April 22, 2022

SHOULD I USE MY PRIVATE HEALTH INSURANCE FOR MY CAR ACCIDENT?

The bottom line up-front:  Yes.  You should always use your private health care insurance to pay for your car accident injuries—it is way cheaper.

Using Private Health Care in Utah Car AccidentsThere are several ways to pay for your medical care that was caused by the at-fault driver.  Some are cheaper than others, some are clearly more expensive options.

(1).  Cash Pay for Medical Services.  Only the rich can truly cash pay for catastrophic medical treatment.  Very few injured plaintiffs in car accidents can afford to cash pay, even a $10,000 knee surgery, let alone a $75,000 emergency room bill.  Physical therapy, chiropractics and other non-surgical treatment options are a bit more affordable with cash pay.   Like paying for all medical services, you ask the at-fault party for reimbursement in your car accident settlement.  But you first must pay up-front.

A Bit Cheaper.  If properly negotiated up-front with the medical providers, cash pay can be a cheaper way to pay for your medical care, if you can afford it.  Using private health care insurance is generally way cheaper.

(2).  Lien Pay.  Lien pay is where the medical provider doesn’t get paid until you get a settlement.  The medical provider charges way more because the provider doesn’t get paid until the end of the case, when and if settlement monies are received.  Much like your personal injury attorney doesn’t get paid until the end of the case when you get compensation for your injuries.  Doing medical lien work on car accident cases can be risky to anyone who is hoping to get paid from settlement monies because sometimes car collision cases don’t settle.  Or they don’t settle for enough.

Most Expensive.  Lien pay medical care is the most expensive type of medical care you can get on your Utah car accident case.  It is full-rate and then some to make up for the fact that the medical provider is taking a risk and not getting paid until the end of the case.  Which can be a year plus.

Utah Car Accidents(3).  Private Health Care Insurance.  BlueCross/BlueShield.  EMI, DMBA or Select Health are common Utah private health care insurance companies.  Using your private health care provider is way, way cheaper.  The only downside of using private health care—in network—is that these doctor’s don’t understand medico-legal aspects of a personal injury case and how to prove your injuries with correct medical documentation.

Generally the Cheapest Way to Go.  Unless you have a super high deductible private health care plan, generally using your private health care is the cheapest way to go.   Sometimes you encounter high deductible, $7,500 plans, or catastrophic only plans which may not be the way to go.

(4).  “PIP.”  Personal Injury Protection Benefits.  PIP benefits involve many insurance benefits, but the aspect most commonly associated with PIP benefits is the mandatory, minimum $3,000  medical pay provisions.

Every Utah car issued policy of insurance requires at-least $3,000 in medical payments associated with any car accident.  Meaning, whether you are the passenger, driver or a pedestrian struck by a Utah issued car policy of insurance, you will have at-least $3,000 to help pay your medical bills.  You should up it to $5,000 or $10,000.

PIP Pays First.  Must Use Your PIP.  Even though PIP pays full-rate for medical services, you must exhaust your PIP before your private health care insurance will start paying out.  Your health care insurance company will require a PIP exhaust letter indicating all PIP medical pay is exhausted before they will start paying.

EXAMPLES OF UTAH CAR ACCIDENTS AND HOW MEDICAL BILLS ARE PAID

Utah motor vehicle collisionsThe below example is what the costs would be if you used the various options mentioned above to pay your medical bills.

Example.  ACL/PCL Tear. Dashboard KneeYou are rear-ended on University Parkway, Orem, UT 84057.  Your knee covering the brake is thrust into the dashboard tearing your posterior acruciate ligament (“PCL”).   It takes you a week to get into the orthopedic surgeon who repairs your knee arthroscopically.  You are referred to physical therapy which takes 20 sessions.

 

 

Full-Rate Medical Costs.

$15,000                ACL/PCL athroscopic knee surgery.  Total charges by the surgeon, anesthesiologists and surgical facility fees.

$5,000                   Physical therapy fees.

Grant Total:  $15,000.

Using Private Health Care Insurance.

Private health insurance for in-network providers would pay a previously contracted rate of reimbursements that is unique to each type of provider.

$15,000                ACL/PCL athroscopic knee surgery.  Total charges by the surgeon, anesthesiologists and surgical facility fees.

Actual amount paid by private insurance:  $8,200.

$5,000                   Physical therapy fees.

Actual amount paid by private insurance:  $2,500.

Grant Total:                                                                               $15,000.

Grant Total Paid at Reduced Insurance Rates:        $10,700.

Total Saved by Using Insurance:                                    $4,300

Cash Pay.  If you cash paid, you can generally negotiate a less than actual billed prices for these surgical and physical therapy services.  Instead of paying  the $15,000 cash price equal to the total full cost price, you might be able to negotiate something less.

PIP Medical Pay. Your own car insurance’s PIP medical pay will the full-rate billed by each medical provider.  Even though it pays the full billed price, it pays out fairly easy.

UTAH CAR ACCIDENT ATTORNEY JAKE GUNTER—CALL/TEXT (801) 373-6345.  Free Consult

If you are having issues getting your medical bills paid from your car accident, call Utah car accident lawyer Jake Gunter.  Call/TXT (801) 373-6345.  Ask for Jake.