Will Health Insurance Pay Car Accident Medical Bills?

The short answer is yes.  Health insurance will, and should, still cover bills for the treatment of injuries suffered in a car accident. However, it often falls on you and your accident lawyer to make sure your bills are submitted to health insurance for payment.

First, the most important thing after you have been injured in a car accident is to get to a doctor and take care of yourself physically. People often wait to seek treatment because they assume they will feel better eventually, or they are in fear of running up medical bills.  Don’t.  If you are experiencing pain or discomfort following an accident, get evaluated right away.

With that said, keeping track of all your medical bills and making sure they get paid can be a daunting task.  One trip to the E.R. usually results in two to five separate bills from separate billing agencies.  Add in visits to your primary care physician, physical therapist, chiropractor, pain management doctor, neurosurgeon, orthopedic surgeon and/or whoever else you are being treated by and the next thing you know you will have five to ten different bills being sent your home every month.

When you have been injured in an auto accident, you want ALL of these bills to be processed by your health insurance carrier.  If a treatment provider is aware that an injury was caused in a car accident, they will often try to skip sending your bill to your health insurance in an attempt to get paid more.  Health insurance carriers, such as Blue Cross Blue Shield, have negotiated reduced rates with treatment providers. Treatment providers would rather be paid directly from an auto insurance carrier following an accident so they can avoid taking the reduction in fee that the health insurance carrier has contracted for.

In Nebraska, health care providers are only entitled to recover the fee they would have received had they submitted the bill to health insurance (Neb. Rev. Stat. § 52-401); however, this does not stop many providers from trying to recover more.  Depending on your injury claim and depending on the type of health insurance you have, you may have to pay back your health insurance carrier for payments made on your behalf.  Even so, it is still in your best interests for your bills to be processed through your health insurance, as the amount you end up paying back will be substantially less after the contracted reductions.

For example, if you receive a $2,000 bill from a treatment provider and the treatment provider waits to be paid directly from your injury settlement, the amount of the bill owed after settlement will still be $2,000.  If, on the other hand, the $2,000 bill is submitted to your health insurance carrier and health insurance receives a $500 contracted reduction, the amount you will owe in reimbursement to health insurance will be only $1,500.  You just saved yourself $500.

Now, there are many other factors that come into play regarding payment of your medical bills, such as (1) if and when a health insurance carrier is entitled to reimbursement for amounts paid; (2) how much reimbursement a health insurance carrier is entitled to; and (3) differences between types of health insurance providers and plans (i.e. private insurance reimbursement vs. Medicare reimbursement).  These are all questions you should discuss with the injury attorney handling your case; however, the bottom line is when possible, always submit your medical bills to health insurance.