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Posted on 06-12-2017

PIP - The Medical Benefit With No Copay And No Deductible

As many of my blog followers are aware, I am a Baltimore Chiropractor with two offices in Baltimore City. We treat a lot of patients with headaches, neck pain, and back pain. In about half of our patients, these headaches, neck pain, and back pain symptoms result from whiplash due to an auto accident. Typically these patients are sitting at a red light when their vehicle suddenly gets rear-ended. Alternatively, some are driving through intersections with green lights allowing them to do so when their vehicles get violently T-boned by other motor vehicles that fail to yield the right of way. The symptoms of each patient differ depending on their human metrics (age, male vs. female, fit vs. unhealthy, etc), preparedness and awareness of the impending crash, and their vehicle metrics (small vs. large car, etc).

One thing that most of our whiplash patients have in common is their ability to pay for their care with PIP insurance. I have spoken about this insurance benefit several times in my past blog posts. PIP stands for Personal Injury Protection. It is an insurance benefit that you pay for every month if you elect to have PIP coverage in Maryland. Typically PIP is written in amounts of $2,500, $5,000 or $10,000. The PIP benefits are meant for all reasonable, customary, and usual fees associated with auto accident injuries. This includes, but is not limited to, hospital visits, ambulance rides, x-rays and other forms of advanced imaging, chiropractic care, physical therapy, and orthopedic evaluation. It also covers up to 80% of lost wages following an accident if an injured party is placed on temporary work disability. The lost wages payment component is one reason why professionals should care more than the legal minimum amount of coverage on their policy. (How would your finances be impacted if you didn't work and receive wages for two weeks?)

While these benefits of PIP are well known, the most important part of PIP is that it is a medical benefit with no copay and no deductible in the State of Maryland. My last blog post featured a situation in which a prospective new chiropractic patient asked if we could summarily waive his copay. He said that if we did (his old chiropractor in another state would do it all the time) then he would choose our office for chiropractic care and that if we didn't he would go elsewhere. I told him that it was illegal for us to waive his copay unless he could prove financial hardship. Needless to say this individual took his business elsewhere. And I understand that. That's his business and I'm not particularly interested in committing fraud or violating my health insurance contract for a stranger.

If you've been injured in a Baltimore auto accident injury and you have PIP, these same issues of copays and deductibles DO NOT APPLY to you. That is, from visit one, you owe no money out of pocket and you have no copay and no deductible for these benefits. These PIP benefits kick in day one with no additional cost to you. (I say no additional cost because if you've paid for PIP benefits you've already paid for these benefits).

Let me repeat that - in a complex health insurance world where there are rising deductibles and copays and coinsurances there exists only one medical benefit that I can think of that doesn't require to you to participate financially in paying for your medical care while you are recovering from your injuries and seeking chiropractic care and/or physical therapy. And that is PIP (Ok, technically MEDPAY would also allow for no out of pocket expense in the case of an auto accident injury, but that's a discussion for another blog post). Every month when you pay for your auto insurance, provided you've elected to pay for PIP coverage, you are paying for this benefit. If and when you are injured you can "withdraw" from this fund up to the fund limits, typically $2,500.

The premiums for PIP are very reasonable. I personally carry $10,000 in PIP benefits on my policy and I pay about $100 a YEAR for these benefits. I strong suggest that anyone driving on the roads in the Baltimore City/Baltimore County metropolitan area consider reviewing their policy to determine if they have PIP coverage. It's only a matter of time until you might need it. And as the saying goes with insurance - its only expensive if you need it and don't have it.

If you, or someone you know, has been injured as a result of a Baltimore auto accident, please contact Mid-Atlantic Spinal Rehab & Chiropractic at (443) 842-5500. We will be able to tell you what PIP benefits may be available to you to help pay for your care while you treat for your injuries. We would be happy to provide this auto insurance policy evaluation service to you free of charge.

Dr. Gulitz

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