Does Health Insurance Cover Motorcycle Accident Injuries?

Key Takeaways

Motorcycle accident injury might or might not get covered by your health insurance. How would the medical bills be covered? Would PIP coverage be available? Questions like this would surface and here’s what you need to learn about it.

• Health insurance coverage could cover your medical costs from an accident, or may not be.
• Motorcycle crash victims can still face deductibles, copays, coinsurance, and other costs even if a health insurer is covering some of the bills.
• In Massachusetts, motorcycle operators and passengers do not typically have PIP coverage for injuries they sustain while riding or operating the motorcycle.
• MedPay, if available, may help cover medical costs that are not covered by health insurance.

Getting hurt in a motorcycle accident can leave you dealing with two problems at once. You may need medical treatment right away, while also trying to figure out who is going to pay the bills.

That leads to a common question: does health insurance cover motorcycle accident injuries?

In many cases, health insurance can cover reasonable and medically necessary treatment after a motorcycle accident. But that does not necessarily mean your health plan will pay every bill.

The way your health insurance works with motorcycle insurance, MedPay, PIP, and a potential injury claim can make the situation more complicated.

Are Motorcycle Accident Injuries Covered by Health Insurance?

For the most part, your health insurance will be able to assist by paying at least some of the medical bills associated with treatment it deems necessary after the motorcycle accident.

This may include, but is not limited to, emergency or urgent care, hospital stays, laboratory services, office or outpatient services, physical therapy, tests or treatments, and surgery, all based on your health plan.

But you still could be responsible for deductibles, copays, coinsurance, or treatment your plan does not cover.

Your health insurance won’t help identify who was at fault for the accident either. If the other driver was to blame and caused the crash, you might still have a personal injury claim with the other driver for the damages that aren’t paid for by your health insurance.

That can include medical expenses, lost wages, pain and suffering, and all other damages if appropriate.

What Are the Effects on Medical Bills Following a Motorcycle Crash?

Post-accident medical bills can originate from a number of different sources.

You could be billed from an emergency room, a hospital, a doctor, an imaging center, a physical therapist, or any other healthcare provider. Your health insurance will, sometimes, pay for a portion of those bills.

The actual amount you pay may be determined by your deductible and other cost-sharing features.

For instance, if you have a health insurance policy that has a deductible that you haven’t satisfied, you might be responsible for some part of the bill even though the treatment is covered by your policy.

That is why it is so important to retain copies of medical bills, insurance statements, and receipts after an accident.

Does PIP Cover Motorcycle Accident Injuries?

This depends on the state and the circumstances.

Massachusetts is particularly important because motorcycle riders do not receive the same PIP protection that applies to people injured in other covered motor vehicles.

Massachusetts regulations state that motorcycle insurance policies are not required to provide PIP coverage for owners, operators, or passengers who suffer bodily injuries while operating or riding as a passenger on a motorcycle. 

That means a motorcycle rider injured in a Massachusetts crash may need to look to other sources of coverage for medical expenses.

The Massachusetts Division of Insurance specifically recommends that motorcycle owners consider Medical Payments Coverage, also known as MedPay. MedPay can help pay reasonable medical expenses resulting from a motorcycle accident.

How Does Health Insurance Work With MedPay?

MedPay and health insurance can sometimes work together.

Massachusetts’ coordination-of-benefits rules provide that MedPay under a motor vehicle policy is generally secondary to health insurance. In other words, covered medical claims are generally submitted to the health plan first, while MedPay may help with expenses that health insurance does not pay, such as applicable deductibles and copayments. The exact result depends on the policies involved.

For example, Massachusetts provides an example involving a motorcycle accident in which PIP is unavailable because the person was operating a motorcycle. The person’s health plan covered expenses, while MedPay covered the remaining deductible and copayment amounts. 

This is one reason it is worth reviewing both your health insurance policy and motorcycle insurance policy after an accident.

How Much Do You Have to Pay After a Motorcycle Collision?

And even if you do carry health insurance, getting in an accident can mean spending money out of pocket.

