Out-Of-Pocket Medical Costs And What PIP Doesn’t Cover

The state’s no-fault insurance system requires every driver to carry Personal Injury Protection (PIP) coverage. But if you’ve been injured in a Florida car accident, don’t assume PIP will cover everything. Understanding what PIP doesn’t cover, and working with an experienced Florida personal injury lawyer, can make all the difference in your financial recovery.

PIP is designed to provide quick access to medical care after an accident, regardless of who was at fault. While it sounds straightforward, many injured drivers and passengers quickly discover that PIP has significant limitations. As a result, accident victims often face out-of-pocket medical expenses that can strain their finances during an already stressful time.

Common Out-of-Pocket Medical Costs After an Accident

Florida law mandates that PIP insurance covers 80% of reasonable medical expenses, up to $10,000, along with 60% of lost wages related to the injury. Some benefits for additional costs may be necessary. On the surface, this sounds comprehensive. But because PIP benefits are capped at $10,000, it’s easy for accident-related bills to exceed that limit.

Here are some of the most common expenses that PIP won’t fully cover:

• Emergency room fees. A single ER visit can cost thousands of dollars, easily eating through PIP coverage.
• Specialist visits. Orthopedists, neurologists, and other specialists often charge more than PIP limits can handle.
• Diagnostic testing. MRIs, CT scans, and other advanced imaging are expensive and usually not fully reimbursed by PIP.
• Long-term therapy. Physical therapy, occupational therapy, and counseling sessions may extend for months or years.
• Surgical procedures. Complex surgeries and post-operative care often go well beyond $10,000.
• Prescription medications. Ongoing prescriptions for pain management or recovery are rarely covered in full.

These gaps often leave injured individuals paying thousands of dollars out of pocket. Fortunately, there are legal avenues to pursue compensation beyond PIP. For starters, your personal health insurance may help, but it often comes with deductibles, co-pays, and limits.

If your injuries are serious, you may step outside the no-fault system and file a liability claim against the driver who caused the crash. It is also possible that an Uninsured/Underinsured Motorist (UM/UIM) policy could step in if the at-fault driver lacks adequate insurance. When insurance is not enough, an injury attorney can pursue a lawsuit to recover medical expenses, lost wages, and pain and suffering.

Dealing with Mounting Bills

Coping with expenses while recovering from an accident can feel all consuming. A skilled Florida personal injury lawyer can evaluate your coverage, negotiate with insurance companies, and fight for compensation to minimize out-of-pocket expenses. By exploring all available options, your attorney can help ensure you’re not left footing the bill for an accident you didn’t cause.

How have accident-related expenses complicated your family finances? Be sure you are not paying for bills that someone else could be responsible for. Have a conversation with the lawyers at Spencer Morgan Law in order to access all avenues of financial relief. Professionals are available to guide you through the process. To schedule a consultation, call 305-423-3800.