Quick Summary:
- MedPay can pay medical bills for you and passengers, regardless of fault.
- It usually covers ambulance and hospital costs, but not lost income.
- Check your travel insurance and health cover first to avoid duplicate benefits.
- Consider MedPay if you lack US medical cover or want fast, simple claims.
When you arrange car hire in the United Estates, the list of optional protections can feel unfamiliar, especially if you are used to UK and European rental cover. One add on that often raises questions is Medical Payments cover, commonly shortened to MedPay. It sounds like health insurance, but it is not quite that, and it does not replace the main types of insurance that deal with damage to the car or liability to other people.
This guide explains what MedPay usually does and does not pay for on US car hire, how it can overlap with travel insurance, and who it is designed to protect. Because policy wording varies by rental company, state, and insurer, treat this as a practical overview and always read the rental terms and your own insurance documents.
If you are comparing providers for car hire in the United States, it helps to understand MedPay in the same way you would assess any add on, by looking at your existing cover, your medical risk tolerance, and the likely cost of treatment.
What MedPay is on US car hire
MedPay is a form of medical expense cover that can pay for reasonable medical bills after an accident involving the rental car. Its key features are that it is usually:
No fault, meaning it can pay out whether you caused the accident or not.
Occupant focused, meaning it is aimed at the driver and passengers in the rental vehicle, rather than people in other cars.
Limited benefit, meaning it typically has a modest maximum payout amount compared with the potential cost of US healthcare.
MedPay is different from liability insurance, which is about injury or damage you cause to others. It is also different from collision damage waivers, which relate to the rental vehicle itself. MedPay sits in a separate box, it is about immediate medical costs for people inside your rental car.
What MedPay typically covers
Exact benefits vary, but MedPay commonly pays for medical treatment expenses that arise from injuries in an accident while using the rental car as permitted. Examples of costs it may cover include:
Ambulance fees, including transport to hospital after a crash.
Emergency room treatment and initial hospital care.
Doctor and diagnostic charges, such as consultations, X rays, and scans.
Necessary follow up treatment within the covered period, where allowed by policy wording.
Two practical points matter here. First, MedPay often pays up to a stated limit, which can be relatively low in US terms. Secondly, it may pay regardless of who was at fault, so it can be useful even if the other driver is uninsured or disputes liability.
What MedPay usually does not cover
MedPay can be misunderstood as a broad medical policy. In reality, it is typically narrow and excludes a lot of costs travellers worry about. Common gaps include:
Lost wages and loss of earnings. Many policies pay medical bills only, not your income if you cannot work.
Pain and suffering or other non medical damages.
Long term rehabilitation beyond covered limits or timeframes.
Non accident illness, such as flu or a pre existing condition flare up.
Injuries while excluded use occurs, for example unauthorised drivers, off road use, or driving under the influence, depending on the contract terms.
MedPay also is not designed to protect the rental company from claims. It is for occupants’ medical expenses, so it does not replace liability protection, which is still central in the US.
Who MedPay protects on a rental
In most cases, MedPay is intended to cover the driver and passengers occupying the rental vehicle at the time of an accident. That often includes authorised additional drivers and any passengers, although some policies limit cover to occupants only, and some may restrict who counts as an insured person.
It usually does not cover pedestrians or occupants of other cars you collide with, those claims fall under liability insurance and the rules of the state where the accident occurs.
This occupant focus matters if you are travelling as a couple, family, or group. A single MedPay election at the rental desk may apply to the vehicle’s occupants, but the detail is always in the policy wording.
How MedPay differs from liability cover
Many travellers buying US car hire protection focus on the vehicle and on third party claims. MedPay is not a substitute for either. The simplest way to separate them is:
Liability helps pay for injuries and damage you cause to others, subject to limits and conditions.
MedPay helps pay for injuries to you and your passengers, regardless of fault, subject to its limit.
Because US medical bills can be high, you may feel that injury cover for occupants is the most personal risk. However, liability claims in the US can also be financially severe. In practice you assess them separately.
If you are reviewing options across different suppliers, for example on pages such as Avis car rental United States or Budget car hire United States, you will often see a menu of protections. MedPay is typically one of the smaller ticket items, but it is not automatically good value if you already have strong medical cover elsewhere.
Where MedPay can overlap with travel insurance
UK travellers commonly rely on travel insurance for emergency medical treatment abroad. If your policy covers the United Estates, it may already pay for hospital treatment following a car accident, subject to excess and conditions. That creates possible overlap with MedPay.
Here is how the overlap often plays out in real life:
Travel insurance may be broader, covering larger medical costs, repatriation, and sometimes cancellation or curtailment due to injury.
MedPay may be simpler, paying smaller, immediate medical bills without having to establish fault, and sometimes without the same documentation burden.
Double cover does not mean double payout. If two policies apply, one may become primary and the other secondary, or you may need to declare the other cover. You cannot usually profit from insurance.
