Who pays my medical bills? The usual order in your state

How to use the tool#

1. Choose your state. The tool reads that state's rules for PIP, MedPay and uninsured motorist coverage, and whether it is a no-fault state.
2. Say how you were hurt. Drivers, passengers and people on foot or on a bike are covered in slightly different ways.
3. Say whether you have health insurance. Count Medicare, Medicaid and plans from work or the marketplace.
4. Say whether your auto policy has MedPay. If you are not sure, the declarations page of the policy lists every coverage you bought.

The result is a numbered list: who usually pays first, who pays next, what you may have to cover meanwhile, and who may want to be repaid at the end. Each state rule shows its official source. The address in your browser updates as you go, so you can share the result. Without JavaScript, the form works when you press the button, and nothing you enter is stored.

The usual order, step by step#

Auto medical coverage pays first. PIP and MedPay on your own policy pay medical bills up to their limits, whoever caused the crash. PIP is broader: depending on the state, it can also cover part of lost wages. MedPay usually pays medical and funeral costs only.

Health coverage pays next. Your health plan, Medicare or Medicaid pays under its own rules, with the usual deductibles and copays, once auto coverage is used up or if you have none.

You cover the gaps for now. Deductibles, copays and anything no plan covers are your responsibility while the claim is open.

The at-fault driver's insurer pays at the end. Its liability coverage pays once, at settlement or judgment, and only up to its policy limits. If that driver has no insurance or too little, your own uninsured motorist coverageUninsured motorist coverage. Coverage under your own policy that pays when the at-fault driver has no insurance, or too little. Glossary may step in.

Some payers want their money back. Health plans, Medicare, Medicaid and some hospitals can claim part of the settlement through a lienLien. A legal claim on part of your settlement by someone who paid for your care, such as a hospital, health plan or Medicare. Glossary or subrogationSubrogation. An insurer's right to be repaid from your settlement for what it already paid on your behalf. Glossary.

No-fault, add-on and at-fault states#

12 states have no-fault auto insurance laws: Florida, Hawaii, Kansas, Kentucky, Massachusetts, Michigan, Minnesota, New Jersey, New York, North Dakota, Pennsylvania and Utah. In these states, PIP is the main source of payment at first, and the right to sue the at-fault driver is limited. Some use a description of the injury as the test (Florida, Michigan, New Jersey, New York and Pennsylvania); the others use a dollar amount of medical bills (Hawaii, Kansas, Kentucky, Massachusetts, Minnesota, North Dakota and Utah). This test is often called the serious injury thresholdSerious injury threshold. A rule in some no-fault states that lets you sue the at-fault driver for pain and suffering only if your injury meets a legal definition of serious, or a dollar level of medical bills. Glossary. In Kentucky, New Jersey and Pennsylvania, drivers can choose whether the limit on lawsuits applies to them.

Other states are at-fault states: the driver who caused the crash, through their insurer, pays for the harm. Some of them still require or offer PIP as an add-on. Texas is one example. Its rule for PIP reads: Included in every policy unless you reject it in writing (required amount: $2,500 per person). The tool reads these rules for your state and shows them under each step, with the source.

Medicare, Medicaid and repayment#

Medicare pays after auto coverage. Federal rules say that Medicare does not pay until the beneficiary has used up their no-fault benefits. When Medicare pays bills that a settlement later covers, those are conditional payments, and Medicare must be repaid its conditional payments when a settlement, judgment or award is paid.

Medicaid works in a similar way. Medicaid is generally the payer of last resort: auto insurance and other sources should pay before it. People who get Medicaid assign to the state their rights to payment for medical care from any third party, so the state can recover what it paid from a settlement. Employer health plans often have repayment terms too. Our guide to medical liens and subrogation explains how these claims are handled and sometimes reduced.

Passengers, pedestrians and special vehicles#

• Passengers are often covered by the PIP or MedPay on the car they were riding in, by their own policy, or by a relative's policy. State law and the policies decide the order.
• Pedestrians and cyclists are often covered by PIP or MedPay on their own or a household member's auto policy, even though no car of theirs was involved. In some no-fault states, the PIP of the vehicle that hit them may apply when no household policy exists.
• Motorcycles, trucks and rideshare trips follow special rules. PIP and MedPay often work differently for motorcycles, and commercial vehicles and rideshare trips usually carry their own policies. See our guides to motorcycle accidents, truck accidents and rideshare accidents.

What the tool does not do#

It shows the usual order, not a promise of payment. Each policy's terms, limits and exclusions decide what is actually paid, and some plans coordinate benefits in their own way. It does not estimate how much any payer will pay or what a claim is worth. Keep every bill and explanation of benefits, and use the claim file checklist to track them. The full background is in our guide to who pays medical bills.