PIP Still Pays Medical Bills When You Have Private Health Insurance

Since Massachusetts instituted a universal health care program, most Massachusetts residents carry some form of private health insurance coverage. But, if you’re injured in an auto accident and you have private health care coverage, the question about whether PIP (Personal Injury Protection or Part 2 of your standard Mass. auto coverage) will cover your accident-related medical bills naturally arises.

The simple answer to the question is: yes, but it’s a little more complex than that.

Remember that with PIP coverage your reasonable and necessary medical bills that are incurred because of injuries from an auto accident. Most insurance policies have a policy limit of $8,000 – meaning that your insurance company will pay up to $8,000 in accident-related medical bills and lost wages.

If you have private health insurance, however, your auto insurer will cover the first $2,000 in accident-related bills. In other words, it is the “primary” insurer for the first $2,000 in bills. After it has paid $2,000, then your private health insurance company becomes primary and your accident-related bills must be submitted to it for processing. So, your private insurer becomes “primary” and PIP becomes “secondary.”

PIP still provides benefits, though, even though it becomes “secondary.” For example, if you have co-pays or deductibles under your health insurance coverage, PIP will be responsible to reimburse you for those out-of-pocket expenses.

For more information on what PIP covers, click here.  Or request a copy of our book Massachusetts Auto Accidents: The 5 Biggest Mistakes Massachusetts Consumers Make When Buying Auto Insurance.