PIP Medical Benefits Coverage Levels in Michigan

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PIP Medical Benefits Coverage Levels in Michigan

For decades, Michigan’s no-fault auto insurance laws required all drivers to carry unlimited personal injury protection (PIP) insurance coverage. Unlimited PIP benefits covered all “reasonable and necessary” accident-related medical expenses no matter who was at fault for the crash. This coverage turned out to be the most comprehensive and least expensive medical coverage that could be purchased anywhere in the U.S.

In 2019, the insurance industry pushed through drastic changes to the no-fault laws that have seriously shortchanged the citizens of Michigan. As the cornerstone of these changes, they dropped mandatory unlimited PIP coverage requirement, and now allow drivers to purchase smaller increments of PIP insurance of $250,000, $500,000, or, if you are covered by Medicare you can bypass purchasing PIP coverage entirely. Fortunately, drivers can, and should, still purchase unlimited lifetime coverage for accident-related care, and this is strongly advised. It is the cheapest and broadest form of health insurance available anywhere.

The insurance promoted these changes by falsely promising temporary reductions in insurance premiums, but these have not materialized. We have seen many unfortunate people with catastrophic injuries that opted for the limited PIP options and their futures are bleak. They will not be able to obtain the rehabilitation and care that will allow them to rehabilitate to their potential. The small increased cost of unlimited PIP is an extremely valuable benefit and should always be selected when buying your insurance.

If you’re a Michigan driver, it’s a good idea to familiarize yourself with your coverage options. Knowing how they could affect your insurance rates and the amount of money you can rely on if you’re injured in a wreck could protect you from a costly mistake. To learn more, continue reading or contact the Michigan car accident attorneys at Christensen Law for a free consultation.

What Are Michigan PIP Benefits?


Michigan is a no-fault auto insurance state. This means that drivers must use their own insurance policies to cover their expenses after a wreck. No-fault insurance policies include Personal Injury Protection (PIP) benefits, which cover injury-related costs regardless of who or what caused the crash.

Michigan PIP benefits can cover:

  • Medical costs, such as ambulance rides, surgeries, hospital stays, diagnostic tests, doctor’s visits, and prescription medications
  • Lost wages, if you’re unable to return to work, including up to 85 percent of your usual salary, with a monthly maximum amount adjusted by state law every year
  • Replacement services, if you need someone to help with day-to-day tasks such as child care, household chores, shopping, and non-medical transportation
  • Attendant care, for people who need help with health needs such as showering, dressing, feeding, supervision, rehabilitation, and medical transportation
  • Funeral or burial expenses, in the event of death

What No-Fault Medical Coverage Is Available?


What Are Michigan PIP BenefitsWhen you receive your PIP medical coverage form, you’ll have the choice of the following levels of no-fault PIP medical benefits coverage:

  • Up to $50,000: If you’re enrolled in Medicaid and your household includes a non-Medicaid recipient with an auto insurance policy, you may purchase a less expensive PIP policy with up to $50,000 in coverage, but you and your family will not be adequately covered.
  • Up to $250,000, with exclusions: If you have non-Medicare health coverage that provides injury benefits for you and your household after a collision, you can select this limited PIP coverage option. Some individuals may be excluded from PIP coverage under this plan as long as they have Qualified Health Coverage, but not Medicare.
  • Up to $250,000 or $500,000: Anyone can purchase a policy with up to $250,000 or $500,000 in PIP insurance coverage.
  • Unlimited coverage: Michigan drivers may also purchase unlimited PIP insurance policies. This is recommended for everyone to be sure of adequate coverage for the driver and their family members.
  • Opt-out: If you’re covered by Medicare Part A or B and other members of your household have their own coverage, you’re eligible to opt-out of PIP coverage altogether.

Keep in mind that if you fail to select a new policy, your plan will include unlimited PIP benefits by default.

Which Level Applies to My Crash?


The PIP medical benefits coverage level that applies to your crash depends on the plan you selected unless you allowed the policy to default to unlimited benefits.

In most cases, all of your reasonable crash-related medical bills up to your policy limits will be covered.

How to Make a PIP Benefits Claim


Under Michigan’s no-fault system, you’re eligible to make a PIP claim no matter who caused the crash. Your PIP benefits cover you and your whole household in the event of a car or pedestrian accident.

To file your PIP benefits claim, you’ll need to submit the following forms:

  • Your PIP application, which a knowledgeable car accident attorney can help you complete and send to your insurance provider
  • A lost wage verification form, if you plan to seek compensation for missed income

When Are PIP Benefits Paid?


If you were injured in a Michigan car accident, you have up to one year from the crash date to file a PIP claim.

After submitting your claim and providing valid proof of your accident-related injuries, the insurance company has 30 days to deliver your benefits. If they fail to pay, the company could be charged 12% annual interest on overdue benefits.

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My Medical Bills Exceed My Coverage Level. Now What?


If you sustained significant or catastrophic injuries in a wreck, the cost of your medical care will exceed the limits of your PIP insurance policy. When this happens, your options are limited to your health insurance or Medicaid. If you haven’t spoken with a car accident lawyer yet, now is certainly the time to do so.

When your medical expenses exceed the amount of PIP medical coverage you purchased, you can seek those excess medical bills from the at-fault driver filing a third-party lawsuit with the help of an experienced attorney.

Your lawyer will also explore how well the responsible driver was insured at the time of the crash. If they were uninsured or underinsured and you purchased UM/UIM coverage, you could turn to your own insurer for reimbursement of leftover medical costs. We always recommend purchasing optional uninsured and underinsured motorist coverage to adequately protect yourself and your family from losses caused by an uninsured or underinsured driver.

If none of these options apply, unfortunately you may be stuck for paying your excess medical expenses. An attorney can evaluate your situation and determine how to maximize your compensation and limit out-of-pocket costs.

To stay on the safe side, Christensen Law always recommends that Michigan drivers purchase as much auto insurance as they can.

How Can a PIP Lawyer Help Me?


If your PIP insurance provider has denied your claim, refused to provide the coverage you’re owed, or neglected to pay your benefits on time, a PIP lawyer can help by negotiating you’re your insurance company for you or filing a lawsuit in civil court. That would be the first step to getting the money you deserve.

Sometimes insurers deny claims due to errors that an attorney can help you avoid. Your lawyer can also help ensure that your PIP benefits claim is filed correctly and before the deadline.

If you need help understanding Michigan’s no-fault laws or deciding which coverage level is best for you, a Detroit PIP lawyer can explain your rights and thoroughly review your options.

Contact a PIP Lawyer in Detroit Today


The Detroit PIP lawyers at Christensen Law are here to help you understand Michigan’s complex auto insurance regulations and determine the best way to seek the compensation you need to recover. Call or contact us today for a free case review.

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