Medical Bills from a Massachusetts Car CrashIf you were injured in a car accident in Massachusetts that was caused by another driver, you probably worry about who is going to pay your medical bills. This is a very common concern many accident victims have. With the increased cost of food, gas, electricity, and more, the last thing anyone wants to worry about is paying medical bills for injuries that were caused by someone else. Enter: Your Framingham motor vehicle accident attorneys.

Before we answer the question of whether you should let your health insurance pay for your medical bills after a car accident in Massachusetts, you should understand who will be responsible for covering said medical bills. While many people believe that the other, negligent driver that caused the car crash and your injuries should pay medical bills, this is not the case in Massachusetts. Here's why...

PIP is Initially Responsible for Paying Medical Bills

Right after an accident, your auto insurance carrier is initially responsible for paying medical bills from the Personal Injury Protection (PIP) benefits. Generally, PIP benefits will cover up to $8,000 of medical bills unless you have private health insurance. In that case, PIP will cover the first $2,000 in medical bills.

Health Insurance Will Pay Medical Bills Once PIP is Exhausted

Once the PIP benefits are exhausted, your medical bills should be paid by your health insurance. There are most likely co-pays and deductible payments due to the medical providers for your treatment, depending on your health insurance plan. These would be your responsibility to pay while you are treating and before any potential settlement of your car accident injury claim.

Keep in mind, however, that if there are remaining PIP benefits even after they are exhausted, any medical bills that health insurance did not cover (i.e., the co-pays and deductibles) should be submitted to the PIP carrier to pay. For a more detailed explanation of this matter, you should read our article Dealing with Outstanding Medical Bills After an Accident.

You Should Let Your Health Insurance Pay Your Medical Bills

Once PIP is exhausted, we always recommend that your medical bills be submitted to your health insurance company. In almost all car accident cases in Massachusetts, if health insurance makes payments for treatment of the injuries suffered in the car crash, they will seek reimbursement for those payments.

Now, I know what you’re thinking; why do I have to reimburse my health insurance after a car accident? In Massachusetts, a portion of the damages sought in a personal injury claim is for compensation for the medical bills incurred. However, if your health insurance company paid for those bills, they may be entitled to be reimbursed for the amount of the bills they paid, especially if you have MassHealth or Medicare, after you settle your injury case.

When you submit a demand for settlement to the negligent driver’s auto insurance carrier you will seek compensation for the full amount of the medical bills. Generally, a successful settlement will include compensation for the total medical bills, excluding the PIP offset.

Your health insurance company, though, will pay your medical bills at a discounted rate. Thus, when you must reimburse them after a settlement, you only have to pay them back for the discounted amount they actually paid – not the full amount of the medical bills. For example, if you have a doctor or physical therapy bill for $500, your health insurance company would pay a discounted rate rather than the total bill, probably $200 or so.

Consequently, when you settle your case, you would be compensated for the full $500 bill, but only reimburse your health insurer for the $200 they paid, rather than pay the doctor or physical therapist the full $500. That means you get more money in your pocket after a settlement.

Our Framingham Car Accident Lawyers Can Help

If you or a loved one were injured in a car accident and you are concerned about how the medical bills are going to be paid, you can call our car accident attorneys in Framingham. We have 50 plus years of combined experience helping accident victims all over Massachusetts recover the compensation they deserve and making sure all the medical bills are covered. Feel free to contact us for help or answers to your questions.

Charles S. Pappas
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Massachusetts injury & workers' compensation attorney serving accident victims in Webster & Framingham.
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