What is medical payments coverage on home insurance?

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Medical payments coverage provides a small amount of money to cover medical bills for someone injured at your home, regardless of fault. It’s a standard part of a homeowners insurance policy.

Medical payments coverage, also called guest medical or medical payments to others, differs from liability insurance in that you don’t need to be negligent or be held liable for the damages for the policy to pay the claim. If a friend trips and sprains an ankle at your home, medical payments will help with the cost of treatment, even if the fall wasn’t due to your negligence.

On a standard HO-3 home insurance policy, medical payments coverage ranges from $1,000 to $5,000; it’s meant for minor incidents

Key Takeaways

Medical payments coverage is part of a standard homeowners insurance policy that can help cover the costs of minor medical expenses if a guest is injured on your property regardless of fault.
Medical payments coverage covers expenses related to ambulance services, emergency room or urgent care visits, medical tests, surgery, physical therapy and more.
Most policies pay out a minimum of $1,000 per injured person, but experts recommend extending this coverage to $5,000 per person or higher.

What is medical payments coverage on home insurance and how does it work?

Medical payments to others coverage, also known as Coverage F or guest medical, is a component of a standard homeowners insurance policy that helps cover minor medical expenses related to a guest injury that happens on your property. This no-fault coverage kicks in whether you (the policyholder) have been found liable for the injury or not.

“It works by reimbursing you, the policyholder, or the injured party directly, for expenses paid out for the injured’s medical bills derived from the injury,” explains Mark Friedlander, director of Corporate Communications for the Insurance Information Institute.

For instance, if your neighbor visits your home, slips on a wet spot in the kitchen, and fractures his elbow, your medical payments coverage would pay for his treatment up to the amount specified in your policy.

Landy Liu, former general manager of Better Cover, a digital home insurance agency in New York City, says this portion of your policy is designed to resolve smaller claims so they don’t escalate into lawsuits.

“Medical payments coverage has low limits, typically between $1,000 and $5,000, which is usually enough to amend a situation that calls for immediate medical attention,” says Liu.

What is covered by medical payments coverage on homeowners insurance?

Medical payments coverage commonly covers the following:

Medical attention
Ambulance services
Emergency room services
Hospital stays
X-rays and other medical tests
Surgery
Physical therapy
Nursing
Prosthetic devices
Dental services
Funeral services

“It will cover any necessary medical expenses that occur within three years from the date of an accident,” says David Griffin Jr., senior vice president of The Dowd Agencies, LLC in Massachusetts.

What is not covered by medical payments coverage?

Medical payments to others coverage usually does not cover the following:

Injuries suffered by a resident of the home or your pets
General pain or suffering
Damage to property
Accidents that occur outside of your home or its boundaries
Communicable diseases, such as a guest contracting COVID-19 while visiting your home
Controlled substances
Acts of war
Intentional injuries

“Medical payments coverage does not apply to anyone who lives in the home, either as a dependent or a tenant. It also doesn’t apply if the injury is expected or intentional, for example as a result of a fight,” Griffin says.

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How much medical payments coverage do I need?

In a standard homeowners insurance policy, medical payments coverage usually pays at least $1,000 per injured person. You can opt to increase this amount.

“There is minimal difference in the premium you’ll pay if you increase the coverage to a $5,000 limit versus a $1,000 limit, so we recommend taking a higher limit. Some insurers offer a limit as high as $25,000 for MedPay; ask your insurance agent if higher limits are available,” says Friedlander.

How much is medical payments coverage?

The portion of your premium that goes toward MedPay is minuscule. That’s why many experts recommend increasing your medical payments coverage limit.

“For example, on a Florida standard homeowners policy that has dwelling coverage of $400,000, the annual premium for MedPay is just $10 for a $5,000 limit,” Friedlander says.

How does a medical payments claim work?

Submitting a claim or requesting reimbursement for medical payments coverage is relatively simple.

“If someone has been injured at your home, such as a friend or neighbor, they can submit their medical bills to your insurance company,” says Liu. “This way, the bills can be paid quickly and without a liability claim being filed against you.”

Or, you or your guest can pay for your guest’s injuries out of pocket, and then you can submit a claim to your insurance company for reimbursement. Follow a few basic steps if you need to file a claim:

Take pictures of where the accident took place.
Document how the accident occurred and gather contact details for the injured party.
Obtain receipts for any expenses incurred.
Contact your insurance agent or carrier to file the claim.

Your home insurance deductible doesn’t apply to claims submitted for medical payments coverage.

Frequently asked questions

What is the difference between liability and medical payments?

Liability coverage on your home insurance policy kicks in when you have been found liable for injuries; your negligence caused the injury. Medical payments doesn’t require negligence.

Additionally, liability covers property damage, while medical payments coverage is only for injuries.

What is the medical payments coverage limit?

This limit is the threshold up to which your insurance company will pay out an eligible claim. Coverage limits typically span from $1,000 to $5,000, but you can purchase extra coverage for a small increase in your premium – up to a $25,000 limit if your insurer allows it. Because the cost of extra medical payments coverage is nominal, experts recommend getting the highest end of the coverage.

Does medical payments coverage replace health insurance?

No. Medical payments coverage is not a form of health insurance and does not replace a health insurance policy.

How does medical payments coverage work with renters insurance?

Medical payments coverage for renters insurance is similar to the coverage on homeowners insurance. If someone is injured on the property you rent and seeks medical attention, this coverage will pay for medical treatment, no matter who is at fault. Your renters insurance policy will cover the expenses caused by the injury up to the limits defined in your policy – usually $1,000 to $5,000.

The biggest difference with renters insurance medical payments coverage is that it only applies to injuries that happen inside the rental unit.

Erik Martin

Contributing Researcher

Erik J. Martin is a Chicago area-based freelance writer whose articles have been published by AARP The Magazine, The Motley Fool, The Costco Connection, USAA, US Chamber of Commerce, Bankrate, The Chicago Tribune, and other publications. He often writes on topics related to insurance, real estate, personal finance, business, technology, health care, and entertainment. Erik also hosts a podcast and publishes several blogs, including Martinspiration.com and Cineversegroup.com.