Who Will Pay Your Medical Bills

How to Pay Medical Bills After a Santa Clarita Car Accident

If you were injured in a car accident in Santa Clarita, Valencia, Saugus, Canyon Country, Newhall, Castaic, Stevenson Ranch, or elsewhere in Los Angeles County, one of your biggest concerns may be: 

Who is going to pay my medical bills?

The answer is not always the other driver's insurance company. In many personal injury cases, the at-fault driver's insurance does not function like health insurance that simply pays each medical bill as it arrives. Instead, accident victims may use health insurance, Medical Payments (MedPay) coverage, or other arrangements to pay for medical care while the liability claim is being investigated and negotiated. Understanding your options can help you get the medical treatment you need without unnecessarily delaying care because you are worried about how the bills will be paid.

Key Takeaways

• Do not delay necessary medical treatment because you are unsure who will pay the bill.
• The at-fault driver's liability insurance generally does not operate like your health insurance and may not simply pay each medical bill as you receive treatment.
• Your health insurance may pay for accident-related medical care subject to your plan's terms, deductibles, copayments, and other requirements.
• Medical Payments (MedPay) coverage under your automobile insurance may help pay certain accident-related medical expenses regardless of who caused the collision.
• California's Department of Insurance explains that MedPay can provide coverage for medical expenses for you or passengers in your vehicle, regardless of fault, up to the applicable policy limit.
• In some cases, medical providers may agree to treat a personal injury patient under a lien or other payment arrangement, allowing payment to be deferred until the claim is resolved.
• Your health insurer or another benefit provider may have reimbursement or subrogation rights, depending on the type of plan and applicable law.
• Your personal injury attorney should review your available insurance coverage and medical-payment arrangements so you understand how medical bills may affect your eventual settlement.

Who Pays My Medical Bills After a Car Accident?

There are several potential sources for paying medical expenses after a car accident. The appropriate source depends on the circumstances, the insurance policies involved, your health coverage, and the arrangements made with your medical providers.

Potential sources include:

1. Your health insurance
2. Medical Payments (MedPay) coverage on your auto policy
3. The at-fault driver's liability insurance
4. A medical lien or other attorney/provider payment arrangement
5. Other applicable insurance or benefits

The important thing to understand is that you should not assume you have to wait until your personal injury case settles before receiving medical treatment. Your attorney can help you determine what options may be available.

Does the At-Fault Driver's Insurance Pay My Medical Bills Immediately?

Usually, you should not expect the at-fault driver's liability insurance company to function like your health insurance. When you receive medical treatment, the provider may submit the bill to your health insurance or another applicable source of coverage rather than simply sending the bill directly to the other driver's automobile insurer.

The at-fault driver's insurer is evaluating a liability claim, which may involve questions about:

• Who caused the accident
• Whether the insured driver was negligent
• Whether your injuries were caused by the accident
• The extent of your injuries
• The amount of your damages
• Whether another person or entity contributed to your injuries

Those issues may take time to resolve. In some circumstances, an insurer may make payments or otherwise address particular expenses before a case is fully resolved, but you should not assume that the other driver's insurance company will automatically pay each medical bill as you incur it. California's Department of Insurance explains that an insurer investigates claims and that medical payments or uninsured-motorist claims require documentation of losses such as injuries and medical expenses.

Can I Use My Health Insurance After a Car Accident?

Yes. If you have health insurance, you can generally provide your health insurance information to medical providers and seek covered treatment according to the terms of your health plan. This can be an important way to obtain medical care while your personal injury claim is still being investigated.

Your health plan may require you to pay:

• A deductible
• Copayments
• Coinsurance
• Other applicable expenses

Your plan may also have requirements concerning which doctors, hospitals, or other providers you can use. For example, California's Department of Insurance explains that health-plan costs and provider requirements can vary depending on the type of plan and whether the provider is in network. The fact that your health insurance pays medical expenses does not necessarily mean that you have given up your personal injury claim against the person who caused the accident.

Will My Health Insurance Want to Be Repaid From My Settlement?

Possibly. This is an important issue that is sometimes overlooked. Depending on the type of health plan and the circumstances, your health insurer or another benefit provider may have a right to seek reimbursement for accident-related medical expenses it paid. These rights are often described using terms such as subrogation, reimbursement, or a lien. The exact rules can vary considerably.

For example, different legal rules may apply depending on whether your coverage comes from:

• An employer-sponsored health plan
• An individual health insurance policy
• A government program
• A health care service plan
• Another type of benefit arrangement

Your attorney should identify potential reimbursement claims and determine how they may affect the net amount you ultimately receive from a settlement. This is one reason that the amount of a personal injury settlement is not necessarily the same as the amount of money you ultimately keep.

What Is Medical Payments (MedPay) Coverage?

Medical Payments coverage, commonly called MedPay, is an optional automobile insurance coverage that can pay certain medical expenses resulting from an automobile accident. California's Department of Insurance explains that Medical Payments coverage can cover medical expenses for you or passengers in the vehicle, regardless of who was at fault, up to the policy's specified limit. MedPay can be useful because it is a first-party coverage—meaning you are looking to your own auto insurance policy rather than waiting for the other driver's insurer to accept liability.

