MedPay or PIP: Which Medical Coverage Is on Your Auto Policy?

Medical payments coverage, known as MedPay, and personal injury protection, known as PIP, both pay for injuries to you and the people riding with you, no matter who caused the crash. What separates them is scope. MedPay stops at medical bills. PIP also covers non-medical losses such as the wages you miss and the household tasks you can no longer handle. Which one you can buy is largely a matter of where you live: PIP is the standard coverage in no-fault states, while MedPay is the optional add-on most other states offer.

What medical payments coverage covers

MedPay is the simpler product. The National Association of Insurance Commissioners describes it as paying for treatment of injuries to you and your passengers. Because it never asks who was at fault, it tends to pay early, often while the fault investigation is still underway and well before any settlement with the other driver. What it does not do is replace lost income or reimburse you for help around the house. Under many policies the coverage also follows you rather than the car, so it can apply when you are a passenger in someone else's vehicle, although the precise wording differs by company.

What personal injury protection adds on top

PIP begins in the same place and continues further. Washington's Office of the Insurance Commissioner describes PIP as paying for medical and hospital costs, wages lost from missing work, services you cannot perform because of the accident, and funeral costs. The third item, usually called replacement services, is the one most people miss. If you normally drive your children to school or mow the lawn and cannot do so for six weeks, PIP is the coverage built to pay someone else to do it.

PIP also tends to protect a wider circle of people. In Washington, the coverage extends to the person named on the policy, household residents related by blood, marriage, or adoption, step and foster children, and non-family passengers and pedestrians. The details vary from state to state, so read your own policy rather than assuming another state's rules apply to you.

• MedPay: medical and hospital bills for you and your passengers, with no question about fault.
• PIP: the same medical bills, plus lost wages, replacement services, and funeral costs.
• Both pay regardless of who caused the crash, which is why they usually pay sooner than a liability claim against the other driver.
• Neither one fixes your car. That falls to collision coverage or to the at-fault driver's property damage liability.
• You choose limits when you buy the policy, and both coverages stop paying once the limit is exhausted.

Why your state picks the coverage for you

The NAIC notes that PIP is available in no-fault states, where your own insurer pays for injuries to you and your passengers regardless of who is at fault. In those states PIP is usually the required or default medical coverage. Elsewhere, insurers typically offer MedPay as an optional add-on instead, and a few states make both available.

Some states also dictate how the coverage must be presented to you. In Washington, buying PIP is your choice, but the law requires your insurer to offer it, and if you decline you must reject it in writing or the insurer will add it to your policy and bill you for it. That is Washington's rule specifically. Other states handle the offer differently, and if you are not sure how yours works, your state insurance department publishes a consumer guide that explains it.

Is it still worth having if you carry health insurance?

Frequently, yes, for three reasons. Your health plan covers you, not the passengers in your car, so when a friend is injured riding with you, MedPay or PIP responds without anyone needing to sue. Your health plan also carries a deductible and cost-sharing that this coverage can absorb. And a health plan pays doctors, not paychecks. Only PIP replaces lost income.

On the other side, you may be paying twice for the medical portion if you already have solid health coverage, which is the usual argument for a modest MedPay limit rather than a large one. It is a real trade-off, and the right answer turns on your health plan's deductible and on whether your state gives you the choice in the first place.

Questions worth putting to your insurer:

• Does my state offer MedPay, PIP, or both, and is one of them already on my policy?
• What limit am I carrying, and is it per person or per accident?
• Does the coverage apply when I am a passenger in another car, or on foot?
• Does my policy require me to submit bills within a set period or to use particular providers?
• If I later receive a settlement from the at-fault driver, does my insurer get reimbursed from it?

When the other driver caused the crash

Your MedPay or PIP still pays first. That is the whole purpose of it. Most policies, however, allow the insurer to recover what it paid if you later collect from the at-fault driver, so the money is not always yours to keep twice over. This surfaces in the settlement arithmetic rather than in your day-to-day treatment, and it is worth asking about before you sign a release with the other driver's insurer.

The bottom line

If you live in a no-fault state, PIP is probably already on your policy and the real decision is how much of it to carry. If you do not, MedPay is a relatively inexpensive optional coverage that bridges the gap between the crash and the day fault is settled, and it is most valuable if you regularly carry passengers or have a high health-insurance deductible. Neither coverage replaces health insurance, and neither one repairs the car. Pull out your declarations page, find the line labeled medical payments or personal injury protection, and confirm what you actually have before you need it.

Not sure which coverage you have or how much is enough? Lanewise Auto offers plain-English guidance. Tell us what you want help with and we will walk you through it. Nothing to buy, no obligation.