we are able to successfully pay for client’s medical expenses with the recovered funds. However, in the event more bills come in after your disbursement, you should contact your attorney to ensure there is no evidence of double billing. Otherwise, you may be responsible for paying such expenses.
What Types of medical expenses can be recovered and paid for?
As long as the at-fault driver is proven liable for your injuries, and your medical care and treatment are proven to be related to the wreck, you may be entitled to recover a variety of economic and non-economic damages, such as:
- Ambulance bills
- Emergency Room visits
- Wound care
- Scar Revision
- Specialist treatment (orthopedists, neurologists, eye doctors, etc.)
- Occupational therapy
- Transportation to and from treatment or rehabilitation
- Medical supplies
- Assistance devices (wheelchairs, bandages, crutches, etc.)
- Other out-of-pocket medical costs not covered by insurance
- Future medical expenses
Medical Care Costs Add Up Quickly
If you have to go to a hospital in an ambulance following a motor vehicle accident, the medical bills will start mounting after the call to 911. The ambulance ride can be over $1,000 in Georgia. The ER visit may cost anywhere from $2,500 to $50,000, depending on the tests performed. If emergency surgery or a hospital stay is required, your medical costs are certain to soar. If your injuries cause a short- or long-term disability or require additional treatment or therapy over a period of time, your bills will continue to add up.
If you have health insurance, your plan should cover most of your medical expenses. But if you don’t have health insurance, or if your insurance is not enough to cover all of the costs, you could find yourself in trouble, financially (more on how to get care if you do not have medical insurance below). And, even if you do have medical insurance, be sure to document and record every medical-related cost such as:
- Emergency department visits
- Over-the-counter medicine
- Hospital stays
- Physical therapy
- Ambulance expenses
Car Accidents Cost Everyone
Vehicle crashes take an enormous toll on the U.S. economy and the financial health of those who are injured or suffer the loss of family members. The National Highway Traffic Safety Administration released a study in May showing that car crashes cost $871 billion a year, equivalent to 2 percent of the country’s gross domestic product.
The figure includes $277 billion in economic costs – nearly $900 for each person living in the United States – and $594 billion in societal harm from loss of life and pain and decreased quality of life for victims who are injured.
Motor vehicle crashes are one of the leading causes of death in the United States. More than 36,000 people are killed in crashes in the United States, including approximately 1,200 in Georgia each year, the NHTSA reports.
Georgia case study: A rear-end collision in Clayton County worth millions
In February 2015, a Georgia man in his 40s was riding as a passenger in a pickup truck in Jonesboro, Georgia. While the truck was stopped at a red light, it was severely rear-ended by another driver.
After complaints of neck pain, the victim was taken by ambulance to an emergency room where he was examined and instructed to follow up with an orthopedist. The orthopedist recommended physical and massage therapy and chiropractic care for about one month.
However, the pain did not end there. The victim then received an MRI, which showed a narrowing of the spinal canal, called spinal stenosis, which can be caused by trauma. Doctors determined that a cervical spine (i.e. neck) fusion was needed. Several months later the victim underwent cervical fusion surgery of discs C3-4, C4-5, and C5-6. Medical care following the surgery included several trigger-point injections and medication to control the pain.
When the case went to trial, the at-fault driver confessed he caused the accident. His insurance company hoped that by admitting fault, the jury would go easy on the defense. However, by the time of trial, the victim’s medical bills exceeded $246,000. An orthopedic surgeon testified that the victim was permanently disabled, and a pain management specialist explained that future medical care would include ongoing trigger-point injections, pain medication, and physical therapy, which could incur future medical expenses of about $375,000.
An expert in vocational rehabilitation also testified that because the victim’s job involved installing utility poles, which requires lifting and standing for long periods of time, that he was permanently disabled from working. Therefore, future lost income was estimated to be more than $620,000.
Finally, the victim himself testified about his constant neck pain, limited range of motion, and inability to work or do the things he enjoys, like riding an ATV and golfing.
The defense lawyer argued that the victim’s injuries and claims for damages were exaggerated and excessive and asked the jury to make a much smaller damages award. However, after a four-hour deliberation, the jury awarded our client more than $3.3 million.
While not all car accident cases are worth this much, having a good trial lawyer can help prove your case. It will also significantly improve your chances of recovering the maximum compensation you may be eligible to receive.
The Millar Law Firm was great and have exceptional lawyers who care about you and your case. Justin Oliverio worked my case and he was diligent and speedy. Always answered my calls and questions.
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