Making the Transition Between Personal Injury Protection and Health Insurance

When you’re involved in an automobile accident one of the first concerns is how am I going to pay for the medical bills? If you have personal injury protection (PIP) coverage it will pay 100 cents on the dollar for all accident-related treatment you receive up to your PIP policy limits. Most people have $10,000.00 in PIP coverage (though it’s possible to purchase more). After $10,000.00 paid, there is no more coverage for treatment under the PIP policy.

At that point, it is necessary to transition from PIP to health insurance (if you have it). You should let your providers that have been billing PIP know that they should now bill your health insurance.

Health insurance carriers (I guess in my cynical view) are always trying to avoid paying claims. They will not automatically accept accident-related bills. Before they start paying them, health insurers need to see what’s called a PIP exhaustion letter.

The PIP exhaustion letter is a letter from your PIP carrier (as the name suggests) that indicates that you have used up all of your PIP. Once presented with this letter your health insurer needs to start paying your accident-related treatment expenses.

One note: PIP doesn’t have limitations in terms of the number of visits you pay, for instance, to a massage therapist or physical therapy. There may be limitations associated with your health insurance policy that put a cap on the number of visits you can pay to a massage therapist, a physical therapist or a chiropractor per year. It’s important to check your policy to confirm these coverages before getting too deep into treatment.

If you have any questions about the relationship between PIP and health insurance I’d be happy to answer them.