You were hurt in a crash, the bills are arriving, and maybe a hospital told you to use your auto insurance instead. If you’re not sure which card to hand over, that’s normal.
The short answer: yes, health insurance usually covers car accident injuries under its normal terms, including your deductible and copays, though your plan’s contract decides. Which insurance pays first depends on your state and your policies. In Michigan, auto insurance (PIP) usually pays first, unless you chose coordinated coverage or left PIP medical coverage off your policy. Your plan may also want repayment from a settlement. This reflects the law as of November 2026.
This guide answers the health insurance question. For every payer side by side, see who pays your medical bills while your claim is pending.
Holding a bill and not sure who owes it? Get a free case review. Four quick questions, no cost, no obligation.
Will health insurance pay for car accident injuries?
Usually, if your plan covers the care. In US Airways v. McCutchen, for example, an employer plan paid $66,866 in medical bills from a car accident, then sought repayment from what the employee recovered.
Check two things:
- Your plan’s terms. Some coverage excludes or limits crash injuries. Michigan’s opt-out law draws that line itself (MCL 500.3107d(7)(b)). Read your plan’s exclusions and coordination of benefits sections, or ask the plan in writing.
- Your network. Expect normal network and approval rules. For emergency services your plan covers, a nonparticipating hospital and its providers generally can’t bill you above your in-network cost sharing (45 CFR 149.410).
Do you use auto or health insurance first?
It depends on your state and on each payer’s contract and rules:
- PIP or medical payments coverage (MedPay) on an auto policy pays regardless of fault (42 CFR 411.50). Whether it goes ahead of your health plan depends on both contracts and your state. See how no-fault and at-fault states differ.
- Medicare generally can’t pay when auto, liability or no-fault insurance has paid or can reasonably be expected to pay (42 U.S.C. 1395y(b)(2)(A)(ii)), and you must pursue no-fault coverage first (42 CFR 411.51).
- Medicaid comes after other coverage: “all other available third party resources” must pay what they owe before it does (Medicaid.gov).
The real obstacle is the claims process. The hospital, the auto insurer and the health plan each have rules that can point to someone else, and none of them is assigned to sort it out for you.
In Michigan, does auto or health insurance pay first?
It depends on what’s on your auto policy. PIP benefits are due regardless of fault (MCL 500.3105(2)).
| Your Michigan coverage | Who pays first |
|---|---|
| Regular PIP with medical coverage | Usually PIP, up to your medical limit (MCL 500.3107c) |
| Coordinated PIP and an ordinary health plan | The health plan. PIP is secondary (MCL 500.3109a(1); Advance Therapy) |
| Coordinated PIP and a self-funded employer plan with clear terms putting auto first | PIP (Frederick & Herrud) |
| PIP medical coverage and Medicare or Medicaid | PIP, up to your limit (42 U.S.C. 1395y(b)(2); Medicaid.gov) |
| Opted out, or excluded, from PIP medical coverage | Medicare or your health plan, under its rules (MCL 500.3107d, 500.3109a(2)) |
| PIP limit used up | Your health plan may pay, if it covers the care. You can claim medical expenses above the limit from an at-fault driver (MCL 500.3135(3)(c)) |
Coordinated coverage. Insurers may offer a lower premium for deductibles and exclusions tied to your other health coverage, and the reduction must appear on your declarations page (MCL 500.3109a(1), (4)). When the two are coordinated, the Court of Appeals repeated in 2023, “the health insurer is primarily liable for the insured’s medical expenses” (Advance Therapy & Rehab v Auto-Owners). To check your policy, look at the declarations page for words such as “coordinated” or “excess,” and ask your agent.
Which doctor you use. If the coordinated plan is an HMO, you generally must use it for care it can provide, or the auto insurer may not owe the bill (Tousignant v Allstate, 1993). A PPO that also covers out-of-network care is different: the Court of Appeals found no requirement to stay in network (Advance Therapy).
If your plan won’t pay first. When a self-funded employer plan clearly puts auto first, its terms control and PIP is primary. The Michigan Supreme Court called that a narrow holding, and health coverage stays primary in other coordinated cases (Auto Club v Frederick & Herrud, 1993). Ask your employer whether your plan is self-funded, and get its answer in writing.