Excess and claims friction matter. If your travel insurance has a high excess, MedPay might effectively cover part of the initial bills, if the policy allows it and coordination of benefits works in your situation.
A practical step before you travel is to check whether your travel policy includes motor related medical cover when you are the driver or passenger in a hired vehicle, and whether it excludes certain vehicle types or activities.
Where MedPay can overlap with health insurance
For some travellers, personal health insurance may respond to emergency treatment in the United Estates, but many non US policies have limited networks, complex reimbursement, or caps. Even US based cover can involve deductibles and co payments. In those cases MedPay may still feel useful because it can help pay initial bills quickly up to its limit.
However, if your health insurance is comprehensive in the United Estates and you are comfortable with the deductible, MedPay may not add much value. It may also duplicate cover you already have through a premium bank account travel policy or a specialist annual policy.
When MedPay is most worth considering
MedPay tends to be most attractive in a few common scenarios:
You have limited medical cover in the United Estates. If your travel insurance excludes certain activities, has low medical limits, or you are travelling without medical cover, MedPay can provide a small financial buffer.
You want no fault simplicity. If you are worried about being stuck between insurers while fault is disputed, MedPay can reduce delays for smaller bills, depending on claims handling.
You are travelling with passengers who may not have strong travel insurance, or whose cover you are unsure about.
You are doing a long road trip with higher exposure hours on US highways, where accident risk rises with time on the road.
Travellers planning longer routes or larger vehicles sometimes focus on comfort and safety as well as insurance. If you are comparing vehicle classes, minivan hire United States can be useful for family travel, but it also increases the importance of understanding how occupant medical costs would be handled if something went wrong.
When MedPay may not be worth buying
There are also plenty of cases where MedPay is not great value:
You already have robust travel medical cover for the United Estates with high limits and low excess.
The MedPay limit is very low compared with likely costs, which can make it feel more like a token benefit.
You are primarily concerned about liability exposure. MedPay does not protect you from claims made by others. It is separate from liability cover decisions.
You rarely carry passengers and you are already well insured personally.
It also may not solve the problems people assume it solves. For example, it does not help repair the vehicle, and it does not pay for damage to other cars. Those are addressed by other protections and by liability cover.
Key questions to ask before selecting MedPay
To decide calmly at the counter or during online checkout, focus on a short checklist:
What is the MedPay limit? Compare it with realistic costs. An ambulance plus emergency room visit can exceed a low limit quickly.
Who is covered? Confirm whether it covers all occupants, authorised drivers only, or named individuals.
Is it primary or secondary? If it is secondary, it may only pay after another policy responds.
What exclusions apply? Especially alcohol, unauthorised drivers, and prohibited use under the rental agreement.
How does it coordinate with your travel insurance? Your travel insurer may require notification and may ask whether other cover exists.
When you are comparing suppliers for car hire, consistency can vary. Looking at a few provider pages such as Dollar car hire United States can help you familiarise yourself with common US rental add ons, so you are not processing new terminology while tired from a flight.
MedPay, PIP, and why terminology gets confusing
You may also see references to Personal Injury Protection, often called PIP. In some states, PIP plays a larger role than MedPay and can include broader benefits, sometimes including lost wages, again depending on state rules and policy wording.
For travellers, the important takeaway is not to assume that every injury related option is the same. If you see both PIP and MedPay, they are not necessarily interchangeable, and the rental company explanation may be brief. If you are unsure, ask for the written description of what the option covers and the limit, then compare it with your existing travel policy.
The bottom line for most UK travellers
MedPay is best seen as a limited, no fault medical expense cushion for people inside your rental car. It can help with immediate bills after an accident, but it will not cover everything, and it does not replace travel insurance or liability cover.
If you already have strong travel medical insurance for the United Estates, MedPay may be unnecessary. If you are underinsured, travelling with passengers whose cover is uncertain, or you want an extra layer for small to mid sized medical bills without fault arguments, it can be worth considering, provided you understand the limit and how it coordinates with your other insurance.
FAQ
Does MedPay cover me if I am not at fault? Often yes. MedPay is usually no fault, so it can pay eligible medical bills even when another driver caused the accident, up to the policy limit.
Will MedPay cover my passengers as well as me? In many cases it covers occupants of the rental vehicle, including passengers. Check the rental terms for who counts as an insured person and any restrictions.
Does MedPay replace travel insurance medical cover? No. MedPay is typically limited to certain medical expenses after an auto accident and has a relatively low maximum. Travel insurance can be broader and may include repatriation.
Does MedPay cover injuries to people in another car? No. Injuries to other road users are generally handled under liability insurance, subject to limits and conditions, not MedPay.
Can I buy MedPay later if I decline it at pickup? Usually you must choose it during the rental agreement process. Rules vary by company and location, so review your options before you finalise the contract.
