Coordinated and uncoordinated PIP
MCL 500.3109a lets insurers sell PIP at a lower price with exclusions tied to your other health coverage. This is “coordinated” coverage. Your declarations page tells you which you have.
| Your auto policy | Your health plan | Who pays first |
|---|---|---|
| Uncoordinated | Any | PIP |
| Coordinated | Insured health plan, even one with its own coordination clause | Health plan (Federal Kemper v Health Ins Admin, 1986) |
| Coordinated | Self-funded ERISA plan with a clear coordination clause | PIP (Auto Club Ins Ass’n v Frederick & Herrud, 1993) |
| Coordinated | Medicare or Medicaid | PIP |
With coordinated coverage, PIP is secondary and still pays reasonably necessary accident care the health plan does not cover, such as attendant care, mileage and home modifications. Follow your health plan’s rules: in Tousignant v Allstate (1993), the Supreme Court held that a no-fault insurer with coordinated coverage owes nothing for care obtained outside an HMO when the HMO offered it.
Check the employer plan document. Many self-funded plans exclude auto injuries or claim reimbursement from any later settlement. See taxes and liens on settlements.
Medicare
Federal Medicare Secondary Payer rules make no-fault insurance primary to Medicare. If you carry PIP medical coverage, your providers should bill PIP first. If Medicare pays a crash-related bill, it does so conditionally and has the right to be repaid from PIP or a settlement.
Since July 2, 2020, a named insured with Medicare Parts A and B may opt out of PIP medical entirely, if everyone in the household has qualified health coverage or other PIP (MCL 500.3107d). Opting out means Medicare is the coverage. Medicare does not pay for most family attendant care, long-term custodial care or vehicle modifications.
The Court of Appeals held in Van Heusen v Michigan Automobile Insurance Placement Facility (October 15, 2026) that a person who took the Medicare opt-out cannot claim PIP medical through the assigned claims plan, even when hurt as a pedestrian. In Canty v Mason (July 27, 2026), the Supreme Court held that an opted-out person suing the at-fault driver for medical costs must mitigate by using Medicare, but the PIP fee schedule does not cap that tort claim.
Medicaid
Medicaid is the payer of last resort. It cannot be made primary to PIP. A named insured enrolled in Medicaid may choose a $50,000 PIP medical limit if every household member has qualified health coverage, Medicaid or other PIP (MCL 500.3107c(1)(a)). Medicaid pays after that limit is used up. The state can seek repayment from a settlement for crash-related care it paid.
Household members excluded from PIP
For policies issued or renewed after July 1, 2020, a named insured who picks the $250,000 level can exclude household members who have qualified health coverage, at a 100% PIP medical premium reduction for each person excluded (MCL 500.3109a(2)). The same structure applies to the Medicare opt-out.
Qualified health coverage means Medicare Parts A and B, or a health plan that does not exclude or limit auto injuries and has an individual deductible at or below the adjusted limit, $6,579 for July 1, 2026 through June 30, 2027 according to DIFS.
Thirty days after health coverage ends. If an excluded person loses qualified health coverage, the named insured must notify the insurer and get PIP medical coverage for them within 30 days. A person hurt during that window can claim through the assigned claims plan. A person hurt after it with no coverage gets no PIP medical benefits for that crash (MCL 500.3109a(2)(d)–(e); MCL 500.3107d(6)).
Job loss, aging off a parent’s plan at 26, and divorce are the common triggers. Call your agent the day coverage ends.
Practical steps after a crash
- Give every provider both your auto claim number and your health insurance card.
- Find out whether your PIP is coordinated before the first big bill.
- Keep explanation-of-benefits statements. They show what the health plan denied and what is left for PIP.
- If each insurer points at the other, send both the denials and keep track of the one-year deadlines. See benefits denied or cut off.
Sources: MCL 500.3107c; MCL 500.3107d; MCL 500.3109; MCL 500.3109a; MCL 500.3172; 42 USC 1395y(b); Federal Kemper Ins Co v Health Ins Admin, 424 Mich 537 (1986); Auto Club Ins Ass’n v Frederick & Herrud, 443 Mich 358 (1993); Tousignant v Allstate Ins Co, 444 Mich 301 (1993); Canty v Mason (Mich. Sup. Ct., July 27, 2026); Van Heusen v MAIPF (Mich. Ct. App., Oct. 15, 2026); DIFS auto insurance FAQ.
Questions people ask us
Is my health insurance or my auto insurance primary after a Michigan crash?
It depends on whether your auto policy has coordinated medical benefits. With uncoordinated (primary) PIP, the auto insurer pays first. With coordinated PIP, your health plan pays first and PIP picks up what the health plan does not cover.
I have Medicare. Who pays first?
If you carry PIP medical coverage, PIP pays before Medicare. Federal law makes Medicare a secondary payer, and Medicare can recover what it paid from PIP or a settlement. If you opted out of PIP medical under the Medicare option, Medicare is your coverage.
What happens if an excluded family member loses their health insurance?
You must get PIP medical coverage for that person within 30 days after the health coverage ends. If they are hurt during the 30 days, they can claim through the assigned claims plan. If they are hurt after the 30 days with no coverage, they get no PIP medical benefits.