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Understanding MedPay

Nov 4, 2019 Brown Moore

Partner Jon Moore joins Paige Pahlke to discuss MedPay. MedPay is short for medical payment coverage. MedPay is available as an add-on with many automotive insurance policies is no-fault, and covers anyone in your car. This means if you have MedPay and you are at fault in an automobile collision, you can still have medical expenses covered for yourself or others. While making a MedPay claim is not difficult, you do need medicals bills and proper documentation to submit to the insurance company.

Key Moments From The Episode:

  • [1:00] – What is MedPay?
  • [1:59] – How do I get MedPay or know if I have it?
  • [3:30] – How do I make a MedPay claim?
  • [5:02] – Does making a MedPay claim raise my rates?
  • [6:00] – Do I have to pay an attorney to make a MedPay claim?
  • [7:06] – Is there a time limit to file a MedPay claim?

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When Accidents Happen is a podcast by Brown Moore and Associates, a personal injury law firm based out of Charlotte, NC. This podcast is for general information purposes only. It does not constitute legal advice and is not a substitute for consulting an attorney. You should always consult an experienced personal injury attorney about your unique situation before making legal decisions. Visit our website for more online resources at, or better yet, call 704-335-1500 for a free initial intake interview so Brown Moore and Associates can evaluate your case.

