Car accidents happen in an instant, but the resulting injuries and medical bills can impact your life for months or even years. For Arizona residents facing the aftermath of a collision, understanding how insurance will cover medical expenses becomes an urgent priority.
Does Health Insurance Cover Car Accident Injuries?
Your health insurance may pay for treatment if you’re injured in a car accident in Arizona, but it usually acts as secondary coverage after any available auto insurance benefits have been exhausted. In such cases, your health insurance company may seek reimbursement through a process called subrogation if another insurance policy is determined to be primarily responsible.
Understanding Arizona’s Auto Insurance Requirements
Arizona law requires all drivers to carry minimum liability insurance coverage of $25,000 per person and $50,000 per accident for bodily injury, plus $15,000 for property damage. However, these minimums only cover damages you cause to others—not your own injuries.
As a “fault” state, Arizona’s insurance system places financial responsibility on the driver who caused the accident. This means if someone else hits you, their liability insurance should theoretically cover your medical expenses—but only up to their policy limits.
The reality is that these minimum requirements often fall woefully short when serious injuries occur. A single day in the hospital can easily exceed $25,000, leaving accident victims with substantial medical bills that exceed the at-fault driver’s coverage limits.
Types of Auto Insurance That Cover Medical Expenses
- Medical Payments Coverage (MedPay) is an optional addition to your auto policy that pays for medical expenses regardless of who caused the accident. MedPay typically covers you and your passengers’ medical costs up to your policy limits, which usually range from $1,000 to $10,000. Unlike health insurance, MedPay has no deductibles or copays, making it a valuable first line of defense after an accident.
- Uninsured/Underinsured Motorist Coverage (UM/UIM) protects you if you’re hit by a driver who either has no insurance or insufficient insurance to cover your injuries. This coverage also applies in hit-and-run accidents where the at-fault driver can’t be identified.
These optional coverages serve as a bridge between auto and health insurance, potentially saving you from paying hefty out-of-pocket costs before your health insurance kicks in. Many Phoenix residents find that investing in these additional protections provides valuable peace of mind, especially given the high rate of uninsured drivers on Arizona roads.
How Health Insurance Processes Car Accident Claims
When you receive medical treatment after a car accident, your healthcare providers will typically bill your health insurance if you provide your insurance information. However, the process isn’t as straightforward as with routine medical care.
If you were injured in a car accident caused by another driver, your health insurance may pay for your care initially but will look to the at-fault driver’s auto insurance for reimbursement.
When using health insurance after an accident, be aware of network restrictions. If your injuries require emergency treatment, most health insurance plans cover emergency care at any hospital. However, for follow-up treatment, your health plan may require you to see in-network providers to receive full benefits.
Your health insurance policy may also contain exclusions for certain accident-related treatments. Physical therapy, chiropractic care, and mental health services sometimes have coverage limitations that can affect your recovery options after an accident.
Additionally, some treatments may require preauthorization from your health insurer. If you need surgeries, specialized diagnostic tests, or extensive rehabilitation, your doctor may need to obtain approval from your insurance company first—a process that can delay necessary care.
The Concept of Subrogation in Arizona
Subrogation is a legal concept that allows your health insurance company to recover costs from another party (typically the at-fault driver’s insurance) after paying for your medical treatment. This process occurs behind the scenes between insurance companies and typically doesn’t require your direct involvement.
Under Arizona law, health insurers have subrogation rights, meaning they can legally seek reimbursement for expenses they covered when another party was responsible for your injuries. This reimbursement typically comes from any settlement or judgment you receive from the at-fault driver.
The timeline for subrogation claims generally follows the resolution of your claim against the at-fault driver, which can take months or even years. Your health insurance will continue to cover your care during this time, assuming you meet all other policy requirements.
As the patient, you have a responsibility to inform your health insurer if you’re pursuing a claim against another party and to honor your insurance contract’s subrogation clause when you receive a settlement. Failure to account for your health insurer’s subrogation rights could result in the insurer taking legal action to recover their costs.
Coordination Between Auto and Health Insurance
Navigating multiple insurance claims after an accident requires careful coordination. The typical process follows this sequence:
- You receive medical treatment and provide both your auto and health insurance information to providers.
- Your MedPay coverage (if you have it) is usually billed first.
- After MedPay limits are reached, your health insurance becomes the secondary payer.
- If another driver was at fault, their liability insurance may eventually reimburse your health insurer and cover additional costs.
When filing claims with multiple insurers, maintain detailed documentation of all medical treatments, bills, and communications with insurance companies. Request itemized statements from all healthcare providers showing dates of service, diagnosis codes, treatment codes, and charges.
Healthcare providers can sometimes inadvertently create complications by billing the wrong insurer first. If you notice billing errors or receive unexpected denials, contact both your auto and health insurance representatives immediately to resolve these issues promptly.
Out-of-Pocket Expenses to Anticipate
Even with both auto and health insurance coverage, you’ll likely face some out-of-pocket expenses after a car accident:
- Health insurance deductibles, which can range from several hundred to several thousand dollars before your coverage begins. If you’ve already met your deductible for the year through other medical care, this may not be an issue.
