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MedPay vs PIP: Which One Pays Your Medical Bills After a Crash

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Key takeaways

  • Both pay medical bills for you and your passengers no matter who caused the crash. PIP can also pay lost wages, replacement services and funeral costs. MedPay is mostly medical.
  • Triple-I counts 12 no-fault states plus Puerto Rico, where PIP is mandatory. Elsewhere, PIP may be optional or not sold, and MedPay is often the option.
  • Required amounts vary a lot: $5,000 in medical benefits in Pennsylvania, $10,000 of PIP in Florida, and up to $50,000 of basic economic loss under New York law.

This guide is part of our car insurance coverage explained section. It explains what each coverage pays and where it applies. It does not recommend a health plan or tell you how to coordinate your own health coverage; for that, read your plan documents or ask your state insurance department.

What is the difference between MedPay and PIP?

The Texas Department of Insurance gives the clearest side-by-side:

Triple-I describes PIP "at its broadest" as covering "medical payments, lost wages and the cost of replacing services normally performed by someone injured in an auto accident," and possibly funeral costs.

MedPayPIP
Medical bills for you and passengersYesYes
Paid regardless of faultYesYes
Lost wagesNoYes, up to state and policy limits
Replacement services (for example, chores you cannot do)NoAt its broadest, per Triple-I
Funeral costsCheck your policyMay be included, per Triple-I
Where you find itUsually optional; Maine requires it, per Triple-I's state tableRequired in no-fault states; included or offered in some others, such as Texas
Tied to limits on suing?NoIn true no-fault states, yes

Sources: Texas Department of Insurance, Triple-I, NAIC.

Which states require PIP?

Triple-I explains that in true no-fault states, "all drivers are required to purchase personal injury protection (PIP)," and each driver files with their own insurer after a crash regardless of fault. Triple-I lists 12 such states plus Puerto Rico: Florida, Hawaii, Kansas, Kentucky, Massachusetts, Michigan, Minnesota, New Jersey, New York, North Dakota, Pennsylvania and Utah.

Three of those, New Jersey, Pennsylvania and Kentucky, are "choice" no-fault states, where drivers can reject the lawsuit threshold and keep the right to sue. Triple-I also describes "add-on" states, where your insurer pays first-party benefits but there are no limits on lawsuits and the coverage "may not be mandatory." Our list of no-fault states covers each state's rules.

Outside no-fault states, PIP can still appear. In Texas, the Department of Insurance says "All auto policies in Texas include PIP coverage. If you don't want it, you must tell the company in writing."

How much PIP is required?

It depends heavily on the state. Examples from state agencies:

StateRequired first-party medical coverageSource
PennsylvaniaMedical benefits, minimum $5,000Pennsylvania Insurance Department
Florida$10,000 PIP; pays 80% of necessary and reasonable medical expenses up to $10,000Florida DHSMV
New YorkBasic economic loss up to $50,000 per person, including lost earnings up to $2,000 a month for up to three yearsNY Insurance Law 5102, quoted by NY DFS
MichiganSix PIP medical levels, from unlimited down to opt-out for some Medicare enrolleesMichigan DIFS
Minimum required first-party medical coverage in three states Required first-party medical coverage, per person Pennsylvania $5,000 Florida $10,000 New York $50,000 New York's figure is basic economic loss, which includes lost earnings. Florida PIP pays 80% of covered medical costs up to the limit.
Bars to scale. Figures from the Pennsylvania Insurance Department, Florida DHSMV, and New York Insurance Law section 5102 as quoted by the NY Department of Financial Services.

Michigan is the outlier. Its Department of Insurance and Financial Services lists six PIP medical levels: unlimited, up to $500,000, up to $250,000, up to $250,000 with exclusions, up to $50,000 for certain Medicaid enrollees, and an opt-out for a named insured with Medicare Parts A and B. If you choose nothing, "the unlimited PIP medical option is selected by default." For why Michigan's system has been costly, see why Michigan car insurance is expensive.

How do PIP and MedPay work with health insurance?

This is where state rules matter most, and where you should read your own documents rather than rely on a general article. A few examples of how states handle it:

What health insurance may not do: the Texas Department of Insurance says that after a crash, "Your health plan will kick in to cover your injuries, but it won't cover long-term care needs or help if you aren't able to work." Lost income is the gap PIP is built for.

If you are between jobs or unsure what health coverage you will have, our informational guide on health insurance options after losing a job explains the official routes. For questions about your own health coverage, check your plan documents or contact your state insurance department.

Do you still need MedPay if you have health insurance?

MedPay pays regardless of fault, and the Texas Department of Insurance notes it also pays if you are hurt riding in someone else's car or while walking or biking. Whether it is worth adding depends on your health plan's deductible, who rides with you, and what your state offers. Ask your insurer for the price of $1,000, $5,000 and higher MedPay limits. The NAIC's sample declarations page shows MedPay at $1,000, and its guide also describes "excess medical payments," which pays necessary medical costs above PIP benefits.

What about injuries the other driver causes and cannot pay for?

PIP and MedPay have limits. When the at-fault driver has no insurance or too little, uninsured and underinsured motorist coverage can pay for injuries, and in Texas the Department of Insurance says it can also pay pain and suffering. See UM vs UIM.

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FAQ

Is PIP the same as MedPay? No. Both pay medical bills regardless of fault, but PIP can also pay lost wages and other nonmedical costs, according to the Texas Department of Insurance.

Which states are no-fault? Triple-I lists Florida, Hawaii, Kansas, Kentucky, Massachusetts, Michigan, Minnesota, New Jersey, New York, North Dakota, Pennsylvania and Utah, plus Puerto Rico.

Can I reject PIP? It depends on the state. In Texas, PIP is included unless you reject it in writing. In true no-fault states it is mandatory, though Michigan lets some drivers choose lower levels or opt out of PIP medical.

Does PIP cover passengers? Yes. The Texas Department of Insurance and Triple-I both describe PIP as paying for injuries to you and your passengers.

Does Florida PIP pay all my medical bills? No. Florida DHSMV says PIP covers 80 percent of necessary and reasonable medical expenses up to $10,000.

Sources

This article is general information, not insurance, legal or health coverage advice. PIP and MedPay rules vary by state and policy.