What Medical Services are Covered By PIP Insurance?

If you’re a Florida resident, it’s important to understand the medical services that are covered by Personal Injury Protection (PIP) insurance. PIP insurance is required for ALL drivers in Florida however, not all medical services may be covered under PIP insurance. 

In this guide, our personal injury attorneys take a closer look at what medical services are covered by PIP insurance in Florida and what you need to know before seeking treatment after a car accident. We’ll also discuss the limitations of PIP coverage and offer tips for maximizing your benefits. 

PIP Insurance Overview  

PIP is a type of car insurance coverage that pays for medical expenses and lost wages if you are injured in an accident, regardless of who was at fault. Because Florida is a no-fault state, PIP insurance is required by law,  making it one of the few states with mandatory Personal Injury Protection coverage. 

$10,000 or more in PIP insurance coverage is required by Florida’s no-fault law.  

This means that regardless of who caused the accident, each driver’s own PIP policy will pay for their medical expenses and lost wages up to the policy limit. In addition to traditional car accidents, PIP also covers injuries sustained in pedestrian accidents or while riding a bicycle. 

Limitations of PIP Coverage 

Personal Injury Protection only covers up to 80% of your medical bills and 60% of your lost wages up to $10,000. If your medical expenses or lost wages exceed this amount, you will be responsible for paying the difference out-of-pocket.  

This can cause significant financial strain on accident victims who require extensive medical treatment or have long-term injuries that prevent them from working. 

What Medical Services Are Covered By PIP? 

Florida Statute 627.736  is a critical piece of legislation that outlines the medical services covered by Personal Injury Protection insurance. The law provides comprehensive coverage for a broad range of initial and follow-up medical services, ensuring that accident victims can access the care they need to recover from their injuries.  

Some of the covered services include:  

• Hospitalization 
• Emergency dental treatment 
• Radiography (X-Rays, MRI, etc.) 
• Prescription medication and pain management 
• Orthopedic medicine 
• Chiropractic treatments 
• Diagnostics and lab services 
• Ambulance services  
• Physical therapy and rehab 
• Surgery  

It is important to note, though PIP covers many medical treatments and procedures, there are some stipulations that you must be aware of: 

• Medical treatment must occur within 14 days of a car accident. Your insurance company will NOT cover a claim outside of this window. Your insurer has 30 days to pay out your claim.  
• All claims must be properly coded, documented, and signed by a licensed physician.  

What Is NOT Covered By PIP Insurance?  

Alternative medical treatments have become increasingly popular in recent years, with many people turning to therapies such as acupuncture and massage to help manage their pain. However, those who are injured in a car accident may be surprised to learn that these treatments may not be covered by Personal Injury Protection insurance. 

Statute 627.736 explicitly names only the above services that are covered by PIP, such as medical care and hospital treatment.  

Unfortunately for proponents of alternative medicine, massage, and acupuncture are generally NOT included on this list. 

This means that if you are injured in a car accident and seek treatment from an acupuncturist or massage therapist, your PIP insurance may not cover the cost of these services. 

Further, if an individual has harmed themselves intentionally or sustained injuries while committing a felony, their medical treatment will not be eligible for PIP coverage. 

Intentional harm and felonies are often excluded from coverage because they fall outside the scope of accidents and unforeseeable events.

How to Maximize Your PIP Benefits  

Many people are not aware of the full extent of their PIP benefits or how to maximize them. By understanding your policy and taking a few simple steps, you can ensure that you receive the full compensation you are entitled to.  

Look for your deductibles, limits, and exclusions. This will help you better understand what expenses are covered and up to what amount.  

Also, take advantage of any additional benefits or resources offered by your insurance provider. Many companies offer services such as free transportation to medical appointments or assistance with filling out claim forms. 

Read More > How to Recover from the Most Common Car Accident Injuries  

Don’t Settle For Less  

Navigating the complexities of PIP benefits can be a daunting task. Our team of experienced personal injury attorneys at Mickey Keenan P.A. is dedicated to helping you understand your rights and get the compensation you deserve.  

We will work tirelessly to understand your unique circumstances, explain your legal rights, and help you fight for what is rightfully yours.  

Your fight is our fight. Contact us today at (813) 871-1300 to schedule a free consultation and let us put our expertise and experience to work for you.