Understanding Ohio Medical Payments (Med-Pay) Coverage

Understanding Ohio Medical Payments (Med-Pay) Coverage

August 6, 2021

Car accidents are stressful events that can leave a person not only traumatized, but also with substantial financial problems. Often a car accident will result in a person sustaining injuries and, sometimes, a tragically lost life. An Ohio car accident attorney could help you determine whether you carry Med-Pay coverage and how it might help you if you were injured in a car crash.

At The Henry Law Firm, we work with clients regularly who need help understanding what it’s like to work with a personal injury lawyer, what Med-Pay is, and how it could help with expenses in the short-term before reaching a larger final settlement.

In 2019, did you know 1,003 people died in a car accident in Ohio? That’s right – car accidents happen more frequently than we think, which is why having expert guidance is vital. When pursuing a car crash claim, you will generally receive a final one-time lump sum settlement. But you may have options to help you pay your out-of-pocket medical expenses and copays along the way. The most popular option is your own auto insurance’s medical payments coverage. 

Should you want to learn more about medical payments coverage, have a look at this convenient guide.

What Is Med-Pay Coverage?

In Ohio, medical payments coverage is an optional auto insurance policy that you must purchase separately from liability, collision, and underinsured or uninsured motorist insurance. Med-Pay coverage helps policyholders pay for medical costs associated with auto accidents up to a certain amount. 

Unlike liability or uninsured motorist coverage, which requires you to prove you were not at fault in the crash, Med-Pay coverage is a “no-fault” coverage – meaning you could make a Med-Pay claim even if you caused the crash.

Med-Pay does not cover a person’s lost income or pain and suffering; only outstanding amounts due (or for reimbursement of amounts you paid out of pocket) for medical treatment directly related to a car crash. The coverage will have a limitations period – meaning those medical charges typically must be incurred within one year of the car accident. However, the time you have to submit your bills for payment can vary depending on your insurance carrier.  

Although Med-Pay is usually pursued through your own insurance, there are instances when you can make a Med-Pay claim through another insurance policy. For example, if you were a passenger in a vehicle and the driver carried Med-Pay coverage, there may be an opportunity to submit your claim through the driver’s insurance. It is important to note that many businesses also carry medical payments coverage to insure their premises. That means if you have an injury at a business – for example, a slip and fall injury at a store – you might be able to submit a claim for your medical bills even if the company or its insurer claims you were at fault. 

It can be challenging to understand who is considered a policyholder, as insurance policies are often complex. The experienced car accident attorneys at The Henry Law Firm are familiar with the various ins and outs of Ohio medical payments coverage and can assist you with determining who is covered under a policy. With our help, you may avoid issues paying your medical bills with a Med-Pay claim.

How Does Med-Pay Coverage Work?

With medical payments coverage, how you receive a claim payout will depend on what your home and auto insurance policies allow, and it will depend on if you live in a “no-fault” state. Med-Pay coverage may issue a check directly to you for your bills, or it may require sending the payment directly to your medical provider.

If medical payments coverage is your primary coverage, you will pay for your medical expenses upfront and ask a specific Med-Pay carrier for reimbursement. Additionally, if Med-Pay is acting as your primary coverage, you won’t need to pay copays or any deductibles commonly associated with health insurance. 

However, the process is different if Med-Pay is acting as your secondary coverage. In this instance, your health insurance will pay for most of your medical bills, but you can use Med-Pay to cover any copays or deductibles.

Why Do You Need Med-Pay Coverage?

It is well known that an “at-fault” party and their insurance company are responsible for your accident-related costs. However, your expenses will not be paid by insurance until after your case is settled. That’s why we advise our clients to consider obtaining this optional insurance policy to avoid upfront costs if they are ever in an auto accident again. 

Med-Pay policy limits can range from $500 up to $10,000+ of medical expense coverage.

Auto accident claims can take months or years to settle, which means you are initially responsible for all upfront medical expenses even if you aren’t at fault. Those with medical payments coverage will have help paying these bills when they first come in, eliminating significant financial strain.

car accident med pay coverage

What Does Med-Pay Coverage Cover?

Although Med-Pay does not cover pain and suffering and lost income, and it will generally not pay for the treatment you may need in the future, there are many things it can help pay for. Below are a few of the expenses medical payments coverage can pay:

  • Various doctors’ visits 
  • Different surgical procedures and X-Ray scans
  • Professional care such as nursing services 
  • Ambulance and EMT expenses
  • Prosthetics
  • Injuries associated with a car that hits you as a pedestrian or cyclist
  • Hospital consultations and stays
  • Dental procedures

What You Need to Know About Med-Pay Coverage

There are two crucial facts you should be aware of surrounding Med-Pay coverage in Ohio. Keep these points in mind when filing a claim or initiating a policy:

  • The Med-Pay portion of your policy is separate from a liability claim. You should be able to receive full financial recovery from a liability policy or your uninsured or underinsured coverage and use your medical payments coverage. 
  • Your auto insurance will typically look to “subrogate” the amounts it pays out under medical payments coverage. That means if your carrier pays $5,000 in medical payments claims, it will likely look to recover that $5,000 back from you when you successfully settle a liability claim. At The Henry Law Firm, we’re experienced in negotiating the lowest possible repayment amounts if your carrier seeks to recover its Med-Pay claim through subrogation. 
  • You must take control of your Med-Pay claim! We prefer to advise our clients’ carriers early on that they should not pay Med-Pay unless and until we instruct them. Waiting to pay helps prevent carriers from unilaterally paying bills that we would otherwise not want them to pay (and avoid subrogation rights). We will continuously pursue strategies designed to maximize your financial recovery, and Med-Pay may or may not be the right option for your case.

Contact An Ohio Personal Injury Lawyer About Med-Pay Coverage

Medical payments coverage can be an incredible asset to those who are involved in auto accidents and who have been injured. Filing a Med-pay claim or understanding how Med-Pay works is often challenging. Therefore, hiring an Ohio personal injury lawyer is highly recommended, so you can get the case outcome you deserve. 

At The Henry Law Firm, we are dedicated to helping you understand the various aspects surrounding your case and medical payments coverage along with whether it will be beneficial for your unique situation. Get in contact with us today.

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