Quick Summary:
- PIP is broader, covering medical, lost income, and essential services.
- MedPay is narrower, usually paying medical bills only, quickly.
- On car hire paperwork, look for PIP, Personal Accident, or MedPay.
- Both can be redundant if your travel, health, or auto policy already pays.
Tourists arranging car hire in the United Estates often see confusing add-ons at the rental counter. Two of the most misunderstood are PIP and MedPay. Both relate to injury-related costs after an accident, but they are not the same, and they can overlap with other cover you already have.
This guide explains what each cover typically pays for, how it may be shown on rental paperwork, and the common situations where paying for it again brings little benefit.
If you are comparing providers and inclusions across the United Estates, it can help to review general rental basics first, such as pickup rules and standard protections shown on vouchers. See car rental United States or the UK-focused overview at car hire United States for context on typical rental documents and counters.
PIP vs MedPay in plain terms
PIP stands for Personal Injury Protection. It is a type of no-fault cover used in some US states. “No-fault” generally means your own policy pays certain injury-related expenses after an accident, regardless of who caused it, subject to terms and limits.
MedPay stands for Medical Payments coverage. It is typically simpler and narrower. It usually pays medical and funeral expenses for you and your passengers after an accident, up to a stated limit, without focusing on who was at fault.
For tourists using car hire, the key difference is scope. PIP often goes beyond medical bills and may include additional benefits such as lost income or replacement services. MedPay is usually medical-expense-only.
What PIP may pay for
PIP benefits vary by state law and the underlying policy wording, but tourists will often hear a consistent description at rental counters: PIP can help with injury-related costs for the driver and passengers in the rental vehicle, even when fault is unclear or disputed.
Depending on the state and wording, PIP may include:
Medical expenses, such as hospital treatment, ambulance charges, surgery, prescriptions, and sometimes rehabilitation.
Lost income, if injuries prevent you from working during your trip or afterwards, subject to caps and proof.
Essential services, sometimes called replacement services, for tasks you cannot perform due to injury, for example help with childcare or household duties.
Funeral expenses, in some forms of PIP cover.
Why it matters to tourists: visitors often do not have a US auto policy. Rental-company products that resemble PIP may be offered as “Personal Accident Insurance” or “PAI” and can bundle medical and accident benefits. The names can be misleading, so you should focus on the benefit list and limits.
What MedPay may pay for
MedPay is usually narrower and easier to understand. It commonly covers reasonable and necessary medical expenses for injuries from an auto accident, for the driver and passengers in the car, up to a stated limit.
Typical features include:
Medical bills only, often including ambulance, hospital care, X-rays, surgery, and sometimes dental injuries from an accident.
Fast access compared with liability claims, because it is often payable without proving fault, subject to the policy terms.
Lower limits than broad injury cover, often in the thousands rather than very large amounts.
MedPay is often described as a “gap filler” for deductibles or immediate bills. For tourists, it can feel attractive because it seems straightforward, but it is also one of the most commonly duplicated covers when you already have travel insurance or private medical insurance.
Where PIP and MedPay show on rental paperwork
Rental documents differ by company and state, but most customers see the same set of items: a rental agreement at the counter, plus a booking voucher or confirmation that shows what is included. On these documents, PIP and MedPay may appear under different names.
Look for these labels on the rental agreement or the optional cover section:
PIP may be shown as “PIP”, “Personal Injury Protection”, or as part of a package described as “Personal Accident” or “Personal Accident Insurance (PAI)”. In some cases the rental company may not call it PIP at all, even if the benefits resemble PIP in practice.
MedPay may be shown as “MedPay”, “Medical Payments”, or “Medical Expense”. Sometimes it is bundled with personal accident benefits, making it easy to assume you need it when you may not.
Important: Collision-related products such as CDW, LDW, or Damage Waiver are different. They relate to damage or theft of the hire car, not injury treatment. You can see these alongside personal covers, which is why people mix them up at the counter.
If you are hiring a larger vehicle such as a people carrier, you may be asked about cover for additional passengers. The number of occupants can matter when you think about injury benefits. For vehicle categories, see minivan hire United States or SUV rental United States to understand typical passenger capacity considerations on car hire bookings.
When PIP or MedPay can be redundant for tourists
Redundancy is common because personal injury-related costs may already be covered by other policies. Paying twice does not usually mean you can claim twice, it often means your claim is coordinated between insurers or reduced by “other insurance” clauses.
