Fully funded group plans and Individual/MyPriority plans

Before Priority Health can consider covering medical or hospital expenses due to car accidents, we must verify what type of Personal Injury Protection (PIP) was in effect on the date of the accident.

• If the patient has EXCESS PIP/COORDINATED MEDICAL

  Priority Health is PRIMARY.

• If the patient has FULL PIP

  Priority Health is SECONDARY, however once the patient's PIP benefit level on their auto policy has been met, we'd then become PRIMARY.
  - Unlimited PIP benefits
  - $500,000 in PIP benefits
  - $250,000 in PIP benefits
  - $50,000 in PIP benefits

• If the patient has FULL PIP with a deductible

  Priority Health is SECONDARY but, depending on the amount of the claim and whether the member's medical plan has a deductible, we may pay the deductible. Once the patient's IP benefit level on their auto policy has been met, we'd then become PRIMARY.

Self-funded group plans

Call to check on the patient's particular plan. 

Medicaid or Medicare

The auto insurance is always primary. However, once the patient's PIP benefit level on their auto policy has been met, we'd then become PRIMARY.

• Unlimited PIP benefits
• $500,000 in PIP benefits
• $250,000 in PIP benefits
• $50,000 in PIP benefits

Note: If a patient opts out of PIP completely because they have health insurance that covers auto-related injuries, we would be PRIMARY. The ability to opt out also applies to those that have Medicare coverage.