Medical payments coverage
Medical payments coverage, often called MedPay, helps pay reasonable, necessary medical and funeral expenses for covered people injured in an auto accident, regardless of fault, up to your limit. Depending on the policy, it can cover you, resident relatives, passengers, or you as a pedestrian. State law and policy wording control exclusions and payment order.
Also called: medpay, med pay, medical payments, medical payments (auto)
Medical payments coverage, or MedPay, pays covered medical and funeral bills after an auto accident without waiting to find out who caused it. The dollar limit on your declarations page caps what it pays, and the policy wording decides who counts as covered and which expenses qualify. It works alongside liability coverage and health insurance, and it replaces neither one.
How a MedPay payment adds up
Massachusetts shows a real limit. Insurers there must offer medical payments coverage of at least $5,000 under Mass. Gen. Laws ch. 175, § 113H (opens in a new tab). Suppose one insured person has $7,500 in covered, reasonable medical expenses and a $5,000 limit.
Hover or tap a row to highlight it.
| Item | Amount |
|---|---|
| Covered, reasonable medical expenses | $7,500 |
| MedPay limit | $5,000 |
| Paid by MedPay | $5,000 |
| Not payable under that limit | $2,500 |
The $7,500 bill is an illustration, not an average. Depending on the state and policy, the remaining $2,500 may be addressed by health insurance, PIP, another policy, a liability recovery, or the injured person.
Limits and options that change what it pays
- Limit. The declarations page can show a per-person limit such as $1,000, $5,000, $10,000 or $25,000, and a higher limit raises the maximum payment. Higher limits can raise the premium, and the difference comes from the insurer's quote.
- State minimums. Maine requires at least $2,000 per person, according to the Maine Bureau of Insurance (opens in a new tab). N.H. RSA § 264:16 (opens in a new tab) requires at least $1,000 per person on private-passenger vehicles.
- Who is covered. A policy may cover the named insured and resident relatives in the covered auto, in another auto or as pedestrians, plus passengers in the covered auto. The definition of an insured varies.
- Expenses. Standard forms commonly include medical, hospital, surgical, nursing, dental, ambulance, X-ray, prosthetic and funeral services that are reasonable and necessary.
- Time period. The ISO Personal Auto Policy (opens in a new tab) pays for services within three years after the accident. Connecticut's regulation permits one year.
- Deductible and coordination. MedPay commonly has no deductible, while the order of payment with PIP, health insurance or other MedPay differs by state.
Where you will see MedPay
On an auto policy, the declarations page lists it as Medical Payments Coverage, MedPay or Part B. The insuring agreement, insured-person definition, exclusions and endorsements control the actual coverage, and a quote may show only the limit and premium, so the issued policy governs. Business auto policies may include it under the commercial form.
Homeowners, renters and condo policies carry a similar-sounding coverage, Coverage F, Medical Payments to Others. It pays reasonable medical expenses for eligible visitors hurt on the insured location, not the insured or regular household residents, according to the California Department of Insurance (opens in a new tab).
Two other auto coverages are easy to confuse with MedPay. PIP is first-party coverage that commonly adds lost wages and replacement services to medical and funeral expenses; the guide on whether personal injury protection is worth it covers that choice. Bodily injury liability pays claims by other people whom you are legally responsible for injuring, while MedPay pays your insureds and occupants without proof that you caused the accident.
What Connecticut and New York change
Connecticut changes who pays first. Regulation § 38a-334-7 (opens in a new tab) permits payment of reasonable medical expenses incurred within one year after the accident for a person injured while occupying the designated vehicle, and it lists permitted exclusions such as certain employment-related injuries and public or livery conveyance use. For policies effective on or after November 1, 2000, qualifying MedPay is primary over health insurance, and Bulletin PC-48 (opens in a new tab) confirms it. MedPay in Connecticut is optional, with typically limited benefits for the policyholder, a resident relative or a passenger, according to the Connecticut Insurance Department (opens in a new tab).
New York requires first-party No-Fault benefits, which changes MedPay's role. Insurance Law § 5102 (opens in a new tab) defines basic economic loss as up to $50,000 per person, and Insurance Law § 5103 (opens in a new tab) requires qualifying liability policies to provide the benefits. Optional MedPay is less important there because it responds when No-Fault does not cover the situation or after No-Fault benefits run out, according to the New York Department of Financial Services (opens in a new tab).
Questions to ask your agent or insurer
- What is my MedPay limit per person, and is there a per-accident or aggregate limit? The limit is the most the coverage pays.
- Who counts as an insured, including resident relatives, passengers and pedestrians? The definition decides whether a particular injury can be claimed.
- Does MedPay pay before or after my health insurance or PIP? Connecticut, Massachusetts and New York each set a different order.
- Which medical and funeral expenses qualify, and what exclusions, deductibles or claim deadlines apply? Forms require reasonable, necessary expenses within a time period.
- What is the premium difference between my limit and the next one up? Insurers set filed rates, so the price is specific to the carrier.
Frequently asked questions
Short answers to common MedPay questions follow.
Does MedPay require the other driver to be at fault?
No. MedPay is first-party coverage and pays covered expenses regardless of fault, up to the limit and subject to exclusions, according to the California Department of Insurance (opens in a new tab).
Does MedPay cover passengers?
The auto policy covers other people while they occupy the covered auto, and the exact result depends on the policy's insured-person definition and exclusions.
Does MedPay replace health insurance?
No. MedPay pays up to its own limit and terms, and the order between MedPay, health insurance and PIP varies by state. The question to ask is which policy pays first in your state.
Does homeowners Medical Payments to Others cover my own injury?
No. Standard Coverage F is designed for eligible people other than the insured and regular household residents, according to the Missouri Department of Commerce and Insurance HO-3 policy form (opens in a new tab).