To start, generally in a car accident in Florida, an injured person’s automobile PIP insurance is primary for the medical bills. By primary, this means that the PIP insurance should be billed first. In fact, i have seen on many occasions that when a client’s health insurance (whether medicare, medicaid or private health insurance) is billed first in an auto accident, the health insurance denies the bill as they are not primary; however, in other instances, i have seen health insurance disregard that fact and just pay the bill. Since PIP insurance is generally 80 percent coverage, even for the first bills that are submitted, health insurance can get involved on paying the 20 percent balance. Further, in more significant injuries requiring hospitalization or surgery, the medical bills go well beyond the PIP $10,000 limits and thus health insurance can become primary once the PIP exhausts. So YES you can use health insurance for your medical providers following a car accident in Florida.
Interestingly, in most instances health insurance is entitled to be repaid WHEN THE INJURED PERSON RECOVERS MONEY FROM THE AT FAULT PARTY. This is called subrogation and the language is that the health insurance has a “lien.” Subrogation is proper when required by statute (medicare and medicaid generally have subrogation provisions by contract) or contract (most health contracts contain a subrogation provision). If you do not recover money, then you do not have to repay health insurance.