- Copays and coinsurance for doctor visits, medications, and therapies can add up quickly when you’re receiving frequent care after an accident. Most health plans require you to pay a percentage (typically 20-30%) of covered services after meeting your deductible.
- Annual maximum out-of-pocket limits cap how much you’ll pay for covered services in a calendar year. However, any services not covered by your plan don’t count toward this limit.
- Balance billing can occur when healthcare providers charge more than what your insurance considers “reasonable and customary.” In Arizona, balance billing protections apply to emergency services, but you may still face these charges for non-emergency accident-related care from out-of-network providers.
These expenses can create considerable financial strain, especially if your injuries require ongoing treatment. Planning for these costs early in your recovery process can help you manage your finances more effectively and avoid surprising bills down the road.
Special Considerations for Medicare and AHCCCS
If you’re covered by Medicare, special rules apply after a car accident. Medicare functions as a “secondary payer” when auto insurance coverage is available. This means Medicare will only pay for services after your auto insurance benefits have been exhausted.
Medicare beneficiaries must report accidents promptly to Medicare’s Benefits Coordination & Recovery Center within specified timeframes. Failure to report could result in Medicare denying claims related to the accident.
For those covered by Arizona Health Care Cost Containment System (AHCCCS), Arizona’s Medicaid program, similar secondary payer rules apply. AHCCCS pays for medical services only after available auto insurance coverage has been exhausted.
Both Medicare and AHCCCS have robust recovery departments that actively pursue reimbursement from at-fault parties and their insurers. If you receive a settlement, these government programs must be reimbursed for accident-related care they provided.
Practical Steps After an Accident
- Ensure everyone receives appropriate medical attention, even if injuries seem minor. Some serious conditions, including whiplash and traumatic brain injuries, may not show symptoms immediately.
- Document the accident scene with photos if possible and collect contact and insurance information from all involved parties.
- Report the accident to your auto insurance company promptly, even if you weren’t at fault. Many policies require timely notification as a condition of coverage.
- Clearly inform healthcare providers that your injuries resulted from a car accident. This ensures proper documentation and appropriate billing.
- Keep a detailed log of all medical treatments, medications, and how your injuries affect your daily life. This documentation supports both insurance claims and potential legal action.
Following these steps methodically can make navigating the insurance process much smoother. Remember that your primary focus should be on recovery, and taking these practical actions helps ensure your financial interests are protected while you heal.
When to Consider Legal Representation
While straightforward accident claims can often be handled without legal assistance, certain situations warrant consulting with a personal injury attorney.
Complex cases involving disputed liability, multiple at-fault parties, or government vehicles may require legal expertise to navigate successfully.
Serious injuries resulting in extensive medical expenses, long-term disability, or loss of income often benefit from professional legal representation to ensure fair compensation. If you encounter resistance from insurance companies—whether your own or the at-fault driver’s—a car accident lawyer can advocate on your behalf and handle negotiations.
Be aware of the applicable statute of limitations for personal injury claims arising from car accidents. Failing to file a lawsuit within the required timeframe typically bars you from seeking compensation through the courts.
Reviewing Your Insurance Coverage
After experiencing the complexity of accident-related claims, many Arizona residents realize their insurance coverage needs adjustment. Consider reviewing both your auto and health insurance policies with these questions in mind:
- Are your auto liability limits sufficient to protect your assets if you cause an accident with serious injuries?
- Would adding MedPay coverage provide valuable protection for out-of-pocket medical costs?
- Does your health insurance provide adequate coverage for potential rehabilitation services like physical therapy?
- How high is your health insurance deductible, and could you afford to pay it if injured unexpectedly?
For comprehensive protection, most insurance professionals recommend carrying liability limits well above the state minimums—ideally $100,000 per person and $300,000 per accident. Adding robust UM/UIM coverage at similar limits protects you from underinsured drivers, who are unfortunately common on Arizona roads.
By understanding how your various insurance policies work together and taking proactive steps to optimize your coverage, you can gain peace of mind knowing you’re prepared for the unexpected challenges that car accidents present.
Speak to a Phoenix Car Accident Lawyer Today
If you have been injured in a car accident or suffered loss due to another’s negligence in Arizona, or you are dealing with an insurance company that is lowballing your claim or outright denying you the compensation you deserve, Hutzler Law can help. Our Phoenix car accident attorneys know what tactics and strategies insurance companies use to protect their interests and minimize payouts to accident victims.
We offer free consultations for car accident matters, so you get answers to your questions without committing to a law firm right away.
Call our office today at (602) 730-4530 or fill out our short contact form.
Jason Hutzler
Jason Hutzler is the founding attorney of Hutzler Law, a Phoenix injury and car accident law firm dedicated to fighting for the rights of injury victims. He represents individuals throughout Arizona, using his experience as a former insurance adjuster to anticipate insurance company tactics and maximize compensation for his clients.