Depending on the policy, MedPay may help with expenses associated with:

• Emergency room treatment
• Ambulance services
• Doctor visits
• Diagnostic testing
• Hospital care
• Physical therapy
• Other covered medical services

The exact expenses covered and the amount available depend on the terms of your policy.

How Much MedPay Coverage Do I Have?

MedPay limits vary by automobile insurance policy. California's Department of Insurance lists examples of Medical Payments limits, including $2,000 under one basic coverage example and $5,000 under a standard increased-limits example. Other policies may have different limits. You should check your declarations page or complete auto insurance policy to determine whether you have MedPay and how much coverage is available. If you are unsure, your personal injury attorney can review the policy with you.

Can MedPay Pay My Deductible and Copayments?

Potentially. Whether MedPay can help with particular out-of-pocket medical expenses depends on the terms of your policy and the way your medical bills are submitted and paid. In some cases, MedPay may be useful for expenses that remain after health insurance processes a medical claim. Because every policy is different, do not assume that MedPay will automatically pay every amount your health insurance does not cover.

What If I Don't Have Health Insurance?

If you do not have health insurance, tell your attorney and your medical providers. Depending on the circumstances, potential options may include:

MedPay

If your automobile policy includes Medical Payments coverage, it may help pay covered medical expenses up to the policy limit. California's Department of Insurance notes that MedPay can provide immediate medical-care coverage regardless of fault.

Medical liens or deferred-payment arrangementsIn some personal injury cases, a medical provider may agree to provide treatment with payment deferred until the injury claim is resolved.

These arrangements can be documented through a medical lien or other written payment agreement.
The exact terms matter. Before agreeing to one, you should understand:

• What services are covered
• What happens if the case does not settle
• What amount will ultimately be owed
• Whether interest or other charges apply
• Whether the provider expects payment from the settlement

Other available coverage

Depending on the circumstances, there may be additional insurance coverage or benefits that can help with medical expenses. Your attorney can help identify potential sources of payment.

Should I Delay Treatment Because I Can't Afford the Medical Bills?

​Generally, you should not delay medically necessary care simply because you are worried about how the bills will be paid. Your health should be the priority. If you have been injured, follow appropriate medical advice and tell your healthcare providers about your symptoms and the accident. At the same time, communicate with your attorney about your medical bills and available insurance coverage. The sooner your lawyer knows about a medical-payment problem, the sooner you can discuss potential solutions.

What If the Medical Provider Wants Payment Before Treating Me?

Some providers may require payment, insurance information, or another financial arrangement before providing certain services. If you are unable to pay the requested amount, explain your situation and ask whether the provider has another payment option. If you have hired a personal injury attorney, let your lawyer know. Depending on the circumstances, your attorney may be able to discuss whether the provider will accept health insurance, MedPay, a lien, or another appropriate arrangement. Never assume that a provider will agree to defer payment. Any arrangement should be clearly documented.

Can I Use Both Health Insurance and MedPay?

Potentially, yes. Health insurance and MedPay can serve different functions, and the interaction between them depends on the applicable policies and circumstances. For example, health insurance may process medical treatment under the terms of the health plan, while MedPay may be available under your auto policy for covered accident-related medical expenses. Your attorney can review your policies and help determine how the available coverage fits into your particular case.

What Happens to My Medical Bills When My Car Accident Case Settles?

When a personal injury claim settles, your attorney generally needs to account for outstanding medical expenses and any valid reimbursement or lien claims.

The settlement process may involve determining:

• Which medical bills remain unpaid
• Which bills have already been paid by insurance
• Whether a medical provider has asserted a lien
• Whether a health plan has a reimbursement claim
• Whether MedPay has paid any expenses
• What amounts are still disputed
• What portion of the settlement will ultimately go to you

This is one reason you should not look only at the gross settlement amount. For example, a $100,000 settlement does not necessarily mean that you receive $100,000 in your pocket. Attorney fees, litigation costs, medical liens, reimbursement claims, and other obligations may need to be addressed. A personal injury attorney can help you understand the anticipated net recovery before you resolve your claim.

Can My Lawyer Negotiate My Medical Bills or Liens?

In appropriate cases, your attorney may be able to negotiate with medical providers or entities asserting reimbursement rights. Whether a reduction is possible depends on the circumstances, the type of claim, the provider or benefit plan involved, and other factors. The goal is often to determine whether outstanding medical obligations can be resolved in a way that leaves the injured person with a reasonable net recovery. There is no guarantee that a provider, insurer, or lienholder will agree to reduce its claim. 

What Should I Give My Personal Injury Lawyer?