How settled this is. Tousignant and Frederick & Herrud came before the 2019 no-fault reform. Advance Therapy applied the older law to an earlier crash, noting that neither side argued the changes mattered. A court could read today’s law differently, and your policy’s wording still matters.
Opted out or excluded. You can’t get PIP medical benefits under that policy (MCL 500.3107d, 500.3109a(2)(c)). For who qualifies and what happens if your health coverage ends, see what Michigan PIP pays since the 2019 reform.
Hospital, auto insurer and health plan all pointing at each other? Get a free case review. Four quick questions, no cost, no obligation.
Can a hospital refuse to bill your health insurance?
In an emergency, this shouldn’t affect your care: a participating hospital can’t delay your screening exam or stabilizing treatment to ask about payment or insurance (42 U.S.C. 1395dd(h)).
- Medicaid. A participating provider can’t refuse to treat you because a third party may be liable (42 U.S.C. 1396a(a)(25)(D)).
- Medicare. Hospitals agree to bill other primary payers before Medicare (42 CFR 489.20(g)). When liability insurance may pay, CMS’s manual says providers generally must bill it for up to 120 days. After that, a provider can bill Medicare and drop most of its claims, or keep its claims against the settlement (CMS Medicare Secondary Payer Manual, ch. 2, § 40.2).
- A private health plan. Don’t take the billing office’s word for it. Get the answer in writing, using the steps below.
- In Michigan. If regular PIP applies, being sent to your auto insurer fits the usual order, and a provider can claim directly against that insurer for overdue benefits (MCL 500.3112). If you coordinated or opted out, tell the billing office and show your declarations page.
If a hospital won’t bill your plan:
- Ask in writing whether it’s in your plan’s network and why it won’t bill.
- Ask your plan whether the hospital must bill it, and how to file the claim yourself. Employer plans must explain how to file, and you have at least 180 days to appeal a denial (U.S. Department of Labor).
- Read before you sign anything promising payment from your settlement. See letters of protection.
- Ask for help. For an auto policy in Michigan, call the Department of Insurance and Financial Services (DIFS) at 877-999-6442. For an employer plan under federal rules, call the Department of Labor at 1-866-444-3272.
Who pays your deductible and copays after a crash?
Usually you, at first, even if the crash wasn’t your fault.
- A regular health plan. Expect your normal cost sharing.
- A coordinated Michigan policy. In Advance Therapy, a PPO plan paid nothing on a bill because the deductible wasn’t met. The Court of Appeals rejected the auto insurer’s argument that using an out-of-network provider excused it, so the provider’s claim could go ahead. So send your explanation of benefits to your PIP insurer and ask it to pay.
- If you opted out, were excluded or passed your PIP limit. The balance is generally yours for now, but you can claim those medical expenses from an at-fault driver (MCL 500.3135(3)(c)). If you opted out because of Medicare, you have a duty to seek Medicare payment for care from providers that take Medicare, and charges must be reasonable and necessary. The driver has to prove you failed to do that (Canty v Mason, Mich, July 27, 2026).
- Elsewhere. Ask whether MedPay on your auto policy can reimburse you.
Will you have to pay your health insurance back from a settlement?
Possibly. The rules depend on who paid:
| Who paid | What limits repayment |
|---|---|
| Self-funded employer plan | Mostly its own terms. State insurance laws generally don’t reach it. If its terms are silent on your lawyer’s fee, it generally shares that cost (McCutchen; FMC v. Holliday) |
| Insured plan, or a policy you bought | The policy and your state’s insurance law (FMC v. Holliday) |
| Medicare | Repay within 60 days of receiving the money, generally reduced by its share of your fees and costs (42 CFR 411.24(h), 411.37) |
| Medicaid | Only the part of the settlement for medical care, past or future (Ahlborn; Gallardo) |
For the math on what you’d keep, see who gets paid from your settlement.
What if you don’t have health insurance?
- Michigan PIP. It doesn’t depend on health insurance. With no applicable policy, you may be able to claim through the Michigan Assigned Claims Plan, which you must notify within one year of the crash. Medical benefits are generally capped at $250,000 (MCL 500.3172(1), (7), 500.3174).
- Medicaid. You can apply any time of year (HealthCare.gov). Coverage can now reach back up to three months for covered care, if you would have qualified then. For applications made on or after January 1, 2027, that drops to one month for the adult expansion group and two months for others (CMS). If you have recent crash bills and may qualify, apply soon.
