Groth Gets it! by Groth Law Accident Injury Attorneys – Medpay and When to Use It

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Why should I use Medpay after a motor vehicle accident?

In this episode of Groth Gets it! from Groth Law Accident Injury Attorneys, Jon talks the 3 reasons you should use medpay after an accident. Also, he discusses how copays can be paid after a crash.


Jon Groth:

That’s a great question, and I think we need to address that now because I think this is something that is not talked about because it’s not really fun to talk about, but it’s very important. So why should you use Medpay after a motor vehicle accident? And there’s three reasons. To help pay for copays because health insurance may be secondary and maybe the most important one is that you paid for it, you pay a premium for it. So let’s go through those three things.

So why should you use your MedPay after a motor vehicle accident in Wisconsin? Number one, copays, because you’re going to be going to doctors and the doctors are going to ask to bill your health insurance, and your health insurance plan may have copays or deductibles that you have to meet before they or the health insurance will start paying the bills. So what you need to do is then keep track of what those copays are because in order to have less stress and in order to not really suffer even more, because now you’re stressed out about getting money to pay for the copays or the deductibles or those things, use what you already have, and that’s your Medpay.

Your Medpay might be a limit of $1000, $5,000 or $10,000 that you’re paying for, and you use that for your medical bills associated with a crash. So if it’s $1000 in Medpay and you have a $50 copay for every physical therapy visit, for example, then you can use your Medpay every time you go to physical therapy. So you don’t have to worry about, okay, how am I going to pay the 50 bucks this time when that $50 should be going to help pay for something else? Or gas prices are so high, I need to use it for that versus something else. So that’s number one. Help it to pay your copays.

Number two, your health insurance might be secondary. So what that means is some health insurance plans say, “Hey, we’re not going to pay anything until you’ve exhausted all your other insurance abilities, all your other insurance that’s available.” And if you have Medpay available and your health insurance is one of these plans that says we’re secondary to other insurance and that’s Medpay, then you have to use your Medpay. If you don’t use your Medpay, health insurance is going to say, “We’re not paying anything.” And then you’re in a position where you have Medpay available, your health insurance isn’t paying anything, and you’re sitting there wondering why you’re getting bills when you have all these ways that you’re a beneficiary of, that you can get things taken care of, you can get your medical bills, your treatment taken care of, but health insurance might say, “Nope, not going to pay.”

And they don’t want to pay, right? Because that’s their business. Their business is to take in premiums and pay out as little as possible. That’s why health insurance oftentimes gets a bad rap, because they don’t want to pay for certain care or you may have met your limit on a chiropractic treatment or physical therapy treatment or whatever, and that’s the business that they’re in. So they’re going to have certain restrictions. Sometimes one of those is using your Medpay first, and that’s super important. You have to know what you have available and how to work within those insurance constraints in order to maximize the benefits for you. And that’s one of the reasons why you hire a law firm, so we can help you navigate these kind of treacherous roads, right?

All right, third thing. A third thing is you paid for it. You paid a premium for MedPay. If you pay a premium for MedPay, let’s say it’s, I don’t know, $20 a month, as little as that, or if you’re paying $100 every six month, whatever it is you’re paying, you’re still paying something for it, so why not use it? If you’re not going to use it, then don’t pay for it. And you have that right in Wisconsin. You don’t have to have Medpay. Now, if you do have Medpay, it can be pretty beneficial for other reasons based on the made whole doctrine and collateral source rule and things like that. But if you are paying for it, why not use it? I think it’s important. I think it’s important to use it.

So long story short, here we go, why use Medpay after a motor vehicle accident in Wisconsin? Number one to help you for copays. Number two, because health insurance may be secondary to your Medpay. And number three, you paid for it, so you might as well use it.

All right, thank you. Good question. Thanks a lot.

Okay, we have another really good question here. So who pays copays after a car crash? So many times people call and say, “Okay, I have to go to the doctor, I have to get some care, but I want the at fault to pay because I don’t want to pay for it,” which I totally understand because it’s not your fault. If the crash was not your fault, then certainly the at fault party should pay. But let’s go and try to go through these three things step by step.

So who pays for the copays after a car crash? Options, number one, Medpay. Number two, one of the options is a doctor might hold a copay or might hold the bill until the end of the case, called the doctor’s lien. So that’s number two. And number three, the at fault party will pay for those bills after you sign a full and final release. So after you’re willing to sign off on any more compensation, they’ll pay for those bills. So those three things. So let’s go through those in a little more detail.

