How Does Med Pay Work?

I highly recommend to all my clients that they purchase Medical Payments (Med Pay) coverage when insuring their vehicle (s). Med Pay coverage is cheap and really helps out when one is injured in a car accident. If you are injured in a car accident, motorcycle accident, truck accident, bicycle accident, and even a pedestrian accident, Med Pay benefits can greatly help you pay your resulting medical bills.

What Is Med Pay & How Does Med Pay Work?

Med Pay is a type of insurance that you purchase when insuring your vehicle or vehicles. Med Pay is a benefit that kicks in if you sustain injuries in an accident. Most people purchase the minimum med pay coverage of $5,000. Accordingly, if you are injured in a car accident, you can call your own insurance company and let them know that you will be seeking treatment for your injuries. Your insurance company will then assign an adjuster to pay your medical bills as they are incurred. For example, if you visit the emergency room of your local hospital, after your accident, then your insurance adjuster will pay your ER bill, up to $5,000. Thus, if your ER bill is $3,000, then your insurance company will pay that bill in full. If your ER bill is $10,000, then your insurance company will pay out the entire $5,000 in benefits, leaving yo with a balance of $5,000 that you will either need to submit to your health insurance or would need to pay out of pocket.

In Colorado, Med Pay is “optional coverage”. You are not legally required to have it. But, Colorado law on Med Pay, enacted in January of 2009, requires all insurance companies to bind Med Pay coverage for everyone (unless it is rejected by the client or customer). So even though Med Pay is not required in Colorado, the insurance companies have to give it to you unless you say “no” in writing. As most people know, Colorado law does require every driver to carry at least $25,000 in bodily injury coverage, per person, per accident (protects you from being sued by the “other driver”), $50,000 bodily injury coverage for all people involved in an accident and $15,000 in property damage (damage to a vehicle). You cannot waive or reject BI and PD coverage in Colorado (like you can for Med Pay).

Med Pay Insurance – Essential Details

Med Pay insurance in Colorado is designed to cover reasonable medical expenses arising from physical injuries if you figure in a car accident.

Med Pay is not part of your medical insurance, but is actually a part of your car insurance coverage. There are no deductibles to be met with Med Pay, unlike in, say, medical insurance. However, Med Pay insurance can cover co-pays required in your medical coverage.

Just like most other types of insurance, Med Pay comes in packages or levels. The minimum offer that insurance companies can make is pegged at $5,000.

As the insured, you have the freedom to choose more coverage for yourself. Of course, opting for a higher coverage package also means higher premiums. Med Pay coverage provided by insurers usually come in the amounts of $5,000, $10,000, $25,000, and $100,000.

With Med Pay insurance, everyone in your vehicle during the crash gets coverage. Med Pay also covers any injuries you sustain as a passenger in someone else’s vehicle during a car accident. Additionally, you get protection if you are hit by a car and you are not inside a vehicle. 

Reasonable Expenses Covered By Med Pay

As mentioned, Med Pay insurance is meant to cover medical expenses for any injuries you sustain in a vehicular accident. Such expenses must be deemed reasonable to be covered. Med Pay covers the following:

  • Emergency care administered by first responders, such as emergency medical technicians at the crash site
  • Ambulance rides
  • Emergency room care
  • Medical imaging services, such as X-rays, MRIs, CAT scans, etc.
  • Diagnostic services
  • Surgeries
  • Pain relief medications and pharmacy expenses for medication
  • Bills for long-term hospital stays
  • Physical therapy

Med Pay can also provide good coverage, even in situations where you get injured because of an uninsured driver’s negligence. In such cases, you really don’t have the option to make a claim against any insurer.

In these situations, you will receive help in offsetting the amount your insurer has to pay out for your medical bills with Med Pay coverage. And the best thing about Med Pay is that it’s relatively affordable, so you risk very little to receive flexible and very useful coverage. This is why choosing to have Med Pay is a smart and practical choice.

Expenses Not Covered By Med Pay Insurance In Colorado

Med Pay insurance is very specific. It can only cover medical expenses related to injuries sustained from a car crash. Therefore, it does not cover the following:

  • Loss of income or wages
  • Loss of one’s earning potential due to long-term injuries
  • Pain and suffering in any form
  • Loss of consortium suffered by your spouse or family
  • Payments relating to any type of property damage, such as car repair costs
  • All other expenses exceeding the policy limit

Also, keep in mind that Med Pay coverage limits itself only to car accidents. 

If you need treatment for medical conditions that have nothing to do with the accident, Med Pay does not cover those. Additionally, it is highly unlikely for Med Pay to cover experimental treatments — even if those are directed toward the rehabilitation or treatment of injuries you sustained in a car accident.

How Med Pay Insurance Figures In Relation To Other Types Of Insurance

Med Pay is a first-party type of car insurance, so it is clubbed with your car insurance coverage. You have the option to refuse it, but you need to do so in writing. Med Pay only compensates the policyholder, and it does not in any way cover people who are hurt or injured by the insured in an at-fault car accident. For example, if you are at fault in a car crash and you injure people in the process, Med Pay won’t cover their accident-related expenses.