- Hospital financial assistance. Tax-exempt hospitals must have a written policy covering emergency and other medically necessary care, and can’t charge eligible patients more than they generally bill insured patients (26 U.S.C. 501(r)(4), (5)).
What to do next
- Get your papers together: your auto declarations page, your health card and plan booklet, and any Medicare or Medicaid details.
- Give every provider all of it, and tell them which coverage you think pays first.
- Send written notice to your auto insurer, and keep every bill, explanation of benefits and letter.
- Ask your plan in writing whether it covers crash injuries and what repayment rights it claims. If it’s an employer plan, ask the administrator for your Summary Plan Description (U.S. Department of Labor).
- Get help before you settle. Get a free case review, or compare Michigan injury lawyers. See how injury lawyers get paid, and get any fee agreement in writing.
What waiting can cost
- A missed claim deadline. Plans set their own, so check your plan documents.
- Lost PIP benefits. In Michigan, you generally must give written notice within one year of the crash, and a lawsuit can’t recover losses from more than a year before it’s filed, though the clock pauses from a specific claim until a formal denial if you pursue it diligently (MCL 500.3145). A bill sent to the wrong payer can use up that time.
What a good outcome looks like
Your bills go to the right payer the first time. Your deductible is claimed from whoever owes it, and nothing lands in collections while you heal. Before you sign a settlement, you know what your plan can take and what you’ll keep. From holding a bill and being told to call someone else to knowing which insurance pays first, what you owe and what you may have to repay.
For more, see the vehicle accidents hub, what to do when a Michigan PIP claim is denied and your injury claim, from fault to value.
Frequently asked questions
Can I use health insurance after a car accident?
Generally yes, for care your plan covers, under its normal terms. Some coverage excludes or limits crash injuries, so check the exclusions and coordination of benefits sections. Your plan may also seek repayment from a settlement. In Michigan, regular PIP usually pays first, so give your provider both your auto and health details.
Do I use auto or health insurance first in Michigan?
Usually auto. PIP is due regardless of fault, up to your policy's medical limit (MCL 500.3105, 500.3107c). If you chose coordinated coverage, your health insurer is generally primary (MCL 500.3109a; Advance Therapy, 2023), unless a self-funded employer plan's clear terms say otherwise (Frederick & Herrud, 1993). If you opted out of or were excluded from PIP medical coverage, Medicare or your health plan pays under its own rules.
Can a hospital refuse to bill my health insurance after a car accident?
It depends on your coverage. A Medicaid provider can't refuse to treat you because a third party may be liable (42 U.S.C. 1396a(a)(25)(D)). A Medicare provider generally bills liability insurance first, for up to 120 days, and bills other primary payers before Medicare (CMS; 42 CFR 489.20(g)). With a private plan, ask the hospital in writing why it won't bill, and ask your plan how to file the claim yourself.
Do I have to pay my deductible if the accident wasn't my fault?
Expect to, at first, on a regular plan. On a coordinated Michigan policy, send your plan's explanation of benefits to your PIP insurer and ask it to pay, since PIP is the secondary coverage. Above your PIP limit, or if you opted out, you can claim medical expenses from an at-fault driver (MCL 500.3135(3)(c)). After a Medicare opt-out, you have a duty to seek Medicare payment for care from providers that take Medicare (Canty v Mason, 2026).
Does my health insurance get paid back from my settlement?
Possibly. A self-funded employer plan can generally enforce clear repayment terms (US Airways v. McCutchen, 2013). An insured plan is also subject to state insurance law (FMC Corp. v. Holliday, 1990). Medicare must be repaid within 60 days, generally minus its share of your fees and costs (42 CFR 411.24(h), 411.37). Medicaid can reach only the medical part (Ahlborn, 2006; Gallardo, 2022).
What if I have no health insurance after a car accident?
In Michigan, a household auto policy's PIP may still pay. If there's none, you may be able to claim through the Michigan Assigned Claims Plan, which you must notify within one year of the crash (MCL 500.3172, 500.3174). Anywhere, you can apply for Medicaid at any time (HealthCare.gov), and tax-exempt hospitals must have a financial assistance policy (26 U.S.C. 501(r)).
