Does Health Insurance Cover Car Accident Injuries?

In order to be allowed to drive a car legally, you have to purchase a car insurance policy that is separate from your other insurance policies. Along with this policy, you likely have some form of health insurance. So if you are injured during a car accident, who is responsible for the bill? The answer is a combination of these services, depending on both your coverage and the coverage of the other drivers involved. When you walk into the auto accident clinic, you will need care no matter how it is paid for, but it can be helpful to understand the logistics.

Understanding Car Insurance

The best way to determine what is covered via health insurance is to understand the details of both your insurance policies.

Some health insurance plans will classify injuries from an auto accident as secondary coverage, meaning they won’t cover medical expenses until auto insurance limits have all been met. Your policy likely has two different limits.

Liability insurance is designed to cover the bodily injuries to another driver in cases where you are at fault. This means that your liability coverage will never go towards paying your own medical bills. However, if another driver is at fault for your injuries, their liability insurance will be the first method of payment for your medical bills. You will be reliant on their coverage being sufficient in this case.

You may also have Personal Injury Protection, or PIP insurance, as a part of your policy. This is typically optional, unlike liability insurance, though rules vary by state. PIP provides reimbursement for medical expenses incurred by the policyholder, whether you were at fault or not. PIP may provide some coverage, though it usually has limits on how far it will go.

Health Insurance

The terms of your health insurance policy will, in part, dictate what you owe after an accident. Where applicable, liability insurance and PIP will be treated as the primary policy and applied towards your charges until you hit the limit. From there, health insurance can step in to cover additional needs.

You will still be responsible for a deductible, copayments, and anything outside of your usual coverage. If something like an alternative treatment is not covered by health insurance, it is best to use a claim payout on this and save traditional medical care for your insurance.

A process called subrogation allows health insurance carriers to recover the cost of your medical expenses from the other driver’s health insurance in instances where they were at fault.

Ensuring Coverage

While you can’t change insurance policies after the fact, there are steps you can take during the process of your treatment to get the best possible coverage.
It is always critical to seek care as soon as an accident occurs, whether you are exhibiting symptoms of an injury or not. Many common injuries sustained in accidents will be hidden for hours, days, or even weeks after the event, giving them time to worsen. Seeking care is critical for your health, but it is also something insurance will look for during a claim process. The more time that elapses, the more difficult it is to prove that your injuries were related to the crash and insurance may argue the claim. Additionally, if your condition worsens, your costs will rise. A skilled auto accident clinic will be able to identify any injuries immediately and create documentation that proves it is a result of your accident.

Insurance will rely on medical records to make decisions about what to cover and how much to pay for the services. While all car accident doctors can provide records, an experienced auto accident clinic will know the type of information insurance is looking for and usually keep much more detailed notes for this purpose. Relying on experts in this way can improve your chances of having a claim covered because they provide information that demonstrates your injuries, their relationship to your accident, and how they will help you recover.

It is important to be honest and upfront with your care provider so that they can provide insurance with the best information possible, as well as provide you the proper medical care. Even if you are at fault in an accident, you will be entitled to coverage for your injuries and to recover.