What counts as an allowable expense
Under MCL 500.3107(1)(a), PIP pays reasonable charges for reasonably necessary products, services and accommodations for your care, recovery or rehabilitation. In practice that includes:
- Emergency care, hospital stays, surgery and follow-up visits
- Physical therapy, chiropractic care, pain management and counseling
- Prescriptions, braces, wheelchairs and other medical equipment
- Attendant care and nursing at home
- Home modifications such as ramps, and vehicle modifications
- Mileage to and from medical appointments
The coverage levels
For policies issued or renewed on or after July 2, 2020, the insured chooses a PIP medical limit:
| Level | Who can choose it |
|---|---|
| Unlimited | Anyone. It is also generally what applies when no valid selection was made, unless the premium paid shows a different level. |
| $500,000 | Anyone |
| $250,000 | Anyone |
| $250,000 with exclusions | Household members with qualifying health coverage can be excluded |
| $50,000 | Named insured enrolled in Medicaid, with spouse and resident relatives covered by qualified health coverage, Medicaid or other PIP |
| Opt-out | Named insured with Medicare Parts A and B, with household members otherwise covered |
Source: MCL 500.3107c and 500.3107d.
Why the limit gets fought over
The limit decides how long your care is paid for, so we look at it closely. Was the selection form signed by the right person? Does the household exclusion actually fit your family? Does a different policy in the priority order carry a higher limit? A wrong answer to any of these can be worth hundreds of thousands of dollars of care.
What providers can charge
Since July 2, 2021, a fee schedule tied to Medicare rates caps what providers are paid for most treatment. It limits what the insurer pays the provider. Providers can read how the fee schedule is applied.
Keep the paper. Save every bill, explanation of benefits, mileage log and prescription receipt. A bill the insurer never received cannot become overdue, and a bill more than a year old may be lost to the one-year-back rule.
Questions people ask us
Does PIP pay for chiropractic care, physical therapy and injections?
Yes, when the care is reasonably necessary for crash-related injuries and charged at a rate the fee schedule allows. Disputes usually turn on whether the treatment is related to the crash and medically necessary, which is why your doctor’s records matter.
Can I choose my own doctor?
Generally yes, unless your policy is one of the managed-care options some insurers sell. Check your declarations page or ask us to read it.
What happens when my PIP limit runs out?
PIP stops paying. Medical expenses above the limit can be claimed from the at-fault driver, and health insurance or Medicare may pick up some care. Plan for this early if your injuries are serious.