Can I Use My Health Insurance for Car Accident Injuries?

After a car accident in Tacoma, the medical bills can start arriving with alarming speed. The ambulance ride, the emergency room visit, the X-rays and CT scans—it all adds up. As you look at these invoices, you might wonder, “Shouldn’t the at-fault driver’s car insurance be paying for this?” While that’s ultimately true, the reality is that the other driver’s insurance company won’t pay a single dollar until their investigation is complete and a final settlement is reached, a process that can take many months or even years.

But your doctors and the hospital need to be paid now. So what do you do? This is where your own insurance policies come into play. Many people are hesitant to use their own health insurance, fearing it’s not meant for car accidents.

The answer is a clear and resounding YES, you can and absolutely should use your health insurance to pay for your medical treatment after a car accident. It is your first and best line of defense against financial stress and can protect your credit while your car accident claim proceeds.

Useful Information for You: In a Nutshell

• Yes, Use Your Health Insurance: It is essential for paying your medical bills promptly while you wait for your car accident claim to settle.
• Auto Insurance is Primary: In Washington State, your Personal Injury Protection (PIP) auto insurance is the primary payer for initial medical bills. Your health insurance acts as secondary coverage.
• Health Insurance Prevents Collections: Using your health insurance ensures your doctors are paid, which prevents your medical bills from being sent to collections and damaging your credit score.
• The Process is Called “Subrogation”: Your health insurer has the right to be paid back from your final car accident settlement.¹ This is a standard process called subrogation.
  
   
• It Can Save You Money: The rates health insurance companies negotiate with hospitals are often much lower than what you would be billed directly, which can ultimately leave more money in your pocket from the final settlement.

The Order of Payment: How Insurances Coordinate

Think of your insurance policies as a sequence. In Washington State, the payment process for your medical bills after an accident typically works like this:

1. Personal Injury Protection (PIP) Pays First:

Your own auto insurance policy’s PIP coverage is the primary payer.2 When you go to the doctor, you should give them your auto insurance and PIP claim number first. PIP will pay for your “reasonable and necessary” medical expenses up to your policy limit (e.g., $10,000 or more).

2. Your Health Insurance Pays Second:

Once your PIP benefits are exhausted (maxed out), your personal health insurance (like Premera, Regence, Kaiser, etc.) steps in. You would then provide your health insurance card to your doctors for all subsequent treatment. They will pay the bills according to the terms of your health plan, meaning you may be responsible for co-pays and deductibles.

Why Is Using Your Health Insurance a Smart Move?

1. It Protects Your Credit and Financial Health:

This is the most important reason. If your bills go unpaid while you wait for a settlement, hospitals can and will send them to collections. This can wreck your credit score for years. Having your health insurance pay the bills promptly avoids this entirely.

2. It Can Increase Your Net Settlement:

This is a benefit many people don’t realize. Health insurance companies have pre-negotiated, discounted rates with medical providers.3 A hospital might bill $5,000 for a procedure, but your health insurer’s contracted rate might only be $2,000. They pay the $2,000. When it comes time for your final settlement, the at-fault driver’s insurance is responsible for the full billed amount ($5,000). While your health insurer gets paid back, the difference can often result in a higher net recovery for you.

The Payback Process: Understanding Subrogation

Your health insurance policy includes a “subrogation” or “right of reimbursement” clause. This simply means that if they pay for your medical bills for an injury that someone else caused, they have the right to be reimbursed from the money you recover from the at-fault party.

This is a standard part of the settlement process. Your personal injury attorney will handle this. At the end of your case, your lawyer will negotiate with your health insurance company, often reducing the amount they need to be paid back, before disbursing the final settlement funds to you.

Navigating the interplay between PIP, health insurance, and the at-fault driver’s policy is one of the most complex parts of a car accident claim. Ensuring all your bills are handled correctly while maximizing your financial recovery is a task best handled by a professional. If you’ve been injured in an accident in the Tacoma area, search the Car Accident Lawyer Directory Tacoma. Compare profiles and reviews of trusted local attorneys who can manage the entire process for you, allowing you to focus on what matters most: your recovery.

References

• Washington State Office of the Insurance Commissioner (OIC) – Coordination of benefits:Official consumer guidance explaining how different types of insurance (like auto and health) work together to pay claims.https://www.insurance.wa.gov/coordination-benefits-cob-and-how-it-works
• Washington State Legislature – RCW 48.21A – Disability Insurance – “Subrogation”:The official state law that provides the legal framework for subrogation rights for disability insurers (which includes health insurance).https://app.leg.wa.gov/rcw/default.aspx?cite=48.21A.010