A new Colorado MedPay law, Senate Bill 11 (PDF), has come into effect as of January 1, 2009. The bill helps protect drivers needing medical attention following an Auto Accident. The bill makes limited medical coverage mandatory for auto insurance policy owners unless the insured opts out in writing.
After no-fault coverage was eliminated in 2003 by governor Bill Owens, there was a perceived need to provide Colorado auto accident victims with a medical coverage safety net. As a solution, Governor Bill Ritter supported Senate Bill 11. The aim of the bill is to help insulate Colorado residents who have been injured in auto accidents from the pressure of unexpected medical expenses. The bill also facilitates faster payment to emergency care providers. Many providers were being forced to wait 18 months to three years – until the resolution of the personal injury lawsuit – before receiving compensation for services they provided.
Bachus & Schanker views Senate Bill 11 as a valuable protection for consumers. MedPay coverage only averages about $5 a month, yet provides $5,000 in medical coverage without any deductible. That same $5 a month to a health insurance company would not provide nearly the same benefit!
Additionally, this can be used by people who lack health insurance, or to supplement existing health insurance policies. Even if a person already has health insurance, they still must pay large deductibles for ambulance and emergency room care. MedPay is now available to cover those costs. Furthermore, some health insurance policies explicitly state that they will not cover treatment for auto accidents. Even if they do, you may not be able to pick your doctor.
MedPay gives you greater freedom in choosing care providers and saves you a lot of money. Another benefit of MedPay is that the $5,000 limit is for each occupant in the car, so even if an occupant does not personally have health insurance, they are still covered. The fact that an occupant’s medical expenses are covered by MedPay may prevent lawsuits from the vehicle occupants against the driver’s insurance.
What is MedPay?
Colorado auto insurance medical payment coverage is an optional policy you can add to your car insurance plan. The MedPay Colorado law went into effect in 2009 and was revised in 2016. The law makes it mandatory for auto insurers to offer medical payments coverage to all clients. MedPay is an alternative to personal injury protection, or (PIP) insurance, which isn’t available in Colorado. MedPay eases your financial burden after a car accident because it pays for costs not covered by your health insurance plan.
What does MedPay cover?
Health insurance covers medical expenses, but there are gaps in coverage. Health insurance policies require beneficiaries to pay deductible fees and copays before paying for the balance of their medical expenses.
The MedPay benefit is designed to cover medical expenses after a motor vehicle accident. Your MedPay coverage pays benefits if you’re a driver in a car accident, a passenger in a vehicle involved in an accident, or a pedestrian hit by a motor vehicle.
The minimum coverage offered by MedPay is $5,000. When opting for MedPay, you can choose a higher coverage amount, ensuring your financial protection if you’re at fault for an accident. While your MedPay benefits cover medical treatment, the coverage is limited to these costs:
- Ambulance Bills
- Chiropractic Treatments
- Dental Bills
- Doctors Appointments
- Funeral Expenses
- Health Insurance Copays
- Health Insurance Deductibles
- Hospital Bills
- Prosthetic Devices
- Surgical Procedures
What does MedPay not cover?
You may have several expenses from your car accident that MedPay does not cover. MedPay is limited to approved medical expenses and does not cover the following:
|Expenses Not Covered
|Childcare and Pet Care Costs
|You may be unable to care for minor children and pets after your accident and need to hire someone to look after your children and pets. MedPay does not cover this expense.
|You may be hospitalized and unable to care for your home while recovering. MedPay does not cover housecleaning costs.
|You could face a lawsuit if you were at fault for the accident. MedPay does not cover these fees.
|MedPay does not cover lost wages, even if your injuries interfere with your ability to work.
|Medical Expenses of Other Parties
|MedPay covers the insured person’s medical expenses but does not cover the medical bills of other persons involved in the accident.
|Personal Care Aide Costs
|You may need a personal care aide to help you bathe or perform routine tasks after your accident. MedPay does not cover personal care aide costs.
|MedPay does not pay to repair or replace items damaged in your accident.
|MedPay does not provide survivor’s loss benefits if your spouse dies in the accident.
|You may need to rent a vehicle after your car accident, or you may need to pay for an Uber if you’re unable to drive. MedPay does not cover these expenses.
|Unrelated Medical Treatment
|MedPay does not cover the costs of medical treatments that weren’t necessitated by your accident.
Do you need MedPay if you already have health insurance in Colorado?
MedPay serves as a bridge between your medical costs and your health insurance plan. It covers many expenses you’d have to pay out of pocket. However, those with low deductibles or copays may feel it’s unnecessary. WalletHub reports that it usually costs less than $120 per year for MedPay coverage. This is a minimal expense compared to the costs of deductibles, copays, chiropractic treatments, and other charges covered by MedPay. However, MedPay costs are notably higher in some states, which is why you should compare prices before determining whether you need MedPay.
Colorado auto insurance companies may discourage you from adding MedPay protection.
