TL;DR

  • MedPay (Medical Payments insurance) provides coverage for medical expenses resulting from car accidents, regardless of fault.
  • It covers medical bills from a wide range of providers, including doctors, specialists, EMTs, hospital stays, surgeries, and rehabilitation.
  • MedPay helps pay for health insurance deductibles, co-pays, and other out-of-pocket medical costs.
  • Unlike Personal Injury Protection (PIP), MedPay does not cover lost wages, pain and suffering, or bodily injury to others.
  • MedPay operates on a no-fault basis, providing immediate financial support without waiting for fault determination.
  • In Colorado, MedPay is mandatory with a minimum coverage limit of $5,000, but drivers can waive it in writing.
  • MedPay covers the policyholder, passengers, resident family members, and pedestrians injured in vehicle-related accidents.
  • Stacking of MedPay coverage from multiple vehicles is allowed in Colorado, increasing available benefits.
  • MedPay does not require reimbursement if you settle with the at-fault party, unlike some other insurance coverages.
  • Filing a MedPay claim involves organizing accident and medical documents, contacting your insurer, and possibly consulting a personal injury lawyer for complex cases.

With a high incidence of motor vehicle accidents in Colorado, having a reliable financial cushion beyond your standard auto insurance policy to cover unexpected medical bills is vital. This is what MedPay is for. Medical Payments insurance, also known as MedPay coverage, is a form of car insurance that provides medical expense coverage for medical bills, including those from a wide range of medical providers, arising from motor vehicle accidents regardless of who is at fault. If you’re dealing with MedPay claims or need help understanding your coverage after an accident, consulting with a car accident attorney in Denver can help protect your interests and ensure you receive the maximum benefits available.

Understanding MedPay vs. Other Insurance Types

MedPay vs. Personal Injury Protection (PIP)

Unlike in some states where similar benefits are included under personal injury protection (PIP) laws, Colorado requires drivers to get additional protection in the form of MedPay, which bridges the gap between health insurance and out-of-pocket costs. The difference between MedPay and personal injury protection (PIP) is that PIP insurance is mandatory in no fault states and covers a wider range of benefits, such as lost wages and psychiatric care, while MedPay focuses on medical treatments and related expenses. (Note: MedPay requirement is mandatory by default. Although you are allowed to waive it, doing so may significantly impact the financial consequences of an accident. Therefore, a waiver is generally not recommended.) In most states, liability coverage is mandatory, while MedPay is optional coverage that you can add to your policy for extra protection.

Understanding how much car insurance you need in Colorado can help you make informed decisions about MedPay limits and other coverage options that best protect your financial interests.

How MedPay Provides Immediate Financial Support

When an accident occurs, determining who is really responsible for the crash may take time. Insurance adjusters and any attorneys involved have to go through police reports, witness statements, and other available evidence to establish this single fact. During this time, medical bills pile up, and immediate financial support becomes necessary, especially if the injured victim is unable to go to work. MedPay covers the injured person, including the policyholder, passengers, resident family members, and even pedestrians, whether they are in your car or someone else’s vehicle at the time of the accident.

This is why you should seek medical attention after an accident even if you think you’re not hurt – MedPay can help cover these immediate medical expenses while you focus on recovery.

Comprehensive MedPay Coverage Details

What Does MedPay Cover?

MedPay pays for medical expense coverage, including bills from a wide range of medical providers such as doctors, specialists, chiropractors, and emergency medical technicians (EMTs), and covers medical treatments like surgery, hospital stays, and rehabilitation. MedPay can help cover health insurance deductibles, co-pays, co-insurance, and other out-of-pocket costs, and it typically does not have a deductible. MedPay coverage work is handled by your auto insurance company or insurer, which pays the medical provider directly or reimburses the injured person for covered expenses. However, MedPay does not cover lost wages, pain and suffering, or bodily injury to others—these are covered by liability insurance or liability coverage.

No-Fault Benefits of MedPay

MedPay covers these expenses without the bureaucratic red tape and lengthy investigations tied to determining who caused the accident. It operates on a “no-fault” basis, so you do not need to wait for an investigation or settlement to receive benefits. If you have MedPay, your injury-related treatment costs and medical bills will be paid for immediately by your insurer—even if it is later determined that you were at fault.

