Medical payments coverage (MedPay) Your own policy pays first, fault or not.

MedPay is medical payments coverage on your own auto policy. It pays medical bills after a crash no matter who caused it, and it pays while the fault argument is still going on. Whether you have to give it back out of a settlement is a question about your policy language, and California law limits what the insurer can take when the answer is yes.

What MedPay is

The California Supreme Court described the coverage the same way in 21st Century Insurance Co. v. Superior Court (2009) 47 Cal.4th 511: med-pay coverage pays the insured's reasonable and necessary medical expenses from an accident up to a relatively low dollar limit, in exchange for relatively low premiums, and the insurer provides that coverage on a no-fault basis. The same opinion makes the other point worth knowing. There is no statutory obligation to provide med-pay coverage at all.

Why MedPay is the fastest money

The other driver's insurer pays once, at the end, in exchange for a release. That is the fact that surprises people most in the first month. MedPay is the only coverage in a typical crash that pays a bill in the week you incur it without anyone agreeing on fault first.

Two rows on that table cost you money at the end, and they cost different amounts. A health plan lien is capped by statute: Civil Code section 3040 limits it to one third of the money due to you when you have an attorney, reduces it pro rata, meaning in proportion, for your attorney fees and costs under the common fund doctrine, and reduces it again by any comparative fault percentage. We walk through that arithmetic in our post on what a Kaiser lien means for your settlement. A MedPay reimbursement is not governed by section 3040. It is governed by your policy and by two rules the courts apply on top of it.

Whether you have to pay MedPay back

Start with the policy. In 21st Century the Supreme Court noted that insurance policies typically have, and the policy in that case did have, a provision requiring the insured to reimburse the insurer for money recovered from a third person that duplicated the recovery under the policy. Quoting an earlier decision, the court wrote that it "has been clearly established in California that [med-pay reimbursement provisions] . . . are valid and enforceable". The idea behind them is narrow: you should not be paid twice for the same bill.

Two rules limit what the insurer can take. The first is the made-whole rule. Your recovery from the at-fault driver has to make you whole as to all the damages proximately caused by the injury before you owe the insurer anything. The second is an equitable apportionment of the attorney fees, meaning a fair division of them, analogous to the common fund doctrine, which the court in 21st Century described as requiring a party that benefits from another person's expenditure of attorney fees to bear a proportionate share of that expenditure.

The arithmetic the court used

The numbers in 21st Century are small enough to follow and they are the court's own. The insurer paid its insured $1,000 in med-pay benefits. She then settled with the at-fault driver for $6,000, which represented her total damages, and spent $2,106.50 in attorney fees to get there. She repaid $600 rather than $1,000: the $1,000 less $400, which was roughly one sixth of her fees, one sixth being the relationship between the $1,000 the insurer paid and the $6,000 settlement. The insurer agreed that satisfied its claim, because the $400 was its pro rata share of the fees spent collecting the money.

That is the whole mechanism. The insurer participates in the cost of the recovery it benefits from. The court also drew the line on the other side, holding that liability for attorney fees is not part of the made-whole calculation itself, and it noted the consequence that matters if your case never pays: an insured may keep the med-pay benefits if he or she does not recover from the third party tortfeasor, the person who caused the crash.

How much MedPay you can buy

The Department of Insurance auto insurance guide states the floor: "The minimum limit you can buy is $1,000 for each person injured." There is no ceiling set by statute, because no statute requires the coverage at all. Insurers commonly sell it in steps. The Department's own coverage comparison, which it uses to compare premiums across companies, puts $2,000 in medical payments in its basic coverage profile and $5,000 in its standard coverage profile.

Set that against the liability limits the same guide lists for California: $30,000 for the death or injury of any one person, a total of $60,000 for more than one person in one accident, and $15,000 for property damage. Those limits went up on January 1, 2025, and we cover what the change does and does not fix in our post on the new minimum insurance limits. A $5,000 MedPay limit does not stand in for a liability policy. It pays the ambulance and the first imaging study while everything else is still being argued about.

Using MedPay in the first three weeks

1. 1
   Find the declarations page

   It is the one or two page summary your insurer sends at renewal, and it is in your online account. Look for a line reading MedPay, Med Pay, or Medical Payments, with a dollar figure beside it.

2. 2
   Open the MedPay claim separately

   It is a different claim number from the property damage claim, and it is against your own policy. Ask for the claim number and the adjuster's direct line in writing.

3. 3
   Send itemized bills, not balances

   MedPay adjusters pay against a bill with dates of service and codes on it. A statement showing an amount due, with no detail, gets held.

4. 4
   Do not let the limit choose your treatment

   MedPay running out does not mean the treatment should stop. It means the next bill goes to a health plan, to a county facility, or onto a lien.

5. 5
   Tell whoever is handling the claim the exact number

   The amount MedPay paid has to be tracked from the first month, because it comes back into the arithmetic at the end. A number discovered on the day of settlement is a number nobody negotiated.

We do this on the first call for a reason. Getting people treated is the first job, and MedPay is usually the only coverage in the file that can fund treatment inside a week. If there is no MedPay, the order of operations changes, and we set that out in our post on getting treated after a crash with no health insurance.

Where MedPay does not help

• You never bought it. It is optional, it is a separate line on the policy, and a driver carrying only the state minimum liability limits usually does not have it.
• The limit is gone in one visit. An ambulance ride and a CT scan can exhaust a $2,000 or $5,000 limit before the first follow up appointment.
• It pays bills only. Lost wages, future care, and the human cost of the injury are not medical payments. Those come from the liability claim or from your own underinsured motorist coverage.
• Who is covered is a policy question. The Department describes the coverage as reaching you, your family, and others in your car. Whether your policy also reaches you while you are walking or riding a bicycle depends on the words in the policy, so read the coverage section rather than assuming either answer.
• The same bill can attract two claims. If your health plan paid part of a bill and MedPay paid the rest, both may look to the settlement. Sorting out who is repaid for what belongs at the start of the case, not the end.
• Repayment can be argued. The reimbursement clause is the beginning of the analysis, not the end of it. The made-whole rule and the fee apportionment both come off the top before an insurer is paid back.

What to do with coverage this small

Use it, and use it early. Pull the declarations page today, find the medical payments line, and open the claim before the bills go to collections. If the line is not there, add it at your next renewal, because it is the one coverage that pays while everyone else is still arguing. Then keep a written record of every dollar it pays, so the reimbursement conversation at the end is a calculation and not a surprise.

If your treatment has already passed the limit, or if an adjuster is asking you to sign something before you know what is wrong with you, that is the point to get help. Our Los Angeles car accident lawyer page explains how a claim is built from here, and our guide to uninsured and underinsured motorist claims covers the coverage that picks up where MedPay stops. There is no fee unless we recover.