Medical Payments Coverage in Arizona: Myths and Facts

Your insurance coverage is intended to protect you regardless of who caused the accident.

In Arizona, medical payments insurance is an optional part of your broader auto insurance policy. You have the choice of whether you want to include medical payments coverage on your policy.

If you have decided to pay for this coverage, using it will not increase your premiums.

Medical payments coverage — also known as “MedPay” — pays medical expenses for you and any passengers in your vehicle who were injured in an auto accident.

Who Needs Medical Payments Coverage in Arizona?

Since medical payments coverage protects you, your family, your employees and other passengers in your car, it can help protect both you and those you care about.

According to Arizona law, you are not required to pay back the first $5,000 of MedPay coverage to your own carrier. However, if medical expenses exceed $5,000 and you use MedPay, you may be required to pay it back if you receive settlement funds from the at-fault driver’s insurance.

Myths About MedPay

1. It’s the other driver’s fault so you shouldn’t use any of your insurance.

This is untrue.

You should use the most readily available policy to take care of an unplanned emergency.

Typically, MedPay is used to pay medical bills. But you are permitted to use these funds for purposes other than paying medical bills.

If you have suffered a significant injury, it can take months to recuperate and settle with the at fault driver’s insurance. The other driver will not pay any medical bills, lost income from time off of work, or pain and suffering until all of your damages have been determined. Using MedPay can alleviate short term financial issues for you.

2. Using this policy will increase my premiums.

False.

The state of Arizona has laws in place to ensure insurance companies only raise your premiums if and when your risk as a driver increases.

So, if you caused an accident and were determined to be at fault, that raises your risk. As a result, your premium goes up. Otherwise, you can use your insurance with no risk of raising your premium.

3. My agent told me to use the other driver’s insurance first.

This is bad advice.

MedPay coverage and the other driver’s insurance have different responsibilities. Your MedPay will have a relatively low limit, and your insurer has to pay you immediately. In Arizona, you can use up to $5,000 of it before you have to pay your insurer back.

The at-fault driver’s policy only pays once all of your damages have been assessed. Given your treatment, that could take months and even years.

Medical Payments Coverage Limits

You must select a limit for your MedPay coverage. This limit determines the maximum amount your insurer will pay for each person involved in an accident.

Here are a few MedPay examples.

Example 1:

You are driving home to Chandler from your Phoenix office. While coming to a stop on the I-10 freeway in Phoenix, a driver rear-ends you. He was texting and driving.

Being distracted, he completely failed to brake before hitting you. Your airbags go off. The EMT recommends hospital care for your sore back and your wrist, which is painful to move.

When you go to St. Joseph’s hospital, the ER physician orders an MRI and CT Scan. Your wrist is fractured and you have damage to your spine. Your hospital is bill is $7,500.

If you have medical payment coverage, the first $5,000 of this coverage can cover the hospital’s bill.

Example 2:

You’re driving in your lane when an out-of-control SUV runs you off the road.

Your car looks fine, but your arm really hurts after it hit the steering wheel. Your wife, in the front passenger seat, hit her forehead on the side window. She now has an ugly lump and a bad headache.

It cost you $1,000 to have your arm x-rayed. Your wife’s doctor visit cost $750.

When you got your MedPay coverage, you had selected a $2,000-per-person limit. Since each of your expenses amounted to less than $2,000 per person, MedPay would cover all of your medical costs in this case.

Example 3:

Your daughter accidentally slams the car door on your hand. Fortunately, you selected medical payments coverage with a $1,000 limit.

Your total bill for an x-ray and cast came to $1,500. MedPay will cover $1,000 of the bill and you will be responsible for the remaining $500.

Medical Payments Coverage Exceptions And Restrictions

To purchase medical payments coverage in Arizona, you must also select other coverage aside from liability insurance. However, there are restrictions and exceptions to MedPay:

Coverage For Multiple Vehicles:

MedPay limits must be the same for all vehicles on a multi-vehicle policy. In Arizona, if you select medical payments coverage on one vehicle, you must select the same coverage for all of your vehicles insured on the policy.

Vehicle Coverage Restriction:

MedPay is available only for regular cars and cannot be applied to trailers or similar attached equipment.

Workers Compensation Exception:

Medical payments coverage will not apply to a person who was injured at work. This is when workers’ compensation should apply.


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