Covered services include doctor visits, hospital stays, surgery, emergency medical technician (EMT) services, rehabilitation, and other necessary medical treatments. MedPay helps cover medical expenses and bills resulting from an auto accident, regardless of fault, and the payment is made up to the coverage limit. The cost of MedPay is generally affordable compared to other coverages. MedPay is a supplemental coverage that can be used in addition to other coverages such as PIP coverage, liability insurance, and health insurance. In some states, the insurer may seek a credit or reimbursement if you recover damages from a third party, but this does not apply in Colorado.

Specific Medical Services Covered

Med Pay Coverage for Healthcare Services After a Motor Vehicle Accident

MedPay covers a wide range of medical treatments provided by various medical providers, including doctors, specialists, and emergency responders. Covered services include:

  • Ambulance fees
  • Emergency medical technician (EMT) services
  • Emergency room visits
  • Hospital stays
  • Surgeries (surgery is a covered medical treatment)
  • Intensive care treatments
  • Visits to primary care physicians and specialists
  • Follow-up appointments
  • X-rays, MRIs, CT scans, and other imaging services
  • Laboratory tests and diagnostics
  • Physical therapy, occupational therapy, speech therapy
  • Prescription medications
  • Mobility and prosthetic devices (crutches, braces, wheelchairs)
  • Emergency dental treatments
  • Funeral and burial expenses (in case of a fatal accident)

The Medical Payments coverage protects the policyholder, passengers in the policyholder’s vehicle, and any pedestrians struck by the car.

Colorado-Specific MedPay Requirements

How Does Med Pay Work in Colorado?

As per the reforms made to the state’s auto insurance system on January 1, 2009, Med Pay is a required, mandatory coverage. Insurance companies must automatically include at least $5,000 in Medical Payments in every auto insurance policy they issue or renew. However, drivers have the option to waive it. If a policyholder decides they do not want or need Med Pay, they can opt-out, but they need to do so in writing.

According to the Colorado Division of Insurance, these requirements ensure that drivers have immediate access to medical expense coverage regardless of fault determination.

Choosing Your MedPay Coverage Limit

When you select Med Pay as part of your auto insurance, the amount you choose is your coverage limit. This coverage limit is the maximum payment your auto insurance company or insurer will make for medical expenses per injured person per accident. You get to decide how much coverage you feel is needed based on your existing health coverage and what you need to protect yourself and your passengers better.

MedPay and Health Insurance Coordination

If you already have health insurance, Med Pay can help cover your health insurance deductible and co-pays, which are out-of-pocket costs that might not be included under your plan or may be exceptionally high for some treatments. MedPay typically does not have a deductible. Medical payments coverage work as a no-fault benefit, meaning your insurer or auto insurance company will pay for medical expenses regardless of who caused the accident. The payment process is straightforward: you submit your medical bills to your insurer, and they reimburse you or pay the provider directly, up to your coverage limit.

Maximizing Your MedPay Benefits

Stacking Med Pay Is Allowed in Colorado

Review the terms of your insurance policy to see if it explicitly allows for the stacking of Med Pay benefits. Stacking means you can increase your plan limits by combining the Med Pay from multiple vehicles under your policy. For example, if you have two cars, each with a Med Pay limit of $5,000, you could combine both these limits and get up to $10,000 in Med Pay after an accident.

What Med Pay Will Not Cover in Colorado

Med Pay does not include any provisions for:

  • Pain and suffering (these are typically covered by liability insurance or liability coverage)
  • Lost income or lost wages (if your injuries prevent you from working; liability coverage or Personal Injury Protection may cover this)
  • Bodily injury to others (MedPay only covers you and your passengers; bodily injury liability insurance covers injuries to other people in an accident where you are at fault)
  • Property damage
  • Long-term rehabilitation or long-term nursing care
  • Home modifications (e.g., wheelchair ramps)
  • Legal costs (liability insurance may help cover legal fees if you are sued after an accident)

Understanding the types of damages that may be recovered after a motor vehicle accident can help you understand what expenses fall outside MedPay coverage and may require additional legal action.

Reimbursement Rules and Settlement Impact

Are You Required to Reimburse Your Med Pay Insurance Provider if You Settle Your Claim with the Other Party?

