Medpay

THE PROBLEM You will have to pay the bills if you’re hurt in a car accident and you don’t have health insurance; even if it’s not your fault. Here’s another problem.  You may have to pay back your health insurance company if they pay your medical bills after a motorcycle accident; even if it’s not your fault.

For nearly twenty years, I have committed my practice to achieving superior results for accident victims seriously injured or killed in trucking, motorcycle and auto accidents.  I’ve noticed a recent trend following the recession.  Many of my clients do not have health insurance and have no way to pay their medical bills.

Most people assume that someone else will pay their medical bills if a trucking, motorcycle or car accident is not their fault.  Unfortunately, this is not true.  If the at fault driver’s insurance company refuses to accept responsibility, they will not pay.  Even if the insurance company accepts responsibility, they rarely pay medical bills before a final settlement.  Typically, settlement is paid in one lump sum after all treatment has concluded.  This can take many months from the time of the accident.  In the meantime, the accident victim needs a source of payment to see a doctor.  If they have no health insurance, doctors will refuse to treat them.

Another problem arises even if an accident victim has health insurance.  In some cases, an injured victim will have to reimburse the health insurance plan from his settlement proceeds.  I wrote an article on the technical issues presented by these Health Insurance Plans in my recent blog, “Protecting your Claim from an ERISA Lien.” See http://burkeylawfirm.com/protecting-your-claim-from-an-erisa-lien/.

THE SOLUTION The solution to these problems is to purchase Medical Payments Coverage, often referred to simply as “med pay.”  Med pay is one coverage part found on a typical auto policy.  This coverage pays medical bills or funeral expenses in the event you are injured or killed in an accident.  Med pay will pay regardless of fault.  There is no deductible or co-insurance payment as with most health insurance policies.  You are not required to seek a participating provider.  Most of the time, you can have your doctor direct bill the med pay coverage just as you would with a PPO under a standard health insurance policy.  In most all cases, you won’t be required to reimburse the med pay coverage from your settlement.  And, the coverage is relatively cheap compared to what you pay for liability coverage.

HOW MUCH? For folks who have no health insurance, I recommend med pay of no less than $50,000.00.  For folks who have an employer health insurance plan that is fully funded by the employer (in other words, if it is subject to ERISA), I recommend no less than $50,000.00.  For folks who have a traditional health insurance policy, I recommend at least 10,000 to $25,000 depending upon whether the policy has a high deductible, co-insurance and strict PPO requirements.  For folks who have HMO style health insurance plans, I recommend no less than $50,000 since these plans are focused on managed, preventive care and are typically hostile to specialists (such as orthopedics) and providers outside their network.

In any of the above scenarios, buy as much as you can afford.  Medical costs can be enormous.  I recently helped a severely injured client who had almost been killed in an auto crash.  After a life flight, hospitalization for three weeks, surgery and rehabilitation, his medical bills were approximately $400,000.00.

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