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Who Pays My Medical Bills After an Accident?

Short Answer Is You, but Then the At-Fault Driver’s Insurance Company Will Reimburse You.

If you are injured in a car accident that is not your fault in Colorado, the other driver (usually through his insurance company) is responsible for your medical bills. However, a settlement with the other driver's insurance could take months, or even years, depending on how long your medical treatment takes. And most doctors and other health care providers want to get paid right away and if they don't, they could send you to collections.

First Choice: Health Insurance

That’s where YOUR insurance steps in. If you have health insurance, Medicare, or Medicaid, you should submit your medical bills to them. Even though the bill gets paid and discounted by health insurance, you are still entitled to collect the original undiscounted billed amount from the at-fault party and their insurance company. So although your health insurance benefits you by reducing the amount you owe, it does NOT benefit the at-fault driver by reducing the amount of compensation they owe to you.

Second Choice: Med Pay

If you have "Medical Payment" coverage (“Med Pay” for short) under your own Colorado car insurance policy, you can also use this to pay your medical bills. However, a better use of these benefits is to reimburse yourself for out-of-pocket costs that health insurance does not cover, such as co-pays or annual deductibles.

Third Choice: Liens

Liens are bills that are "on hold" and get paid out of the settlement money. Generally, if someone is willing to wait that long to get paid, they are not willing to offer a big discount off their bill. That means that more money has to come out of your settlement to pay for health care providers that have a "lien." But sometimes this is the only option if you don't have health insurance or Med Pay benefits.

Getting the Best Deal Requires Strategy and Coordination

The amount of a settlement you put in your pocket can be significantly affected by which bills you pay first, which bills you submit to health insurance or Med Pay, and which bills can wait until settlement. This involves strategy and careful negotiations with your car insurance company, health care providers, and health insurance companies.

Simple Example of How A Medical Bill Gets Taken Care of In a Personal Injury Case in Colorado:

  1. John gets injured in an accident in Colorado caused by someone else.

  2. John has a $1,000 medical bill that he submits to his health insurance company. Instead of owing $1,000, he only owes a $40 co-pay.

  3. John has his own car insurance company reimburse him the $40 out of his "Med Pay" coverage (which does not effect his insurance rates).

  4. John's attorney collects the undiscounted amount ($1,000) from the at-fault driver as part of the settlement.

  5. Instead of having to use $1,000 of his settlement money to pay this medical bill, John keeps it and walks away with more money in his pocket.

  6. Be advised that sometimes the health insurance company has a right to be reimbursed from the settlement. Even this outcome is still much better than not using health insurance. For example...

  7. Let's say the health insurance paid $100 of the $1,000 bill and the rest was adjusted/written-off. So the health insurance company wants to be reimbursed the $100 they paid for this bill. That means that John has to use $100 of his settlement money to reimburse his health insurer (still much better than using $1,000 of his settlement money to pay the bill) OR he can use his Med Pay to pay $100 to his health insurer (even better because nothing comes out of his settlement money).

    *Disclaimer: This is based on Colorado laws only. Other States may have different laws regarding the payment and reimbursement for medical bills related to a car or truck accident. If you have been injured in another State, contact an attorney licensed in your State to determine who pays your medical bills.

STILL CONFUSED?? That's understandable! Just call Gama Law Firm in Aurora today and we'll answer all your questions - even if you don't hire us. Joe and Richard Gama have been helping injured victims deal with medical bills for nearly 70 combined years and we want to help you.