Yes, health insurance can cover car accident injuries, but it often doesn’t pay for everything—and it may not kick in until other forms of coverage are exhausted. For many injured drivers and passengers, navigating the layers of insurance coverage after a crash can quickly become confusing and frustrating.
That’s why many people choose to speak with an Atlanta car accident lawyer after a crash—to make sure they’re not left paying out of pocket when another driver or insurance policy should be responsible instead.
What Health Insurance Typically Covers After a Crash
If you carry private health insurance, it will generally cover reasonable and necessary medical treatment for injuries sustained in a car accident. This can include:
- Emergency room visits
- Hospital stays and surgeries
- Imaging tests like X-rays and MRIs
- Physical therapy
- Follow-up doctor visits
- Prescription medications
However, your health insurer may require you to use your auto insurance coverage first—especially if your policy includes MedPay or PIP (personal injury protection). In many cases, your health insurance will only kick in after those policies have been used.
Also, most health insurance plans still come with:
- Deductibles
- Co-pays
- Out-of-network limitations
- Coverage exclusions
And crucially, your health insurer may have the right to seek reimbursement from your car accident settlement later through a process called subrogation.
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The Role of Auto Insurance and MedPay
Before your health insurance gets involved, your auto insurance policy often comes into play. Here’s how:
- MedPay (Medical Payments Coverage): Optional in Georgia, MedPay covers medical bills for you and your passengers regardless of who caused the accident. It kicks in before health insurance and helps cover deductibles or out-of-pocket expenses.
- PIP (Personal Injury Protection): While not required in Georgia, this coverage operates similarly to MedPay in other states.
- Liability insurance (the other driver’s): If another driver is at fault, their liability coverage should ultimately pay for your medical expenses—but this may take weeks or months to resolve through a claim or settlement.
We help our clients coordinate these coverages so they don’t end up stuck paying upfront or dealing with unnecessary delays.
Can Health Insurance Deny a Car Accident Claim?
Yes—your health insurance company may delay or deny claims if they believe another party should be responsible. They may also refuse to cover certain treatments or providers if:
- Your auto coverage hasn’t been billed first
- You received out-of-network care
- There’s a pending liability claim and they expect reimbursement
- The treatment isn’t considered medically necessary under your policy
In these cases, we step in to resolve disputes, file appeals, and make sure clients get the care they need without interruption.
What About Subrogation?
One of the most overlooked issues in car accident claims is health insurance subrogation—when your health insurer demands repayment from your settlement.
Let’s say your insurer pays $25,000 for your treatment, and then you receive a $100,000 car accident settlement. Your health plan may assert a right to take that $25,000 back. If you’re not prepared, that could dramatically reduce what you walk away with.
At John Foy & Associates, we help protect your settlement by:
- Reviewing all subrogation claims
- Negotiating reductions or waivers when possible
- Ensuring repayment demands are legally valid
- Calculating your final recovery accurately before you accept any offer
Without legal help, many injured people are blindsided by these demands—and lose a large portion of their compensation without even knowing they could challenge it.
Why Legal Help Can Protect You
Even when insurance companies claim to be “on your side,” they often prioritize minimizing payouts over your recovery. We’ve seen clients face unnecessary delays, denied treatment, and low settlement offers simply because they didn’t know their rights.
When you work with us after a car accident, we:
- Determine which insurance policies apply to your situation
- Coordinate between your auto, health, and third-party insurers
- Calculate the full cost of your current and future medical needs
- Challenge lowball offers from the other driver’s insurer
- Protect your recovery from subrogation or unexpected bills
We don’t just pursue compensation—we manage the process from every angle so you aren’t left with stress, debt, or unanswered questions.
Common Scenarios We Handle
Every accident is different, but here are a few examples of cases where we’ve helped clients untangle overlapping insurance issues:
- A client’s MedPay ran out, and their health insurer refused to cover rehab. We appealed the denial and ensured their care continued without interruption.
- A hospital filed a lien against a client’s settlement. We negotiated it down and kept their recovery intact.
- A client didn’t realize their health plan wanted reimbursement. We intervened before the settlement and reduced the subrogation amount.
- A client with high-deductible insurance was facing $10,000 in out-of-pocket costs. We secured compensation from the at-fault driver’s insurer to cover it.
These kinds of results aren’t automatic—they happen because we know how to deal with the insurance industry and fight for our clients every step of the way.
We’ve Been Fighting for Georgia Drivers for Over 20 Years
At John Foy & Associates, we’ve helped thousands of injured drivers throughout Georgia get the medical care and financial recovery they deserve. With more than $1 billion recovered and a track record built on compassion and results, we understand how to protect your interests when insurance companies make things difficult.
If your health insurance isn’t covering what it should after a car accident—or if you’re unsure which policy is responsible—we can help you sort it out. You focus on getting better. We’ll handle the rest.
(404) 400-4000 or complete a Free Case Evaluation form