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Miami Injury Lawyer > Blog > Car Accidents > Does Health Insurance Cover Car Accident Expenses?

Does Health Insurance Cover Car Accident Expenses?


Following a car accident, it is paramount to promptly determine what party is responsible for the accident and whether or not that party has the appropriate insurance coverage to compensate for your injuries. In rare instances, you may be required to use your own health insurance coverage to pay for your medical expenses. This article will discuss whether health insurance covers the medical expenses that typically result from car accidents.

When would I ever need to use my own healthcare insurance to pay for my medical expenses after an accident?

Ideally, you would not necessarily need to use your own healthcare insurance to pay for any medical bills that you incur resulting from an accident because the at-fault driver’s insurance should cover your expenses. However, there are some instances where you may need to use your insurance to cover your medical expenses, which include the following:

  1. Where you are unable to determine which party caused the accident and therefore cannot obtain payment from that party’s insurance company
  2. Where you are unsuccessful at getting the at-fault driver’s insurance company to pay you (at which point you should consider consulting a personal injury attorney)
  3. Where the insurance company reimburses you for some, but not all, of your medical expenses via settlement

What does health insurance typically cover?

If you are required to use your own health insurance to pay for your medical expenses, you will first need to understand what is and is not covered under your specific plan. There are various health insurance plans that one can choose from, all with different types of coverage. However, most health insurance plans provide some of the following types of coverage:

  • Ambulatory patient services (outpatient care you get without being admitted to a hospital)
  • Emergency services
  • Hospitalization (like surgery and overnight stays)
  • Prescription drugs
  • Rehabilitative and habilitative services and devices (services and devices to help people with injuries, disabilities, or chronic conditions gain or recover mental and physical skills)
  • Laboratory services

What does health insurance typically not cover?

As previously mentioned, what is not covered under health insurance depends on the specific plan. However, in general, most health insurance plans do not cover the following:

  • Alternative medicine: This includes treatments such as massage, acupuncture, and herbal healing. If you typically use alternative medicine, be aware that the at-fault driver’s insurance company may not provide compensation for these types of medical costs and your insurance may also refuse to cover these expenses.
  • Cosmetic surgery: If you are severely injured in a car accident and need plastic surgery, most health insurance plans will not cover these expenses.
  • Unapproved medical care: Most often, injured parties are required to receive “pre-approval” from their health insurer before receiving certain types of procedures or treatments. As such, if the injured party obtains a procedure or treatment that has not already been approved, the insurance may not cover the associated costs.
  • Experimental treatments or procedures: Similar to alternative medicine, if you are interested in utilizing experimental treatments or undergoing an experimental procedure, your insurance may refuse to cover these expenses. Likewise, it is unlikely that the at-fault driver’s insurance company will reimburse you for these costs.

Have You Recently Been Injured in a Car Accident? Contact Our Firm Today

If you were recently injured in a car accident, please contact Pita Weber Del Prado. Our experienced Miami car accident attorneys can help you hold the liable parties responsible for your injuries and will ensure that you are fairly compensated for any damages you suffered.

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