Your attorney should receive information about your medical treatment and insurance coverage as early as possible. Consider providing:

Auto insurance information

• Insurance company
• Policy number
• Declarations page
• MedPay limits
• Uninsured/underinsured motorist limits
• Relevant insurance correspondence

​Health insurance information

• Health insurance card
• Plan name
• Member information
• Correspondence concerning accident-related treatment
• Bills or statements showing patient responsibility

Medical information

• Emergency room records
• Doctor information
• Medical bills
• Physical therapy records
• Diagnostic imaging
• Prescriptions
• Other treatment records

Give your attorney copies of any documents you signed concerning:

• Medical liens
• Letters of protection
• Deferred-payment agreements
• Medical financing
• Other arrangements for paying accident-related treatment

Your lawyer needs this information to understand both the value of your claim and the potential obligations that may reduce your final recovery.

What If the Other Driver Doesn't Have Insurance?

If the driver who caused your accident is uninsured, your own uninsured motorist (UM) coverage may become particularly important. California's Department of Insurance explains that uninsured motorist bodily injury coverage can provide coverage for injuries to you and others in your vehicle when an at-fault driver does not have liability insurance. If the other driver has insurance but insufficient limits, underinsured motorist (UIM) coverage may also be relevant. Your attorney should review your automobile policy to determine whether these coverages are available.

What If the Other Driver's Insurance Company Says It Won't Pay My Medical Bills?

Do not assume that this means you have no way to obtain treatment. The liability insurer may be disputing fault, causation, the extent of your injuries, or the amount of your claim. In the meantime, you may have other options for obtaining necessary medical care, including health insurance or MedPay. If you have an attorney, provide the insurer's correspondence to your lawyer. Your attorney can evaluate the coverage and determine how the insurer's position affects your claim.

Don't Let Medical Bills Keep You From Getting Necessary Treatment

After a serious car accident, dealing with medical bills can be overwhelming—especially when you are also dealing with pain, missed work, vehicle damage, and an insurance claim.

If you were injured in Santa Clarita, Valencia, Saugus, Canyon Country, Newhall, Castaic, Stevenson Ranch, or elsewhere in Los Angeles County, you may have more than one potential source for paying accident-related medical expenses. Your options may include health insurance, MedPay, uninsured or underinsured motorist coverage, or an appropriate medical payment arrangement.

The important thing is to get the medical care you need and address the payment issue at the same time. A Santa Clarita personal injury attorney can review your insurance policies, medical bills, liens, and other payment issues and help you understand how they may affect your personal injury claim and eventual net recovery.

Frequently Asked Questions

1. Who pays my medical bills after a car accident in California?

Potential sources can include your health insurance, Medical Payments (MedPay) coverage under your auto policy, the at-fault driver's liability insurance in appropriate circumstances, and medical lien or deferred-payment arrangements. The appropriate source depends on the circumstances and applicable insurance policies.

2. Does the at-fault driver's insurance pay my medical bills immediately?

Not necessarily. The other driver's liability insurer generally investigates liability and damages rather than functioning as your health insurer. You may need to use health insurance, MedPay, or another payment arrangement while the claim is being investigated.

3. What is MedPay?

MedPay is optional automobile insurance coverage that can pay certain medical expenses resulting from an accident, regardless of fault, up to the applicable policy limit.

4. How much MedPay coverage can I have in California?

MedPay limits vary by policy. The California Department of Insurance provides examples of policies with $2,000 and $5,000 Medical Payments limits, while other policies may have different limits.

5. Can I use my health insurance after a car accident?

Yes. If you have health insurance, it may pay covered accident-related medical expenses according to the terms of your health plan, including applicable deductibles, copayments, and coinsurance.

6. Will my health insurance company get paid back from my settlement?

Possibly. Depending on the type of health plan and applicable law, your health insurer or benefit plan may have reimbursement or subrogation rights relating to accident-related payments. Your attorney should identify and evaluate any such claims.

7. What if I don't have health insurance after a car accident?

Depending on your circumstances, you may have MedPay coverage, may be able to arrange treatment through a medical lien or other deferred-payment agreement, or may have another source of insurance coverage. Discuss your situation with your attorney and medical providers.

8. Can I use MedPay and health insurance together?

Potentially. The interaction between the two depends on the policies and circumstances. Your attorney can review your coverage and help you understand how the available payment sources may work together.

9. What happens to unpaid medical bills when my case settles?

Outstanding medical bills, liens, and valid reimbursement claims generally need to be addressed as part of the settlement process. Your attorney should determine what amounts are owed and how they may affect your net recovery.

10. Can a personal injury lawyer reduce my medical bills?

An attorney may be able to negotiate with certain medical providers or entities asserting reimbursement claims, depending on the circumstances. There is no guarantee that a bill or lien will be reduced.

11. Should I stop medical treatment because I cannot afford the bills?

You should not make decisions about medically necessary treatment solely because you are worried about the eventual settlement. Discuss your medical needs with your healthcare provider and tell your attorney about any problems paying for treatment so that available options can be explored.

12. What should I do if the insurance company refuses to pay my medical bills?

Find out why the insurer is refusing payment and provide the correspondence to your attorney. Depending on the situation, health insurance, MedPay, uninsured/underinsured motorist coverage, or another payment arrangement may be available.