Auto Accident companies may try to encourage a consumer to opt out of MedPay by falsely telling them that their health insurance already covers them. The goal of insurance companies to dissuade you from participating in MedPay is not to save you money; it is to force a premature settlement of a case. Accident victims may feel pressure to settle because they are personally responsible for the expense of their treatment following an accident. Often, the bills go unpaid for as long as two years, until a settlement is secured. Meanwhile, the victim sees their medical bills piling up and receives collection threats from bill collectors. MedPay can reduce the pressure that many injured parties feel to settle prematurely just to get their medical bills paid.
In looking out for the best interest of its constituents, the Senate has included a provision in the new act that prevents an insurance company from being reimbursed for the $5,000 MedPay benefit out of any final settlement. The Senate takes the same position as Bachus & Schanker, which is that when you pay for a benefit, you should receive that benefit when it is owed to you. If the large auto insurance companies could get reimbursed for the $5,000.00 paid out on your behalf, then the insurance company is essentially loaning you $5,000.00, and you are paying for an illusory benefit.
Opting for Medpay is a sound financial decision. MedPay is cost-effective by covering expenses health insurance may not. At the same time, it does not have to be paid back out of the final settlement. Also, MedPay may even prevent lawsuits from vehicle occupants to recover medical expenses because it covers each occupant. If you opt out of MedPay, you are taking a gamble that, by saving a small amount of money now, it will cost you later.
It’s crucial to understand that car insurance companies have a conflict of interest when advising you about MedPay. It is essential to learn about the following before finalizing your automobile insurance plan:
- What is the Colorado MedPay law
- How MedPay works
- The benefits of having MedPay
- How to select the best auto insurance
Every auto insurance company is required by law to offer MedPay coverage. You can be confident that you’ve found suitable insurance coverage from an auto insurance provider you can trust when you understand your legal rights.
How does MedPay work if you aren’t at fault for the accident?
MedPay covers approved costs whether you were or were not at fault for the accident. Either way, you, your doctor, or your hospital will contact your car insurance company to file your claim. You can provide your MedPay insurance plan information to your healthcare provider if they file claims for their patients. You don’t have to wait for your MedPay claim before you use your health insurance.
Since MedPay covers all accidents, regardless of fault, you can claim MedPay benefits if you’re in an accident with an uninsured motorist. It’s also a good idea to consult a car accident attorney about your legal rights in an accident involving uninsured motorists.
Summing Up How the Changes in Colorado MedPay Law Affect You
The following lists outline the major changes to MedPay that will affect your safety net coverage. The lists provide a comparison of the major effects to the law prior to January 1, 2009, and after January 1, 2009.
Prior to January 1, 2009 Senate Bill 11 Changes
- An insurance company was not responsible for any medical bills unless their client was proven to be at fault for the accident
- Persons injured in auto accidents were responsible for paying for their own medical treatment, and would only later get reimbursed by the at-fault party, if there is one.
- Persons with health insurance had to pay large deductibles for emergency care and were limited by where they could go for treatment and what would be covered.
- Persons without health insurance had to petition for a lien to secure treatment, and many medical providers refused to treat on a lien.
After January 1, 2009 Senate Bill 11 Changes
- This act shall take effect January 1, 2009, and shall apply to policies issued or renewed on or after the applicable effective date of this act.
- The new law requires insurance companies to provide consumers with the option of carrying a minimum of $5,000 in coverage per person involved in a collision to cover medical expenses incurred as a result of an automobile injury.
- An insurance company may try to act against your best interests and encourage you to opt out now to save a few dollars, even though carrying MedPay can save you a lot of money later.
- A car accident victim in Colorado can now avoid paying high health insurance deductibles for emergency care. Also, persons without health insurance can seek immediate treatment without the hassle of trying to find a healthcare provider who will treat an uninsured person, or receiving collection notices from the hospital’s emergency room or ambulance service.
Bachus & Schanker has the same goal as the Senate had in the enactment of this new law on January 1, 2009. It is the same goal Bachus & Schanker undertakes with every case; to preserve the public peace, health, and safety of Colorado individuals and families.
Car Accident Attorneys in Colorado
An auto accident is a stressful event that can create short- and long-term financial, physical, and mental health challenges. Depending on the accident’s severity, you may need months or years of medical care if you sustained a bodily injury. Although your health insurance can cover some of these expenses, medical bills for out-of-pocket costs, such as copays and medications, can add up quickly. You may also need to replace damaged property and cope with reduced income if your injuries cause you to take time off work.
Our car accident attorneys will fight to protect your financial future. Contact our Colorado auto accident attorneys to discuss your situation. We’ll explain your rights and options. As your legal team, we can file court paperwork, investigate the accident, build a case against the at-fault party, negotiate with insurance companies, and fight to secure the compensation you deserve.
McWhirter, K. (2022). No-Fault Car Insurance: What is PIP Insurance and do you need it?
Taylor, J. (2022). Medical Payments Coverage (MedPay).