Call 24/7 (920) 222-2222

Should I File a Car Accident Claim if Health Insurance is Paying for My Medical Bills?

One of the most common concerns for those involved in a car accident is how to pay for medical expenses. If you have health insurance, you may assume that your medical bills will be covered and that you don’t need to file a car accident claim. While your health insurance may pay for some medical costs, it doesn’t cover all damages from a car accident.

Understanding what medical insurance covers can help you recover from a car crash with fewer out-of-pocket expenses. Speak with an Appleton car accident lawyer from Brian Hodgkiss Injury Lawyers to review your damages and learn why filing a claim covers all your medical costs.  

What Medical Insurance Pays for After an Accident

Medical insurance typically pays for basic medical expenses for injuries sustained in a car accident. This can include various medical fees such as emergency room visits, hospitalizations, surgeries, diagnostic tests, physical therapy, and prescription medications.

Depending on the policy, your medical insurance may also cover costs such as ambulance fees, rehabilitation, and follow-up care.

Limits to Medical Insurance Coverage

While your health insurance pays for medical procedures and follow-up care, most policies limit what they will pay for following a car accident. Policy features that may impact your ability to receive coverage include out-of-pocket maximums, deductibles, and co-pays.

Out-of-Pocket Maximums

Out-of-pocket maximums are a common feature of health insurance policies and can impact your medical coverage. An out-of-pocket maximum is the combined limit you must pay in a year to receive a 100% payout on covered benefits. 

If your plan has an out-of-pocket maximum, it can limit your coverage for medical expenses related to your injuries. For example, some policies exclude certain healthcare services or treatments or apply a separate maximum for benefits such as prescription drugs.

Additionally, if you have a high out-of-pocket maximum, you must pay it before your insurance gives you full coverage for your accident expenses.


A deductible is the amount of money you must pay out of your pocket before your health insurance coverage kicks in. For example, if you have a $1,000 deductible and incur $5,000 in medical expenses in a car crash, you are responsible for paying the first $1,000, and your insurance covers the remaining $4,000.

If you have health insurance with a high deductible, you may pay a lot of money out-of-pocket for medical expenses before your insurance coverage begins.


A co-pay, or copayment, is a fixed amount of money that you pay out of pocket for a specific medical service. Co-pays can vary depending on your insurance plan and the services or medications provided. For example, you may have a $20 co-pay for a doctor’s visit or a $40 co-pay for a specialist.

After a car collision, your insurance may require co-pays for medical services, such as doctor’s visits or physical therapy. Depending on your insurance plan and the specifics of your injuries and required medical care, these costs can add up quickly, leaving you with hundreds or thousands of dollars in out-of-pocket expenses.

Additional Damages You Can’t Get from Health Insurance

While health insurance may cover some of your medical bills after a car accident, it typically does not cover other damages you may be entitled to.

  • Lost Wages: If your injuries prevent you from working, health insurance may cover your medical bills but not your lost wages during treatment and recovery. Car accident claims can include compensation for lost income and reduced earning capacity.
  • Vehicle Repairs: Health insurance does not cover the cost of repairing or replacing your vehicle or other property that was damaged in the accident. Filing a car accident claim ensures you receive compensation for property damage.
  • Pain and Suffering: Car accidents can cause physical pain and emotional distress, impacting your quality of life. Health insurance does not compensate you for these non-economic damages, but a car accident claim can financially compensate for pain and suffering.

Subrogation and Health Insurance

Subrogation is when an insurance company seeks reimbursement from a third party for damages the insurer paid upfront. For example, if your health insurance pays for your medical expenses, the company may seek reimbursement from the at-fault driver’s auto insurance company.

When you sign a subrogation agreement with your medical insurer, you may be responsible for paying back funds they cannot recover from the liable party’s car insurance company. If you win compensation for your injuries, you will pay back the insurer from these funds; however, if you do not win a settlement, you are responsible for paying them back out-of-pocket.

Seek the Maximum Settlement for Your Car Accident

When you are involved in a car accident, relying solely on your medical insurance to pay related expenses can leave you with high bills and missed compensation.

Our car accident attorneys at Brian Hodgkiss Injury Lawyers can help you understand your right to file a car accident claim and how your settlement can cover more than just medical-related costs.

Contact our legal team today to discuss your case and find out how filing a claim can get you fair compensation for your injuries.

Get Help Now

"*" indicates required fields

This field is for validation purposes and should be left unchanged.