Read Full Transcript

Announcer:[00:02]Chances are you’re here because of an accident involving yourself or someone you love. Before the dust even settles, you’re dealing with an insurance company that doesn’t have your best interests at heart. You may be feeling overwhelmed, you may be feeling scared. Welcome to When Accidents Happen, a podcast brought to you by the attorneys of Brown Moore & Associates. With more than five decades of experience, our attorneys are here to guide you through these uncertain times and provide you with the information and answers you need today.
Paige Pahlke:[00:37]Hey everybody, this is Paige Pahlke again. I have Jon Moore here with me today, and we’re going to cover a topic that we touched on in some of our other podcasts. We’re going to jump more into med pay today or medical payments and what that is and how you go about getting it.
Paige Pahlke:[00:51]Welcome, Jon, I’ll let you go ahead and kick us off. Tell us what med pay is.
Jon Moore:[00:56]Thank you, Paige. Thank you for having me here. Med pay is really just a shorthand term for medical payments coverage. That is coverage that individuals have under their own automobile policy that covers not only them, but also would cover family members of theirs, as well as people that might be friends and happen to be in their vehicle at the time. It is a no-fault insurance coverage, and what that means is that it pays regardless of who caused the collision. In other words, I could have caused the collision, and I could’ve gotten hurt in that collision which was 100% my fault, and I have some medical bills that come up. My med pay coverage under my automobile policy, if I have it, will cover that. So that’s what it is.
Paige Pahlke:[01:45]Jon, how do you go about getting med pay?
Jon Moore:[01:48]Sure. That’s something that people often have when they first get their automobile policy, or you can get it during a renewal period if you don’t have it, but you need to talk with your insurance agent about it.
Jon Moore:[02:00]The great thing about medical payments coverage is it is very cheap. It is great. It’s really like health insurance, and it can help people who have high deductibles to cover the costs that they would otherwise incur through those deductibles.
Jon Moore:[02:14]Usually what we see is medical payments coverage ranges between $1,000 and $10,000. It may be possible to find some insurance companies that write higher amounts of medical payments coverage, but that’s the standard amount that we see.
Jon Moore:[02:29]To get $1,000 of medical payments coverage is something really cheap. It’s about $6 to $10 every six months, is what I see on people’s declarations pages, what they pay in their premiums. Obviously, $10,000 of coverage is going to be more than that, but it’s there to protect you. It’s there to protect your family. It’s there to protect people riding in your car.
Paige Pahlke:[02:52]Jon, when I have a client who has … Well, in order to determine whether or not they have med pay, I always ask them to bring in their declaration page, which we talked about in an earlier episode as well, and how do identify that. That’s what sets forth your premium amounts. But on that, what I would be looking for are the different types of coverage you have, and one of those line items would be med pay. If you’ve got it, it’ll set forth the variations, like you talked about. Maybe it’s $1,000, maybe it’s $10,000, maybe $25,000.
Paige Pahlke:[03:19]When I have a client who has that in their policy, I am happy to go ahead and move forward and make those requests on their behalf. But in order to do that, what I need are their medical bills and their associated records from the providers to submit to the insurance company on their behalf. Is that also how you handle the med pay claims for your clients?
Jon Moore:[03:38]That’s pretty much it. I think that one thing that a lot of clients learn, or don’t necessarily know about, is if they’re in a car wreck or some other incident resulting in injury, one of the first places they go is the emergency department. What they are kind of surprised to learn is, they get multiple bills from that emergency department. They’re going to get a bill from the hospital. They’re going to get a bill from the doctor or the PA, physician’s assistant, who may have seen them there in the hospital. If they get an x-ray, they’re going to get a bill from a radiologist that they probably never met in the hospital, but that reviewed their x-ray and provided an opinion to the doctor. So you typically get at least three bills coming out of an initial emergency department visit, and the medical payments coverage is something that is very useful in terms of having the money there to pay those initial bills.
Jon Moore:[04:31]So we can’t necessarily make the claim immediately, because we do have to collect the medical records. We do have to collect the medical bills. But for those of you listening at home, if you’re curious if you have medical payments coverage on your policy, just look at that page that you have that shows the premiums, and there’ll be a line item that says medical payments. It typically, like we said, ranges between $1,000 and $10,000.
Jon Moore:[04:57]Now, a lot of clients come in and ask me, because they’re reluctant to make a claim under their own insurance policy. They’re worried that, “Oh, if I make this claim, my insurance premiums, they’re going to go up.” What do you tell those folks, Paige?
Paige Pahlke:[05:12]I tell them, no, that’s not the case, that they won’t be penalized for tapping into this type of coverage. They have this coverage available to them, because they made a wise decision and got it. But they won’t be penalized for using it, and they should use it.
Paige Pahlke:[05:24]But that was a very good point, because there is a lot of apprehension, I think, for people about tapping into that, because they are scared that their insurance rates will go up, but that’s not the case.
Jon Moore:[05:33]Now, we want to be clear that insurance rates do just ordinarily go up over time; but legally speaking, an insurance company is not allowed to increase a person’s premiums because they make that medical payments claim.
Jon Moore:[05:48]All right, Paige, I get a lot of questions from clients about what it’s going to cost them for our firm to handle the medical payments coverage part of their claim. What do you tell folks?
Paige Pahlke:[06:00]We don’t take a fee on that, Jon. We help them submit the claims, but we don’t take a fee on it. All the med pay would go to them or go to their providers depending upon what type of health insurance is involved.
Jon Moore:[06:13]Right. I know that there are some other firms out there that do take an administrative fee associated with making a medical payments claim, but at Brown Moore & Associates here, we believe that that’s part overall of what we need to do, and so we don’t take a fee on that. A lot of times, we do work with our clients to ask them what medical payments or what medical bills they may wish to have paid off. So it’s really up to the client as to whether or not that money is going to come into their trust account here at our firm that we can then use to pay their medical bills, or if the check is just going straight to the client. Usually we have that happen. There are a couple of exceptions. Medicare, by law, is entitled to that medical payments money to reimburse them for expenses they paid, for example.
Paige Pahlke:[07:03]So Jon, is there a time limit that somebody, if they’re going to make a med pay claim, that they have to make that claim within?
Jon Moore:[07:08]Yeah, somebody needs to make that medical payments claim basically within a year of the car wreck in order to have it. If you’re making the claim more than a year after the car wreck, then the insurance company has an exclusion that it just doesn’t have to pay.
Jon Moore:[07:21]In my opinion, it’s some of the best and cheapest health insurance that you could get. When I have a client who comes in, I’m always looking over what their insurance coverages are; and anytime they don’t have that coverage, I am recommending to them that they get it.
Paige Pahlke:[07:35]I think that’s great advice, Jon, and thank you for being here today. I think what you covered was very, very helpful, and hopefully our listeners got some good information. Thanks again.
Jon Moore:[07:43]Thanks for having me.
Announcer:[07:47]We appreciate you joining us on this episode of When Accidents Happen. To learn more about today’s discussion or to tell us your story, visit our website at . That’s B-R-O-W-N-M-O-O-R-E-L-A-W dot com. Or call 704-335-1500.
Announcer:[08:05]The insights and views presented in When Accidents Happen are for general information purposes only and should not be taken as legal advice for any individual case or situation. The information presented is not a substitute for consulting with an attorney nor does tuning into this podcast constitute an attorney-client relationship of any kind. If you’re ready for the personal attention you deserve, contact Brown Moore & Associates today.