February 2, 2023
Auto Accidents and Health Insurance in Michigan
Imagine: you’ve just been in a car accident, and you need to be hospitalized. Between the ambulance ride and the medical testing and treatment, costs are adding up fast. How are you going to pay for them? In the state of Michigan, medical coverage is provided as part of No-Fault driver’s insurance (mandatory for all drivers in the state). No-fault insurance doesn’t mean that someone can’t be found at fault of an accident, only that each driver’s individual insurance pays for their own medical and damage costs. (With some exceptions depending on the circumstances of the accident.) This portion of Michigan’s No-Fault insurance is called Personal Injury Protection, or PIP.
What Is Personal Injury Protection (PIP) Coverage?
As regulated by law, PIP will pay for “all reasonable medical expenses” with no maximum. But what exactly is “reasonable”? The law can be somewhat finicky in this way. If you’re not sure what, if any, of your injuries may qualify you for a PIP payout, make sure to consult with a car accident attorney right away. Our team is happy to answer any questions you might have.
PIP will also help cover lost wages (due to an inability to work as a result of injuries from your accident) for up to three years. Though, keep in mind, you will most likely have to reach your auto insurance deductible before these PIP benefits begin to pay out. You also have the option to coordinate your health insurance with your PIP coverage; this will allow your medical insurance to take precedence and trigger your no-fault insurance only after your health insurance coverage has been fully utilized.
Medical Coverage Levels
Starting in July of 2020, No-Fault auto insurance policies in Michigan began to allow drivers to choose their level of medical coverage. The total coverage amount plays a key role in determining the driver’s monthly car insurance payments. The options are:
- $50,000 (limited to drivers enrolled in Medicaid)
- $250,000
- $500,000
- Unlimited
Does Medicare Cover Auto Accident Injuries?
All drivers in the state of Michigan are legally required to have MI No-Fault insurance. For this reason, your No-Fault policy will take precedence over Medicare when paying for any medical bills related to an accident. If an inaccurate filing occurs and Medicare is charged in place of your No-Fault insurance, this would be considered a conditional payment. This simply means that your auto insurance will reimburse Medicare for any expenses that should have been paid for under your No-Fault policy.
If you have Medicare and have chosen to opt out of the PIP benefits of your auto insurance policy, Medicare will provide coverage toward your accident-related medical expenses.
Coverage Exclusions
If you are considering coordinating your PIP coverage and health insurance benefits, or if you are looking to potentially lower your PIP coverage, make sure to look at the fine print! Because No-Fault insurance requires PIP, many Michigan health insurance providers have begun to include “auto accident exclusion” provisions which specifically exclude coverage for any injuries or medical expenses that occur as a result of an automobile accident. These exclusions have started to become more and more common as employers attempt to reduce medical insurance costs.
Not sure if you’re covered? Have questions about existing or potential claims? Need help getting the benefits you deserve? When you schedule a free consultation with the team at Elia & Ponto, we walk through your case with you, lay out your options, and fight for what you’re owed. Oh, and did we mention that we’ll come to you? Yes, we do that too. There’s no risk, only reward—call today!