First Party Medical Benefits in Pennsylvania

Doctor going over personal injury protection benefits in New Jersey

Your car insurance policy consists of several coverages that help pay for expenses in different situations. One of those coverages is first party benefits coverage. What does this cover in Pennsylvania? Here’s what you need to know about first party benefits, what it covers, how much coverage you should get and more.

What is first party benefits coverage?

First party benefits coverage helps pay for medical and other expenses regardless of fault for you and your household family members. It is sometimes known as “no fault coverage” because it provides coverage no matter who was at fault.

First party benefits coverage details

In Pennsylvania, you are required to carry at least $5,000 of first party medical benefits coverage on your car insurance policy. A limit is the amount of coverage up to which an insurance carrier will pay in the event of a claim.  

First party benefits coverage covers medical expenses, and may also cover lost wages, accidental death and funeral costs up to the elected limits if you choose to purchase those coverages under combination first party benefits.

The exact coverages you have will vary based on your individual policy and what you elected to purchase, so check in with your insurance company for specifics.

No fault insurance: How does it work?

No fault insurance is a type of insurance system where each party’s own insurance coverage pays for their medical expenses, regardless of fault. States with this no fault insurance system are known as “no fault” insurance states.

In no fault states like Pennsylvania, your own coverage will be the primary source to help pay for your injuries and medical expenses in the event of an accident.

Extraordinary medical benefits

You can purchase extraordinary medical benefits coverage up to $1,000,000. This coverage helps pay for medical expenses after $100,000, up to the limit you choose to purchase*.

Requirements and limitations

In Pennsylvania, first party medical benefits coverage is mandatory for insurance policies. Pennsylvania is considered a “no fault” state when it comes to insurance law, which means drivers must have their own medical coverage on their insurance policy. Coverage for lost wages, accidental death and/or funeral expenses are optional. Double check with your insurance carrier for the specifics of your policy.

First party medical benefits are required for insurance policies in PA. Coverage for lost wages, accidental death and/or funeral expenses are optional. Double check with your insurance carrier for the specifics of your policy.

Medical benefits coverage does not cover physical damage to your car, another driver’s car or any other personal property. To protect your vehicle, you will need collision and comprehensive coverage. Your property damage liability coverage will help pay for property you are liable for damaging in an accident.

Conclusion: First party medical benefits in Pennsylvania

First party medical benefits coverage helps pay for the medical expenses of you, your household family members and in some cases passengers, if they do not have their own coverage available, when injured in an accident. Additional first party benefits can include coverage for lost wages, accidental death benefits and funeral expense benefits. First party medical benefits coverage is required in Pennsylvania, where individuals go to their own insurance policies for medical expense coverage regardless of fault.

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* Subject to a limit of $50,000 per year – this limit does not apply to medical benefits that are covered by Extraordinary Medical Benefits and incurred within eighteen (18) months following the accident.

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