New Jersey PIP Coverage: The Options, the Limits and How Health Insurance Can Come First

New Jersey personal injury protection (PIP) pays covered medical expenses after a car accident regardless of who caused it, according to the NJ MVC (opens in a new tab). A Standard policy offers PIP medical limits of $15,000, $50,000, $75,000, $150,000 or $250,000, and some insurers offer more. The Basic policy provides $15,000 per person and per accident, with up to $250,000 for specified catastrophic injuries, according to the NJDOBI 2026 Buyer's Guide (opens in a new tab). You may be able to make a qualifying health plan your primary medical payer, but Medicare and Medicaid cannot be selected for that option. Deductibles, a 20 percent copayment, limits and treatment rules all affect what gets paid.

What New Jersey PIP covers

PIP benefits are paid without regard to negligence, liability or fault for covered bodily injuries, under N.J.S.A. 39:6A-4 (opens in a new tab). The medical part covers hospitals, doctors, other providers and medical equipment, according to the NJDOBI 2026 Buyer's Guide (opens in a new tab).

On a Standard policy, an extra PIP package can add benefits beyond medical care:

• Income continuation if an accident injury keeps you from working, reduced by any Temporary Disability benefits.
• Essential services for household tasks the injured person normally does.
• Death benefits for family members or the estate, subject to benefits already collected.
• Funeral expenses up to the selected limit.

The extra package can be declined, so lost wages are not automatically part of every policy. Check your declarations page to see whether you have it and what limits apply.

PIP has clear edges. It is not liability coverage for injuries you cause to someone else, and it does not pay for damage to your car. Pain and suffering is outside PIP entirely; that belongs to the separate lawsuit option. And PIP does not simply pay every bill, because treatment is subject to limits, deductibles, copayments, medical protocols, decision point review, precertification, fee schedules and medical necessity decisions.

Which PIP medical limits are available?

The available limit depends on which policy you have. On a Standard policy, the PIP medical limit options listed in the NJDOBI 2026 Buyer's Guide (opens in a new tab) are:

The Basic policy has a medical limit of $15,000 per person and per accident, according to NJDOBI's Basic policy planner (opens in a new tab).

Lower limits carry a catastrophic injury provision. Up to $250,000 is available for specified injuries regardless of the lower limit selected, according to the NJDOBI 2026 Buyer's Guide (opens in a new tab). The qualifying injuries are permanent or significant brain injury, spinal cord injury, disfigurement, and medically necessary treatment for other permanent or significant injuries given at a trauma center or acute care hospital immediately after the accident, until the patient is stable and no longer needs critical care. Injuries outside those categories are paid up to the limit you chose.

The limit on your own policy is whatever your declarations page and Coverage Selection Form show.

How much PIP do you need in New Jersey?

The right amount depends on the policy type, the health coverage in your household, the deductible and copayment you would face, whether you carry the extra PIP package, and your own circumstances. A driver with strong health coverage that pays for auto injuries is in a different position from a driver with no health plan, or with Medicare or Medicaid, which cannot be made primary for auto injuries.

A few questions help frame the choice. How would medical bills beyond the PIP limit get paid? Does your health plan cover auto accident injuries, and what are its deductibles and network rules? Who in the household depends on the policy? The Riskado guide to whether PIP is worth it and how much car insurance you need cover the broader tradeoffs. An agency can show the premium for each limit side by side.

Can health insurance pay first?

Yes, if your health coverage qualifies. On the Coverage Selection Form, you can select a qualifying health insurer as the primary source of medical coverage for auto accident injuries, according to NJDOBI's health insurer for PIP option page (opens in a new tab). Your auto insurer then provides secondary PIP coverage for necessary expenses the health plan does not cover.

Qualifying coverage can come from an insurance company, an HMO or an employer benefit plan, but you need to confirm that it covers injuries from car accidents. Medicare and Medicaid cannot be selected as the primary health insurer for auto accidents, though they may provide secondary coverage in some situations.

This choice changes how a claim works. Your health plan's deductibles, copayments, limits, network rules and precertification requirements apply. You also have to keep the health coverage in force. If it ends before an accident, the auto insurer pays PIP medical benefits, but you pay an additional $750 deductible, according to NJDOBI (opens in a new tab). Selecting this option may reduce your auto premium; the amount depends on the insurer.

If you change jobs or health plans, tell your agent so the PIP selection still matches your coverage.

What do the PIP deductible and copayment mean?

The standard PIP medical deductible is $250, with options of $500, $1,000, $2,000 and $2,500, according to the NJDOBI 2026 Buyer's Guide (opens in a new tab).

On top of the deductible, you pay a 20 percent copayment on medical expenses between your deductible and $5,000, whatever deductible you choose. The insurer pays the other 80 percent of that range. The Buyer's Guide gives two examples:

A higher deductible lowers the copayment portion but raises what you pay before PIP starts. If your health plan is primary, its own deductible and copayments apply instead, and losing that plan triggers the extra $750 deductible.

Who does New Jersey PIP cover?

