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Making sense of your health insurance policy after a car crash

On Behalf of | Sep 11, 2020 | Auto Accidents

Car crashes can mean a lot of stress. You have to worry about getting your car fixed or possibly buying a new vehicle. On top of that, you and the other people involved in the crash will probably require medical attention for the injuries you suffer.

The more severe the injuries, the more expensive the care you need is going to be. In the immediate aftermath of a major crash, you will probably feel confused about your health insurance. Many people don’t ever need to make major claims against their health insurance because they only need routine care, like an annual physical, that receives full coverage under the policy.

Understanding what your insurance covers and what it won’t cover can help you make better decisions after a car crash.

There are four primary ways that health insurance companies limit their costs

Most people are familiar with the idea of a deductible. It is an amount that you have to pay out-of-pocket before the insurance company is going to start paying for the care that you need. Many people have deductibles that are several thousand dollars.

In addition, you may have a co-pay, which is a specific amount that you pay for each prescription medication or doctor’s visit. You may also have coinsurance, which involves a patient’s responsibility to cover a specific percentage of the medical costs. You may have to pay as much as 30% of the billed amount of the care that you received depending on the coinsurance rate for your policy.

Finally, insurers also reduce what they have to pay by establishing different compensation and coverage rates for in-network and out-of-network care. In other words, you have to see a physician who is in-network with your insurance company to receive the optimal coverage.

Your health insurance may not pay anything after a car crash

In the insurance world, there is a practice known as subrogation. That is where an insurance company that pays a claim for a policyholder goes after another insurance company because the person who holds that policy is the party that has fault for the incident.

In a car crash scenario, your health insurance company may initially approve claims for care that you receive after the crash, only to later go back after the other driver or their policy for the amount that they paid.

Instead of worrying about your patient responsibility for medical costs after a crash, make sure that you tell the people at the hospital that the care is related to a car accident. That way, you can likely delay payment at the time of service until the insurance companies figure out who should actually pay.

You may be able to file a car insurance claim for your medical costs or possibly file a civil suit if the costs are higher than the coverage of the other driver.