No, you are not required to reimburse your Med Pay insurer if you settle with the at-fault motorist in Colorado. In some states, the insurer may seek a credit or reimbursement for bills paid if you recover damages from a third party, but this does not apply to MedPay in Colorado. This aspect sets Med Pay insurance apart from other types of insurance.

Example Scenarios

Example Scenario 1: John incurs $20,000 in medical bills after being injured by Sarah in a car accident. His medical insurance covers these costs by paying the bill. Later, John settles a lawsuit with Sarah for $50,000. His medical insurance company (insurer) can then claim a $20,000 credit from his settlement.

However, Med Pay insurance does not allow for such reimbursement or credit. When you receive compensation from an at-fault driver, you get to keep the entire amount.

Example Scenario 2: John uses his Med Pay coverage to pay for $20,000 in medical costs. He later settles his car accident claim with Sarah for $50,000. His Med Pay insurer cannot reclaim the $20,000 it paid in bills or seek a credit.

Filing Your MedPay Claim: Step-by-Step Process

How Do You File a Medical Payments Claim in Colorado?

Step 1: Organize Your Documents

Before you start the claim process, compile the following information in one place:

  • Your car insurance policy number
  • The date, time, location, and description of the accident
  • Bills and treatment records from all medical providers who treated you after the accident
  • Police report (if available, this will support your claim)
  • Contact information of the other driver involved, passengers, as well as any witnesses.

Step 2: Consult a Personal Injury Lawyer

Hiring an attorney is not legally mandatory, but if you have sustained significant injuries or the question of “who is liable” seems complex in your situation, they can help. A car accident lawyer with a thorough knowledge of Colorado’s insurance laws will guide you on how to proceed and protect your rights.

Understanding what a personal injury lawyer does can help you determine whether professional legal assistance would benefit your specific situation.

Step 3: Contact Your Insurance Company

If your auto insurance company or insurer offers an online notification option to report accidents, it is recommended to do so within 24 hours of being injured. You should call their customer service or claims department within a week. Still, it should be done under the guidance of your lawyer because they can ensure your conversation is documented properly.

Step 4: Complete Claim Forms

A claims adjuster will be assigned to your case at this point. They will send you forms to fill out and ask for:

  • Invoices and bills from all medical providers, including hospitals, doctors, and specialists, so the insurer can process payment directly to the provider or reimburse you
  • Doctor’s notes, diagnostic reports, and other documentation of treatments received
  • Proof of payments you have made from your pocket
  • Police report (if you have it)

Your attorney will handle this part, but do not forget to keep a copy of all documents for your records before sending them to the adjuster.

Step 5: Keep Communications Open

Contact the adjuster to confirm they have received everything you sent; ask for written confirmation, if possible. Sometimes, they ask for additional information, like:

  • Referral letters to specialists from your primary care physician
  • Bank statements showing payments made to healthcare providers if receipts are not available
  • A signed consent form authorizing your insurance company to obtain your medical records directly from the hospital

The National Association of Insurance Commissioners provides consumer guidance on insurance claim procedures and your rights during the claims process.

Comprehensive Legal Support for Maximum Recovery

Choose Fuller Personal Injury Law to Maximize Your Med Pay Claim in Colorado

Medical Payments is an affordable supplemental coverage that provides a safety net in many situations:

  • If you get injured in a car accident, even if you were responsible for it
  • If your passengers are injured
  • If you or a family member are hit by a car while walking
  • If you are hit by a vehicle while riding your bicycle
  • If you are injured while riding in a rideshare vehicle (e.g., Uber or Lyft)

However, it does not guarantee that you will be rightfully compensated for your post-crash medical damages, considering insurance adjusters do not always have your best interests in mind. Also, Med Pay does not pay for damaged property, lost earning potential, and any long-term care you may need because of the debilitating injury (or the disability caused by it).

At Fuller Personal Injury Law, we will handle the Med Pay claims process on your behalf and go one step further to explore all possible avenues for maximum financial recovery. If Med Pay or your health insurance will not fully compensate for all the damages you have incurred, we may be able to file a personal injury lawsuit against the individual(s) responsible for covering the remainder of your losses or a third-party claim against their insurance company to recover financial compensation.

Learning how to file a personal injury lawsuit can help you understand your options when MedPay coverage isn’t sufficient to cover all your accident-related expenses and losses.

Call us at (720) 770-3832 or get in touch online to schedule a free case evaluation today.