Sources
- MCL 500.3105, PIP benefits due without regard to fault · Michigan Legislature
- MCL 500.3107c, PIP medical coverage levels · Michigan Legislature
- MCL 500.3107d, Opting out of PIP medical coverage; qualified health coverage · Michigan Legislature
- MCL 500.3109a, Deductibles and exclusions related to other health coverage · Michigan Legislature
- MCL 500.3112, Who PIP benefits are paid to; provider claims · Michigan Legislature
- MCL 500.3116, Reimbursement of PIP from a tort recovery · Michigan Legislature
- MCL 500.3135, Tort liability under the no-fault act · Michigan Legislature
- MCL 500.3145, Limitations on actions for PIP benefits · Michigan Legislature
- MCL 500.3172, Claims through the Michigan Assigned Claims Plan · Michigan Legislature
- MCL 500.3174, One-year notice to the Assigned Claims Plan · Michigan Legislature
- Tousignant v Allstate Ins Co, 444 Mich 301 (1993) · Michigan Supreme Court (via the Caselaw Access Project, Harvard Law School Library)
- Auto Club Ins Ass'n v Frederick & Herrud, Inc (After Remand), 443 Mich 358 (1993) · Michigan Supreme Court (via the Caselaw Access Project, Harvard Law School Library)
- Advance Therapy & Rehab Inc v Auto-Owners Ins Co, No. 359673 (March 2, 2023) · Michigan Court of Appeals
- Auto insurance: File a Complaint · Michigan Department of Insurance and Financial Services
- 42 U.S.C. 1395y(b)(2), Medicare as secondary payer · Legal Information Institute, Cornell Law School
- 42 CFR 411.24, Recovery of conditional payments · Legal Information Institute, Cornell Law School
- 42 CFR 411.37, Amount of Medicare recovery after a judgment or settlement · Legal Information Institute, Cornell Law School
- 42 CFR 411.50, Liability and no-fault insurance definitions · Legal Information Institute, Cornell Law School
- 42 CFR 411.51, Beneficiary's responsibility with respect to no-fault insurance · Legal Information Institute, Cornell Law School
- 42 CFR 489.20, Basic commitments of Medicare providers · Legal Information Institute, Cornell Law School
- Medicare Secondary Payer Manual, Chapter 2, section 40.2, Billing in MSP liability insurance situations · Centers for Medicare & Medicaid Services
- 42 U.S.C. 1396a(a)(25), Medicaid third party liability · Legal Information Institute, Cornell Law School
- CMCS Informational Bulletin, November 18, 2025 (section 71112, retroactive eligibility) · Centers for Medicare & Medicaid Services
- Coordination of Benefits & Third Party Liability · Centers for Medicare & Medicaid Services (Medicaid.gov)
- Arkansas Dept. of Health and Human Services v. Ahlborn, 547 U.S. 268 (2006) · Legal Information Institute, Cornell Law School
- Gallardo v. Marstiller, 596 U.S. 420 (2022) · Legal Information Institute, Cornell Law School
- US Airways, Inc. v. McCutchen, 569 U.S. 88 (2013) · Legal Information Institute, Cornell Law School
- FMC Corp. v. Holliday, 498 U.S. 52 (1990) · Legal Information Institute, Cornell Law School
- Filing a Claim for Your Health Benefits · U.S. Department of Labor, Employee Benefits Security Administration
- 42 U.S.C. 1395dd, Emergency medical treatment (EMTALA) · Legal Information Institute, Cornell Law School
- 45 CFR 149.410, Balance billing in cases of emergency services · Legal Information Institute, Cornell Law School
- 26 U.S.C. 501(r), Requirements for tax-exempt hospitals · Legal Information Institute, Cornell Law School
- Your options outside Open Enrollment · HealthCare.gov (Centers for Medicare & Medicaid Services)
- Canty v Mason, No. 167772 (Mich, July 27, 2026) · Michigan Supreme Court
- Call v L & KJ Enterprises, LLC, No. 366229 (Mich Ct App special panel, April 20, 2026) (published) · Michigan Court of Appeals
Updated November 6, 2026
This guide is general information, not legal advice, and laws change. For advice about your situation, talk to a lawyer licensed in your state. Reading this page or contacting us does not create an attorney-client relationship.