By Ray Kahler
How to get your medical bills paid after an injury depends on the circumstances of how and where an injury occurs.
SOURCES OF MEDICAL COVERAGE
With the expansion of access to medical insurance through the Affordable Care Act, most people now have medical insurance that will cover at least some of their medical bills. Depending on how and where an injury occurs, however, other sources might be first in line for paying medical bills.
If you are injured on the job, you will most likely have a worker’s compensation claim that will pay your medical bills related to the injury.
If you are injured as a result of a fall, the owner of the business/property/home where the injury occurred might have insurance that includes “Med Pay” coverage. Med Pay coverage is a no-fault coverage, meaning that it applies regardless of whether or not the owner of the property was at fault for causing the injury. Med Pay coverage is usually limited to $5,000 or $10,000 and only pays for medical bills.
PERSONAL INJURY PROTECTION (PIP)
If you are injured in a motor vehicle crash, Personal Injury Protection (PIP) coverage will come into play if you have PIP coverage on your automobile insurance. In addition, passengers in a vehicle are entitled to PIP coverage on the vehicle owner’s insurance, and pedestrians who are hit by a car are entitled to PIP coverage under the insurance covering the car that hit them. Like Med Pay coverage, PIP coverage is a “no-fault” coverage that applies regardless of who is at fault for causing an injury.
PIP coverage is usually limited to $10,000 or sometimes $35,000 and will pay for medical bills. PIP coverage also provides limited compensation for wage loss and household services that people need to hire due to an injury. Not all automobile insurance policies include PIP coverage. PIP coverage can be waived through a written waiver.
CRIME VICTIMS COMPENSATION PROGRAM
If you are injured as a result of a crime, the Crime Victims Compensation Program might provide coverage for medical expenses. The Crime Victims Compensation Program will only pay medical expenses after you have used all other options for payment of medical expenses.
COORDINATING PAYMENT OF MEDICAL EXPENSES
Coordinating payment of medical expenses by medical insurance and Med Pay or PIP insurance is very important when you have significant medical bills. An emergency room visit can quickly use up the money available under Med Pay or PIP coverage. Most medical insurance has deductibles or out-of-pocket payments that you are responsible for. When we are retained soon after an injury, we like to determine if there is Med Pay or PIP coverage and if so, request that those funds be paid to our trust account so that we manage those funds to our client’s maximum benefit, such as paying deductibles and out-of-pocket expenses that are not paid by the client’s medical insurance.
Most medical insurance plans will require that you fill out and return an incident questionnaire before they will pay medical expenses related to an injury. They want to know if there is other insurance or other parties that might be responsible for paying the medical expenses. It is important not to ignore paperwork from your medical insurance plan, because failure to return the incident questionnaire will usually result in the medical insurance plan denying payment of medical bills.
If you do not have medical insurance and received treatment at a hospital, you should contact the hospital’s billing department for information about their charity care program. You can apply for a waiver of your medical bills or a reduction in your medical bills through a hospital’s charity care program.