So number one, who’s going to pay for copays after a crash? If you have health insurance and your health insurance says, “Hey, you have a $50 per chiropractic visit and a $5,000 deductible or what have you, you’re responsible to pay for those bills out of your pocket.” So if you have auto insurance and you pay a premium for Medpay, medical payments coverage, then your medical payments coverage can step in and help pay for the copays and deductibles that are related to the crash. So number one, you’re paying a premium for health insurance. Health insurance has terms that you agreed to. And those terms in part are that you have to pay copays or meet deductibles, and you also have car insurance, and the car insurance has a Medpay portion. You can use the Medpay portion to pay for your copays and deductibles. There you go.

Number two, sometimes doctors will hold the bills. So many times if you’re at certain facilities, they’ll hold the entire bill because you sign what’s called a hospital lien or a letter of protection for the doctor, we’ve seen this for some of the big facilities, UW for example. [inaudible 00:07:03] sometimes does this, where they will have a hospital lien and they’ll take care of you and they’ll treat you, but then they have done certain things to perfect their lien, and then they can come at the end of the case and be the first person in line with their handout to get all the bills paid back.

The other thing is you can go to a doctor. Many times this is more like a chiropractor. Some physical therapy places will do this. Some small doctor shops, not like in Aurora, in Ascension, a Mayo, not those facilities, but a doctor who owns a little rehab clinic, for example. Those doctors will hold their bill until you’re able to pay from the at fault insurance. So that’s another way that you’re going to get the bills paid.

The third way is the at fault will or the at fault insurance will pay the bills that you incurred after a crash, but they’re going to pay it only after you sign off on a full and final release. So what that means is that the insurance wants the security that you’re not going to come back and ask for more money later on. So they’ll say, “Okay, we’re going to pay X amount of money for all your bills, all your pain and suffering, all your wage loss and any incidentals.” Once you sign that document, then they’ll give you a check for whatever the bills are, and that’s going to include copays and deductibles and other outstanding debts you might have that are related to medical care.

So those are three things. Who pays for copays after a crash? Medpay, doctors might hold the copays until the end, and ultimately the at fault party’s going to pay for it. All right, thank you. Interesting questions. Thanks a lot. Next.

Okay, very good question. So why won’t the at fault party pay right away? So if you’re in a motor vehicle crash in Wisconsin, why won’t the at fault party pay for all your losses right away? Well, there’s three reasons. The at fault party wants finality. They want this to be an unknown amount, unknown risk, so they’re going to want you to sign off on a document saying that this is final. So number one, finality.

They’re not going to pay for the second reason, which is they want to delay, delay to pay, because the money is in their account and their money is earning interest, so they’d rather have it in their pocket as long as they can, so they’re going to delay and delay and delay.

And that kind of goes into the third thing, is that they’re gathering evidence to help the insurance. So if they delay, maybe while they’re delaying this, you’re posting something online on social media that is going to hurt you, and you don’t think it will, but it might hurt you. Maybe they’re getting more witness statements, they’re getting other information, or they’re waiting for you to finish treatment and you don’t know that gaps in treatment are going to be difficult. And then you think, well, I’ll just wait for two or three months and if I feel better after two or three months, it’ll be fine. I’ll go back to the doctor, get cleared, and then have the insurance company pay.

If the insurance company does that and you come back two or three months after a crash, after not seeing a doctor for two or three months, the insurance company’s going to say, “Sorry, we have no proof that what you’ve been going through over the last two or three months is related to the crash. You may have been taking a bike ride and fell off your bike, or you picked up a milk jug the wrong way at the Aldi, or whatever it’s going to be. And those are the reasons that you’re hurting not the crash. Therefore, because you have no proof, we’re not going to pay for it.”

So the delay to pay, the gathering evidence, the waiting, the creation of a gap in treatment is going to help the insurance company. So that’s why they are going to wait. That’s why they will wait until they really are forced to pay because it’s going to help them.

All right. The other thing that they’re going to try to do is maybe gather evidence or gather statements from other people so they can figure out what’s called comparative fault or contributory negligence, to see if there’s something that they can convince you that hey, just merely because you were on the road, you’re 5% at fault or 10% at fault, or this person says that maybe they remember your car maybe was going a little bit faster than it should have, and then they’re going to use that against you to say, “Well, hey, we think you were speeding, therefore we’re going to offer you 10%,” and there’s nothing you can do other than filing a lawsuit to force them to not reduce your payout by 10%.

So things like that are going to hurt your case, so it’s important to have a strategy in place from the very beginning to make sure that you know what you’re doing and you know that what is going on is going to help your case, not hurt your case. So why won’t the at full party pay right away? Because they want finality. If they pay, they want to make sure that’s all they’re ever going to pay. They want to delay to pay because the longer they wait, the better it is for them usually. And number three, they want to gather evidence, get information that may hurt you. So that’s why they’re going to wait to pay. All right, thank you very much.

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