Key Takeaways
- Part B is FIRST-PARTY coverage — it pays medical expenses for the insured and passengers regardless of fault
- Coverage applies to injuries from auto accidents for the named insured, family members, and occupants of the covered auto
- Typical limits are $1,000 to $10,000 per person — relatively low compared to actual medical costs
- The named insured is covered as a PEDESTRIAN if struck by a motor vehicle
- Part B pays promptly without waiting for fault determination — designed to cover immediate medical expenses
Part B: Medical Payments Coverage
Part B provides quick payment of medical expenses for you and your passengers after an auto accident — without waiting to determine who was at fault.
What Is Medical Payments Coverage?
Definition: First-party, no-fault coverage that pays reasonable medical expenses resulting from an auto accident.
Key Characteristics
| Feature | Description |
|---|---|
| Type | First-party coverage |
| Fault | No-fault — pays regardless of who caused accident |
| Payment | Prompt — doesn't wait for liability determination |
| Limits | Per person (not per accident) |
What Part B Covers
Covered Medical Expenses
- Doctor and hospital bills
- Surgery and surgical procedures
- X-rays and diagnostic tests
- Ambulance services
- Professional nursing care
- Prosthetic devices
- Dental services (injury-related)
- Funeral expenses (some policies)
Coverage Trigger
Expenses must result from:
- Occupying a motor vehicle
- Being struck as a pedestrian by a motor vehicle
Who Is Covered Under Part B
Named Insured and Family Members
Covered while:
- Occupying YOUR covered auto
- Occupying ANY private passenger auto (owned or non-owned)
- Struck as a pedestrian by a motor vehicle
Other Persons
Covered while:
- Occupying YOUR covered auto (with permission)
Coverage Chart
| Person | Your Covered Auto | Non-Owned Auto | As Pedestrian |
|---|---|---|---|
| Named Insured | YES | YES | YES |
| Family Member | YES | YES | YES |
| Other Occupant | YES | NO | NO |
Part B Limits
Typical Limits
| Limit | Usage |
|---|---|
| $1,000 | Minimum (rarely adequate) |
| $5,000 | Common |
| $10,000 | Recommended |
| $25,000+ | High protection |
Per Person: The limit applies separately to each person injured.
Example Scenario
Limit: $5,000 per person Accident: You and 3 passengers injured
| Person | Medical Bills | Part B Pays |
|---|---|---|
| You | $8,000 | $5,000 |
| Passenger 1 | $3,000 | $3,000 |
| Passenger 2 | $6,000 | $5,000 |
| Passenger 3 | $2,000 | $2,000 |
| Total | $19,000 | $15,000 |
Part B vs. Part A (Liability)
| Feature | Part B (Medical) | Part A (Liability) |
|---|---|---|
| Type | First-party | Third-party |
| Pays | Your medical bills | Others' damages |
| Fault | No-fault | Must be at fault |
| Payment speed | Immediate | After liability determined |
| Limits | $1K-$25K | $25K-$500K+ |
Part B Exclusions
Part B does NOT cover injuries:
| Exclusion | Example |
|---|---|
| Occupying vehicle owned by insured but not listed | Your second car not on policy |
| Struck by farm/agricultural equipment | Tractor accident |
| Public transportation | Bus, subway |
| Vehicle used as a residence | Living in a van |
| Racing | Auto racing injuries |
| Vehicle with fewer than 4 wheels | Motorcycle (need separate) |
| Business vehicle not covered | Company car |
Coordination with Other Coverage
Other Auto Insurance
If multiple auto policies apply:
- Part B pays its limit first
- Other policies may contribute
Health Insurance
Part B typically pays first, then health insurance covers the remainder.
Order of Payment:
- Part B Medical Payments
- Personal health insurance
- Part A Liability (if other driver at fault)
Practical Tips
Why Choose Higher Limits?
- Medical costs have risen dramatically
- $5,000 may not cover an ER visit
- Higher limits = relatively low additional premium
- Protects you and your passengers
Exam Tip: Part B is sometimes called "MedPay" — it's first-party, no-fault medical coverage.
Part B Medical Payments coverage is considered what type of coverage?
The named insured is walking across a street and is struck by a car. Their Part B Medical Payments would:
Part B Medical Payments limits typically apply:
5.4 Part C: Uninsured/Underinsured Motorists
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