Under N.J.S.A. 39:6A-4 (opens in a new tab), PIP benefits extend to:

• The named insured.
• Family members living in the named insured's household.
• Covered people hurt while in, getting into, getting out of, or using the insured car.
• Other people in or using the named insured's car with permission.
• Covered people hurt as pedestrians by a car or by an object thrown from a car.

When more than one policy could apply, such as a passenger who has their own auto policy, the policy terms, statutory definitions and other insurance decide which one pays first.

How does a PIP claim work after a crash?

Notify your auto insurer promptly and follow its claim instructions. Your treating provider then uses the insurer's address and forms to give notice of treatment, and submits the Uniform Attending Provider Treatment Plan Form for decision point and precertification requests, according to NJDOBI's PIP information page (opens in a new tab).

Timing matters. Under N.J.A.C. 11:3-25 (opens in a new tab), the treating provider generally must notify the insurer that treatment has started within 21 days. Late notice allows the insurer to reduce eligible charges:

Exceptions include certain emergency or secondary providers, situations where compliance was impossible, and timely decision point or precertification submissions.

An insurer's Decision Point Review Plan lists the treatment, tests, diagnoses, medical equipment or services subject to review or precertification. When the insurer responds by phone, it must follow up within three business days with a written authorization, denial or request for more information, under N.J.A.C. 11:3-4 (opens in a new tab). Ask your provider whether a planned treatment needs precertification before it starts.

Keep the claim number, accident details, treatment records, bills, provider forms, insurer letters, authorization decisions and any appeal documents in one place. The Riskado guide to filing a car insurance claim covers the general steps.

What happens if treatment is denied or reduced?

Disputed treatment or payment decisions go through an internal appeal first. Providers must use the uniform pre-service and post-service appeal forms, according to NJDOBI's internal appeal FAQ (opens in a new tab). A post-service appeal must be submitted at least 45 days before starting alternate dispute resolution or filing in Superior Court.

PIP alternate dispute resolution is administered by Forthright, the administrator NJDOBI identifies under N.J.A.C. 11:3 (opens in a new tab).

If the issue involves how an insurer or producer handled your claim, you can also contact NJDOBI Consumer Assistance (opens in a new tab) at 609-292-7272 or 1-800-446-7467, or send the NJDOBI insurance complaint form (opens in a new tab) online, by fax, or by mail to NJDOBI, P.O. Box 471, Trenton, NJ 08625-0471. Include the insurer or agent name, policy number, claim information, documents and the resolution you are asking for. A complaint does not pause the policy's claim, appeal, arbitration or court deadlines.

How does PIP relate to the lawsuit option?

PIP pays covered medical expenses and specified economic benefits up to your limits, regardless of fault. The lawsuit option is a separate choice about suing an at-fault driver for pain and suffering. Under the Limited Right to Sue option, injury thresholds apply to pain and suffering claims, but the option does not remove the ability to pursue economic damages such as medical expenses and lost wages, according to the NJDOBI 2026 Buyer's Guide (opens in a new tab). The two choices sit on the same Coverage Selection Form.

Questions to ask an agent about PIP

• Is this a Standard or Basic policy, and what PIP medical limit is on my declarations page?
• What PIP deductible do I have, and how does the 20 percent copayment apply?
• Is the extra PIP package included, and what are the income continuation, essential services, death and funeral limits?
• Does my health plan cover auto accident injuries, and does it qualify for the health insurer primary option?
• What happens if I lose or change health coverage?
• Which treatments need decision point review or precertification, and where should my provider send the treatment plan and 21-day notice?
• Can I see the coverage choices and premiums for each option in writing?

Check that the agent or agency is licensed through the New Jersey insurance license lookup (opens in a new tab) and NJDOBI's Division of Insurance (opens in a new tab), which licenses and regulates insurance producers and agencies. Riskado's directory lists insurance agencies in New Jersey and across the US by city and category, so you can find one near you to walk through the form.

Frequently asked questions

Is PIP required in New Jersey?

Yes. PIP is part of the mandatory auto insurance New Jersey drivers carry, according to the NJ MVC (opens in a new tab). The Basic policy includes $15,000 of PIP, and the Standard policy offers a choice of limits.

Does PIP pay if I caused the crash?

Yes. PIP benefits are paid without regard to fault, under N.J.S.A. 39:6A-4 (opens in a new tab). Limits, deductibles, copayments and treatment rules still apply.

Can Medicare be my primary coverage for auto injuries?

No. Medicare and Medicaid cannot be selected for the health insurer primary option, according to NJDOBI (opens in a new tab). They may provide secondary coverage in some situations.

Does PIP cover me if I am hit while walking?

PIP covers people injured as pedestrians by a car or an object thrown from a car when they are covered people under the policy, under N.J.S.A. 39:6A-4 (opens in a new tab). Whether a given policy responds depends on the statutory definitions and any other insurance.

Next steps

Pull your declarations page and Coverage Selection Form, and note the policy type, PIP limit, deductible, health insurer option and whether the extra PIP package is included. Then check your health plan's auto injury terms and ask an agency to show the premium for each choice you are considering.