Medicare & Auto Insurance in Michigan
Why is it vital to review your auto insurance after enrolling in Medicare? Because you may have opted out of covered services your auto policy could provide that Medicare plans do not cover – including things like transportation to and from medical appointments, vehicle modifications, long-term and custodial care, and household services.
When Michigan implemented the no-fault auto insurance reform on July 2nd, 2020, there were many considerations for Medicare beneficiaries that did not apply to you then. Now that you are enrolled in Medicare, we therefore strongly encourage you to review what those changes mean to you.
Since this area involves both health insurance (Medicare) as well as property and casualty insurance (home & auto), it is best to have a review by an expert with knowledge of both your Medicare and auto insurance needs.
Under the new law, as of July 2, 2020, Medicare beneficiaries will have the option to opt out of no-fault allowable expense PIP benefits if they meet the following conditions:
1) the person is covered under Part A and B of Medicare, and
2) the person’s spouse and any resident have Medicare “qualified health coverage,” or have no-fault PIP coverage under a separate policy.
Insureds who select this option can NOT receive coverage through the Michigan Assigned Claims Plan (MACP) when injured as an occupant of a motor vehicle but are likely entitled to the MACP (where benefits are capped at $250,000 and not as inclusive as No-Fault) when injured as a non-occupant of a motor vehicle and there is no other insurer in the line of priority from which to recover PIP benefits.
Prior to opting out, we recommend you review the following chart to understand what benefits are not available under Medicare but may be needed should you be severely injured in an auto accident. Please see below for the differences:
Medicare vs. PIP
Under the new law, as of July 2, 2020 Senior Citizens will have the option to opt out from no fault allowable expense PIP benefits if they meet the following conditions:
- The person is covered under Part A and B of Medicare;
- The person’s spouse and any relative residing in the household has Medicare or a qualified health coverage, or has no fault PIP coverage under a separate policy.
Seniors who select this option can NOT receive coverage through the Michigan Assigned Claims Plan (MACP) when injured as an occupant of a motor vehicle, but are likely entitled to the MACP (where benefits are capped at $250,000 and not as inclusive as No-Fault) when injured as an non-occupant of a motor vehicle and there is no other insurer in the line of priority from which to recover PIP benefits.
Prior to opting out, we recommend you review the following chart to understand what benefits are not available under Medicare, but may be needed should you be severely injured in an auto accident. Please see below for the differences:
| BENEFITS | AUTO NO-FAULT | MEDICARE |
| Post‑acute Care/Sub‑acute Rehabilitation | Yes 100% as long as needed |
Limited 100 days at 80% |
| Long term Care/Custodial Care | Yes 24/7 if needed | Not Covered |
| Residential Treatment Programs | Yes | Not Covered |
| Case Management Services | Yes | Not Covered |
| Attendant Care (assistance w/care and supervision) Unlimited in duration and number of hours | Yes | Limited home health aide 2 or 3/wk for 4/hr during recovery |
| Guardianship or Conservators | Yes | Not Covered |
| Transportation Services (medical) | Yes | Not Covered |
| Physical, speech, Outpatient Therapy (Unlimited) | Yes | Limited Covers 80% |
| Chiropractic Treatment | Yes | Limited coverage for spinal subluxations. Does not cover tests, x-rays and acupuncture |
| Medications | Yes | Coverage gap and limitations under Part D |
| Dental | Yes | Not covered (Medicare Advantage Plans provide some coverage) |
| Vision | Yes | Limited coverage for age related macular degeneration. Routine eye care not covered. |
| Office Visits | Yes | Variable |
| Durable Medical Equipment | Yes | Limited Covers 80% |
| Massage Therapy | Yes | Not Covered |
| Home Modifications for Accessbility | Yes | Limited |
| Vehicle Modification | Yes | Not Covered |
| Specialty Assistive Devices | Yes | Limited |
| Wage Loss – if senior is still working | Yes – Up to 3 Years | Not Covered |
*2019 limits according to Medicare.gov
OTHER CONSIDERATIONS:
- Not only may care options be limited since not all specialists participate with Medicare, but if a Senior Citizen has a previous medical condition, the length of time needed to heal can be lengthened.
- Important to note: if a Senior Citizen receives a settlement from an accident claim, Medicare is entitled to recover the cost of any medical expenses paid to the claimant.
Other Considerations
- Care options could be limited since not all specialists participate in Medicare. If a Medicare beneficiary has a previous medical condition, the length of time needed to heal can be lengthened.
- Important to note: if a Medicare beneficiary receives a settlement from an accident claim, Medicare is entitled to recover the cost of any medical expenses paid to the claimant.
The review is free and in no way changes the Medicare recommendations we provided you. Accordingly, during your review we also look for other issues that could result in higher auto premiums or more out-of-pocket expenses for non-covered services. Since most families combine their homeowner’s insurance and their auto insurance with the same company, we will also provide a free review of your homeowner’s policy.