According to your plan, these may include:

• Deductibles
• Coinsurance 
• Copayments
• Non-covered treatment. The treatment may not be covered under this insurance plan.
• Certain out-of-network charges from another insurance.

You might be asked to visit a certain provider or adhere to other rules that could affect your coverage.

Don’t assume the total on the bill is what you will have to pay. An insurance company might reduce or adjust the charge for services that are covered.

If you cannot afford the medical bills, call the medical office and your insurer instead of ignoring them.

What is a medical lien?

The term medical lien is sometimes used for an arrangement that, in certain circumstances, might enable a medical provider to claim compensation out of the settlement in a personal injury matter.

This can be useful when, for example, an injured person refuses or is unable to use health insurance.

A medical lien does not mean your medical treatment is free. It means that the payment may come afterwards, often from the settlement recovered in the injury claim.

Understand the terms before accepting treatment on a lien, including the amount that can be owed and in what manner the provider will be paid.

Can My Health Insurance Take Money From a Settlement?

It can occur.

Nevertheless, subrogation is where it gets interesting.

If your health insurer paid for a medical expense resulting from an accident and you recover money from the person or company that was responsible for the accident, your health insurer may have a right to subrogation depending on your policy and applicable law.

It is not guaranteed to be easy. How much the insurance company may demand, if it has a valid right to reimbursement, and how it is then determined may depend on the circumstances and the provisions of that particular health plan.

In the event you are offered a settlement, make sure you know where you stand as far as any medical reimbursement claim or subrogation interest needs to be addressed prior to the resolution of the case.

What if it was the other driver who caused the motorcycle accident?

In circumstances where someone else was liable for the motorcycle crash, there may be a personal injury claim to pursue against the other driver.

If you have health insurance, this can help to pay for your doctor or hospital treatment while you are making a claim. This ought not to influence your right to make a claim for compensation from the at-fault party.

A motorcycle accident claim can include medical costs, lost wages, damage to personal property, and any other damages that are permitted under law.

The insurers involved may also disagree about who should pay certain costs.

This is one reason why it is handy to keep all accident documentation together in one place.

Is it necessary to see a motorcycle accident attorney?

You don’t have to wait until mounting medical expenses are debilitating to seek the advice of a motorcycle accident attorney. For instance, an attorney can help you figure out the details of the MedPay coverage, health insurance policy, motorcycle insurance policy, medical liens, and reimbursements.

An attorney can assist you with understanding the reimbursement process, especially if you have extensive injuries or treatments that are ongoing.

An attorney can tell you the kinds of coverage you can get, what types of compensation may be available to you, and whether someone else may be responsible for reimbursing their insurance company.

Get Help Understanding Your Motorcycle Accident Claim

Health insurance can be an important source of coverage after a motorcycle accident, but it may not be the only source available. PIP limitations, MedPay, deductibles, medical liens, and subrogation can all affect how your medical expenses are handled.

If you were injured in a motorcycle accident, you can learn more about your legal options through Tapalian Law’s motorcycle accident practice area.

Attorney David Tapalian can review your situation and explain your options. Book a consultation now! Book a consultation now. 

Frequently Asked Questions

Does PIP cover motorcycle riders in Massachusetts?

No. Massachusetts does not require PIP coverage for motorcycle operators or passengers who are injured while operating or riding on a motorcycle.

What is MedPay?

Medical Payments Coverage or MedPay is optional coverage that can cover specific health-related expenses. Massachusetts recommends that motorcycle owners consider this coverage. 

Can my health insurer claim it back?

Once your money is recovered from the third party, your insurance company may file a subrogation or reimbursement claim pursuant to your contract and state law.

What can I do to take care of my medical costs after the motorcycle wreck?

Verify that you’ve given your doctor’s office or other health care providers your health insurance information, make a copy of the bills and statements from your health insurance company, and verify whether you still owe any money or have any outstanding bills. If you were struck by another driver, speak with an attorney before closing out your injury claim.

Note: This article provides general information and is not a substitute for legal advice about a specific accident or insurance policy.