What Exactly is "Med Pay" Insurance in California

Posted over 4 years ago. Applies to California, 5 helpful votes



What "Med Pay" Is

Medical Pay Benefits coverage is simply known as "Med Pay" and it is additional coverage that attaches to an individual's automobile policy. This additional policy must be chosen by the policy holder; that is, it is not required in California. In other States, it is mandatory and it is known as "PIP Coverage" or "Personal Injury Protection (PIP);" for example, the States of Texas, and Florida have such a mandate. These policies have specific coverage limits that must be reasonably related for necessary medical care to an automobile accident causing bodily injury; usually you see them in amounts of $1,000.00; $2,000.00; $5,000.00; $10,000.00; $25,000.00; and $100,000.00. In my law practice, I typically see $1,000.00 - $10,000.00 limits, with the occasional $100,000.00 plus in available limits.


What "Med Pay" Coverage Does For You In California

If you, or any of your passengers, are injured in an automobile accident in California, whether it is your fault, or the other driver's fault, your insurance with Med Pay coverage will be responsible for paying all of your (and your passenger's) reasonable and necessary medical bills as a result of any bodily injury that arises from said accident. Some folks are hesitant about using this benefit coverage because they worry their insurance rates will go up; however, insurance companies cannot raise your insurance rates for utilizing your insurance benefits, including Med Pay coverage, if you were NOT AT FAULT in an automobile accident; however, Med Pay coverage applies REGARDLESS OF FAULT.


Information To Know On "Med Pay" Coverage

Simply put, it is like having additional health insurance attached to your automobile policy and it contains a liberal coverage for many different types of medical care. The point to remember is the medical care must be accepted medical care in the community and it must be: 1. necessary; 2. reasonable; 3. and due to injuries from an accident (some policies dictate time constraints on beginning the medical care; for example, I have seen some Med Pay policies specifically state the medical care MUST begin within the first year following an auto accident, OR all medical bills, or the medical bills must be submitted within the first year following the auto accident. As you can see above in item 3, it is EXTREMELY important to know your Med Pay policy and any exclusions it might have; particularly if you were involved in an auto accident, it is best to see if you have Med Pay, and if so, get familiar with any exclusions and all the benefits it has under the policy.

Additional Resources

The California Department of Insurance has a link of what to know while shopping for automobile insurance.

California Department of Insurance

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