If you're hurt in an accident that's someone else's fault, you may wonder who's going to pay for your medical treatment. A personal injury settlement is great—as is a favorable verdict on the very rare occasion when a personal injury lawsuit goes to trial. But those future outcomes won't help you pay your medical bills now. This article will discuss how your medical bills get paid on an ongoing basis. The simple answer is that it depends on the type of accident you have, the state where you live, and the type of insurance coverage involved. Read on for the details.
The most important thing to know is that, if you get into an accident, you are generally responsible for the payment of your medical bills as you incur them. The only exceptions are usually car accidents in “no fault” states (discussed below) and accidents involving "medical payments" (or "med pay") insurance coverage.
Even if the person who injured you is clearly at fault, the law does not require him or her to pay your medical bills on an ongoing basis. The only thing the law requires is that, if the other person is found at fault in court, he or she must pay your damages—and in a personal injury case, your medical treatment is a big part of those damages. But the defendant does not have to pay your medical bills as they come in. Learn more about damages in a personal injury case and how medical treatment affects the value of an injury claim.
If you're injured in a car accident, quick payment of your medical bills often depends on whether the accident happened in a “no fault” state. No fault car insurance means that your own automobile insurer will pay some or all of your medical bills if you get into a car accident, (often more promptly than in traditional "fault" states) regardless of who was at fault for the accident, up to the limits of your no-fault coverage.
After your medical bills exceed the state’s “no fault” limit, you are responsible for paying them. If you have health insurance, your health insurer will pay your medical bills. If you are on Medicare or a state run health insurance program through Medicaid, those entities will pay the bills. If you do not have health insurance, Medicare, or Medicaid, then you are responsible for working out payment arrangements with your health care providers.
It's important to note that if your medical bills exceed a certain amount (or your injuries qualify as sufficiently serious) you'll be able to step outside the no-fault system and file a traditional liability claim against the at-fault driver, but this process will almost certainly take a while to resolve, so you'll still need to find a source of payment for incoming medical bills.
Learn more about how no-fault car insurance claims work.
If you get into a car accident in a state that does not have no-fault insurance, you will generally be responsible for paying your medical bills as they accumulate. However, some drivers in these states have medical payment insurance coverage (known as “med pay” coverage). “Med pay” coverage will pay the medical bills of drivers or passengers involved in a car accident with the insured, up to the insured’s “med pay” policy limits, which are generally less than $10,000. After your bills exceed the “med pay” policy limits, you will be responsible for paying them. “Med pay” coverage is not always required, so if neither you nor the person at fault for the accident have “med pay” coverage, you are responsible for paying the bills.
In a premises liability or slip and fall case, the injured person will generally be responsible for payment of his or her medical bills, unless the property owner’s liability insurance policy includes “med pay” coverage. If the policy does include “med pay," then the insurer will likely pay the injured person's medical bills up to the “med pay” policy limits. After that, the injured person is responsible for paying the bills.
If you get hurt in a work-related accident and you make a workers' compensation claim, the workers’ compensation insurer will likely pay all of your medical bills. You do not typically have to pay any bills or deductibles. Further, many states require the workers’ compensation insurer to reimburse you for transportation expenses (mileage, tolls, and parking) for travel to and from your medical appointments.
If a health insurer, Medicare, or the state agency administering Medicaid benefits pays your medical bills related to your accident, they are entitled to be reimbursed for what they paid your health care providers, if you eventually receive a personal injury settlement or a favorable court verdict against the defendant. Learn more about health care liens in personal injury cases.