Who pays your medical bills while the claim is open?
At first, you and your own coverage do. In Virginia the at-fault driver's insurer usually pays once, at the end, not bill by bill. Until then, medical expense coverage on your auto policy and your health insurance can cover treatment.
Bills do not wait for a claim to finish. That can feel unfair. Here is a calm look at who may pay, and in what order.
Who pays first?
In many cases, the order looks like this. It is general information, and your policy and facts can change it.
- Your own coverage: medical expense coverage (MedPay) on your auto policy, if you have it.
- Your health insurance: if you have it.
- You: for anything left over, at least for now.
- The at-fault driver's insurer: usually at the end of the claim, not bill by bill.
Keep paying attention to due dates, and ask providers about payment plans. Ask each provider to bill your insurance.
What is MedPay?
MedPay is medical expense coverage on your auto policy. Under § 38.2-2201 (opens in a new tab):
- It is optional for you, but each insurer must offer it on request.
- It can pay up to $2,000 per person.
- It covers reasonable medical, dental, hospital, surgical, rehabilitation, emergency medical services and funeral expenses.
- The expenses must be incurred within three years of the accident.
- Other limits can be agreed.
Look at your declarations page, or call your agent, to see if you carry it.
What does your health insurance do?
Your health plan may pay for treatment while the claim is open. Some plans ask to be repaid from a settlement, so read your plan documents and ask the plan. Save every explanation of benefits (EOB), which is the statement your plan sends showing what it paid.
What is a lien?
A lien is a legal claim on money you may recover, used to repay a bill. Virginia law gives some groups a lien on an injured person's claim:
- Providers: § 8.01-66.2 (opens in a new tab) covers hospitals, nursing homes, physicians, registered nurses, physical therapists, pharmacies and EMS providers. The caps are $2,500 for a hospital or nursing home, $750 for each physician, nurse, physical therapist or pharmacy, and $200 for each EMS provider.
- The Commonwealth: § 8.01-66.9 (opens in a new tab) gives a lien for the total paid under Medicaid and related programs. It attaches to your claim and to funds from your own insurance or UM/UIM paid for that care.
For the Commonwealth lien, the amount may be compromised under § 2.2-514, and reasonable legal fees and costs are deducted from the total recovered. A lawyer can explain how this works.
What about Medicare or Medicaid?
- Medicare: the Centers for Medicare & Medicaid Services (CMS) has the right to recover payments that should have been another payer's responsibility. A conditional payment must be repaid when a beneficiary receives a settlement, judgment, award or other payment (CMS (opens in a new tab)). The Benefits Coordination & Recovery Center handles repayment for Parts A and B in liability cases. Recovery for Parts C and D belongs to the plan.
- Medicaid: see the Commonwealth lien above.
What should you keep?
- Every bill and every explanation of benefits
- Receipts for prescriptions and travel to treatment
- A list of providers, with dates
- Letters about liens or repayment
- Notes of calls about bills
Who may pay
| Who may pay | When | What to know |
|---|---|---|
| MedPay on your auto policy | During treatment | Optional; insurer must offer it on request |
| Your health insurance | During treatment | Ask if it expects repayment |
| You | While the claim is open | Ask about payment plans |
| At-fault driver's insurer | Usually at the end | Not usually bill by bill |
| Medicare or Medicaid | If you are covered | Repayment rules apply |
Check your dates with the deadline checker, and read how a claim moves. If the other driver is uninsured, see the UM guide.
Common questions
Does the at-fault driver's insurance pay my bills as I go?
Usually not. Claims typically resolve at the end, not bill by bill, so you may need to use your own coverage first. That can include medical expense coverage on your auto policy and your health insurance. Keep every bill and statement, since they become part of your claim later.
Is MedPay required in Virginia?
No. Medical expense coverage, often called MedPay, is optional for the insured, but insurers must offer it on request. Under the statute it can pay up to $2,000 per person for reasonable expenses incurred within three years of the accident. Check your policy to see if you have it.
Can a hospital take part of my settlement?
Virginia lets certain providers place a lien on an injured person's claim, with caps of $2,500 for a hospital or nursing home and $750 for each physician, nurse, therapist or pharmacy. A lien is a legal claim on money you may recover. Ask a lawyer how it applies to you.
What if I have no health insurance?
You still have options to explore. Ask whether you carry medical expense coverage on your auto policy, ask the provider about payment plans, and ask a lawyer about your claim. Keep every bill. If you receive Medicaid or Medicare, special repayment rules apply, so read the sections below.
Last reviewed · Reviewed by the roanokecrashhelp editorial team