PIP vs. Medical Payments Coverage: How Your Car Insurance Pays for Injuries

PIP vs. MedPay at a glance

How personal injury protection works

Triple-I describes PIP at its broadest as covering medical payments, lost wages and the cost of replacing services an injured person would normally perform, such as child care or housework, and sometimes funeral costs. It covers you and your passengers, and in many states it also covers you as a pedestrian or when riding in someone else's car.

In the 12 no-fault states and Puerto Rico, PIP is mandatory: Florida, Hawaii, Kansas, Kentucky, Massachusetts, Michigan, Minnesota, New Jersey, New York, North Dakota, Pennsylvania and Utah. Some at-fault states also include it. Oregon's DMV lists PIP among required coverages, and Maryland requires insurers to provide PIP, which some policyholders may waive using a state form. Benefit levels, deductibles and options differ a lot from state to state; Michigan, for example, lets drivers choose among PIP medical coverage levels.

How medical payments coverage works

MedPay pays reasonable medical and funeral expenses for you and your passengers after a crash, regardless of fault, up to the limit you choose. It generally doesn't pay lost wages. It's usually optional and is sold mainly in states that don't require PIP, though availability varies.

MedPay is often most useful for:

• Covering health insurance deductibles and copays after a crash
• Protecting passengers who may not have their own health coverage
• Paying quickly without waiting for a fault decision

How PIP and MedPay work with health insurance

The order of payment depends on your state's laws and your policies. In some states, PIP pays first and health insurance pays after PIP limits are used up; in others, you may be able to coordinate benefits so health insurance pays first, sometimes for a lower PIP premium. Health plans may also seek reimbursement from an auto settlement through subrogation.

If you have good health insurance, you might choose lower MedPay limits. But health insurance doesn't replace lost income, and it won't cover passengers who aren't on your plan. PIP's wage and service benefits can matter a lot to households that depend on one paycheck.

Where PIP fits in no-fault states

No-fault laws make your own PIP the first source of payment for injuries after a crash, regardless of who caused it. In exchange, they limit your right to sue the other driver unless your injuries meet a threshold, such as a serious injury (a verbal threshold) or medical costs above a set amount (a monetary threshold). Property damage is still generally handled based on fault.

Our guide to no-fault vs. at-fault states explains thresholds and "choice" states in detail, and you can check your state's rules on its page in our state directory.

How to decide how much to carry

• If PIP is required, start with the state minimum and ask what higher limits and options cost. Check your state's required coverages with the coverage checker.
• If your health plan has a high deductible, MedPay or extra PIP can fill that gap.
• If you often carry passengers, such as children or carpool riders, these coverages protect them regardless of fault.
• If you'd struggle to cover lost income, PIP with wage benefits, where available, may be worth more than MedPay.
• Don't confuse these with liability. PIP and MedPay protect people in your car; liability pays others you injure. Uninsured motorist coverage adds protection when another driver is at fault and can't pay; see uninsured motorist coverage.

Common gaps and exclusions

• Limits run out. Required PIP amounts in many states are modest compared with the cost of a serious injury, so larger bills flow to health insurance or to a claim against the at-fault driver.
• Lost wage caps. PIP wage benefits are usually a percentage of income up to a weekly or total limit.
• Excluded situations. Policies commonly exclude injuries while committing a crime, racing, or driving a car you own that isn't insured. Some exclude injuries while working in a vehicle used for business.
• Deductibles. Some states allow PIP deductibles that lower the premium but increase what you pay first.
• Non-economic losses. Neither PIP nor MedPay pays for pain and suffering. That comes from a liability claim against the at-fault driver or your uninsured and underinsured motorist coverage.

A simple example

Suppose you and a passenger are hurt when another driver runs a stop sign. In a state where you carry PIP, your policy pays both of your medical bills up to its limits and, if you miss work, part of your lost wages, without waiting for a decision about fault. In a state where you carry MedPay instead, it pays medical bills up to your MedPay limit for both of you, but not your lost income. In either case, if your costs exceed those limits, you can pursue the at-fault driver's liability insurance, subject to your state's no-fault rules, or your underinsured motorist coverage. This is a general illustration; your policy and state law determine the details.

Filing a PIP or MedPay claim

1. Get medical care promptly and tell providers the injury came from a car crash.
2. Notify your auto insurer quickly. Some states set short deadlines for PIP claims or for getting initial treatment.
3. Keep bills, receipts, mileage to appointments and proof of lost wages.
4. Ask your insurer whether bills should go to the auto policy first or to your health plan.
5. Keep copies of all forms and correspondence, and ask for denials in writing.

For the full claim process, including when people consult an attorney, see what happens after a car accident.

Related guides

• No-Fault vs. At-Fault States: How Car Insurance Pays After a Crash
• Uninsured and Underinsured Motorist Coverage: How UM/UIM and Stacking Work
• What Happens After a Car Accident: Claims, Rate Increases and When People Call a Lawyer
• Minimum Car Insurance Requirements: What "30/60/25" Means and Why It's Rarely Enough