Since Med Pay is not a type of medical insurance, it only covers losses arising from injury sustained in a car crash. If you get hurt or injured in a different way, Med Pay will not provide you with the coverage you need. So, you cannot use Med Pay as a substitute for your medical insurance.

You can probably consider Med Pay as a hybrid type of cover hovering between a basic car insurance and medical insurance. It is useful to have Med Pay as it functions as a supplement to medical insurance. Having Med Pay becomes especially significant when you use it to fill in for medical insurance, which usually involves high deductibles or co-pays.

Will Your Insurance Premium Increase If You Use Med Pay Coverage?

If you were proven to be at fault in a car crash, your car insurance company could raise your Med Pay premium. But if you were not at fault, your car insurer cannot increase Med Pay premiums.

How Does Med Pay Work In Colorado?

As I said previously, Med Pay is optional coverage and not legally required in Colorado (like is the case for bodily injury and property damage coverage). However, Colorado does require every insurance company to offer Med Pay. So, everyone will have Med Pay in Colorado, unless they specifically reject it. This is very important to remember. Unless you specifically reject Med Pay, in writing, then your insurance company is legally required to bind that coverage for you. If you reject Med Pay, then you would need to sign a form with your insurance company rejecting this coverage. Sometimes, drivers do not believe they have Med Pay, but they do have it. This commonly occurs when a driver thinks he or she has rejected this coverage. If your insurance company does not have your signed rejection on file, then you will legally have Med Pay coverage (even though you may have thought you did not have it).

Have Your Attorney Answer “How Does Med Pay Work?”

When a client comes to me and says that he or she does not have Med Pay coverage, I still investigate whether or not that is true. I have a lot of clients who say “no, I don’t have Med Pay”. I will say ok, but will call my client’s insurance company and specifically ask them to send me a copy of the signed waiver of med pay coverage. If the insurance company says they cannot find it or something similar, then I tell the insurance company: “Ok, I will now assume that my client does have $5,000 in Med Pay and will send my client’s bills to you for payment”. The insurance company has no choice but to pay my client’s medical bills (up to $5,000). They were not able to produce a signed waiver, so they are legally bound to provide Med Pay coverage.

How Much Med Pay Coverage Should You Purchase?

The minimum Med Pay coverage is $5,000. Is this really enough? In today’s world of increasing medical care costs, I highly recommend that drivers purchase more than $5,000 in Med Pay. I have $25,000 in Med Pay coverage because I know the consequences of not having good Med Pay coverage. I highly recommend that drivers carry at least $10,000 in Med Pay. If you only have $5,000, then those entire benefits can easily be eaten up with one trip to the emergency room. For that reason, I recommend to my clients that they purchase at least $10,000 in coverage. Med Pay coverage is incredibly cheap and normally costs around $5-$15 per month. Get the most coverage that you can afford as it will help you immensely when you are injured in a vehicle accident.

Tell Your Insurance Agent “I Want Med Pay”

Have Your Insurance Agent Explain “How Does Med Pay Work?

The bottom line is that you should always tell your insurance agent that you want Med Pay. It is then up to you to decide how much Med Pay to purchase based on your current budget and financial situation. Don’t sign a waiver saying you are declining this coverage! You will regret it as soon as you are injured in an accident. You may say to yourself, but I have health insurance. Health insurance is great, but there are many exclusions in health insurance policies for those injured in car accidents. You cannot rely on your health insurance to pay all of your medical bills resulting from an accident. Not everything or every doctor will be “covered” by your health insurance. Med Pay covers everything and everyone so it is a much better coverage for your injuries than is health insurance.

Also, when I settle your case, I will have to pay back your health insurance company the amount of money that they paid for your medical bills. Your health insurance carrier will have a “LIEN” on your settlement. Med Pay does not have such a Lien on your settlement money and thus I will not have to pay your Med Pay carrier anything upon settlement. As an example, say I settle your case for $12,000 and your health insurance company paid out $3,000 towards your medical bills. I would have to pay them back the $3,000 directly out of the $12,000 settlement. If your Med Pay carrier pays out $3,000 towards your medical bills, then I do not have to pay them a dime out of your settlement money. There is no lien!

You should now have a good understanding of “how does Med Pay work?” If you need any help choosing the proper amount of Med Pay coverage, please contact me. I would be more than happy to help you decide how much Med Pay coverage that you need to buy. I am always available by phone, text or email. Please do not hesitate to contact me. If you need an experienced and expert attorney in car accident cases, then please contact me. I have more than 30 years of experience handling all kinds of vehicle accident cases, involving very minor injuries on up to death cases. I used to represent insurance companies like State Farm and GEICO. Let me use that valuable experience to get you the best settlement possible.

For the expert legal advice concerning Med Pay insurance in Colorado, please contact Allen Accident Law.


Back to Home Page

Related Posts