Common situations where PIP or MedPay may duplicate cover include:
Travel insurance with medical cover. Many UK and EU travel policies cover emergency medical treatment abroad, including in the United Estates, though limits, excesses, and pre-existing condition rules vary. If your travel policy already pays hospital and ambulance bills, MedPay may add limited value.
Private medical insurance. Some international or employer plans reimburse treatment, and some may include assistance services. If so, MedPay can be a small duplicate layer.
Credit card travel benefits. These more often focus on car damage cover than medical costs, but some premium cards include accident medical benefits. You need to check the benefit schedule, not the marketing summary.
Existing US auto policy (less common for tourists). If you are a visitor driving a relative’s vehicle often, or you have a US policy for longer stays, you may already have MedPay or PIP. In that case, buying similar cover through a rental company can be unnecessary.
Also consider your risk tolerance for small, immediate bills. MedPay limits can be relatively low, so if you already have solid travel medical cover, you may decide it is not worth paying extra for a small duplicate benefit.
When PIP can be useful even if you have medical cover
PIP can be valuable because it may cover non-medical costs that travel policies may not pay, or may pay only partially.
Situations where broader PIP-style benefits may help include:
Lost income after a serious accident. Many travel policies do not replace wages, or have strict conditions.
Replacement services. If you need paid assistance because you cannot perform daily tasks due to injury, PIP benefits can sometimes address that, whereas travel insurance may focus on treatment and repatriation.
Coordination delays. Even when another policy should eventually reimburse you, having a no-fault injury benefit can reduce friction for certain expenses, depending on how claims are handled.
That said, tourists should be cautious about assuming rental-counter products match statutory PIP. Rental companies can sell personal accident products that sound similar but have different limits and exclusions. Always ask for the coverage summary and check the maximum payout per person, per accident, and any exclusions for risky activities.
How to evaluate the cover in five quick checks
Use these checks when comparing PIP, MedPay, and personal accident products offered with car hire:
1) What is the limit per person? A low limit may not move the needle for US medical costs.
2) Does it cover passengers? If you are travelling as a family, confirm whether each occupant is covered and whether there is a separate cap per person.
3) What is included beyond medical? If it is sold as PIP-like cover, look specifically for lost income and essential services, not just medical bills.
4) Is it primary or secondary? Some benefits pay only after other insurance, which can reduce the practical value if you already have travel medical cover.
5) Where is it listed? Check the rental agreement line items before signing. If you decline, ensure it is removed from the total and not bundled into another product name.
If you want to compare how different rental brands present optional covers at the counter, browsing brand pages can help you understand what you may see on documents. For example, see Hertz car rental United States and note how optional items may be described compared with other suppliers.
Common misunderstandings that lead tourists to overpay
Mixing up injury cover with damage waiver. CDW or LDW relates to the rental vehicle, while PIP and MedPay relate to people in the vehicle. Tourists sometimes buy personal injury cover thinking it reduces the excess for vehicle damage. It does not.
Assuming “required by law” means “required for you”. Some states require drivers to have certain cover. That does not automatically mean you must buy the rental company’s personal injury product. Requirements can be met in different ways depending on residency, existing policies, and state rules.
Thinking higher price equals broader cover. A more expensive option can still have tight limits. The benefit schedule matters more than the label.
Not checking what your travel policy excludes. If your travel insurance excludes driving certain vehicles or requires you to follow local licensing rules, your medical cover might still apply, but related benefits could be complicated. It is worth checking before you travel.
So which is better for tourists, PIP or MedPay?
Neither is universally “better”. MedPay is typically the simpler medical-bills-only option. PIP is often broader, and can include non-medical benefits that might matter if an accident disrupts your ability to work or function day to day.
For many tourists with strong travel medical insurance, MedPay can be redundant. PIP-style benefits can still be redundant if your travel policy includes comprehensive accident and income protection, but that is less common. The decision should be based on what you already have, the limits offered, and who will be in the vehicle during your car hire period.
FAQ
Is PIP the same as Personal Accident Insurance on a rental agreement? Not always. Rental companies may use “Personal Accident” or “PAI” for a product that resembles PIP, but limits and benefits can differ. Compare the actual benefit list and caps.
Does MedPay cover injuries if another driver caused the crash? Typically, yes, it can pay medical expenses regardless of fault, up to the limit. Separate claims against the at-fault driver’s liability insurance may still apply.
Will PIP or MedPay cover injuries from activities outside the car? Usually these covers relate to injuries caused by an auto accident while occupying the vehicle, entering, or exiting. Coverage for other activities is generally handled by travel insurance or health insurance.
If I have travel insurance, should I always decline MedPay? Not automatically. Check your travel policy limits, excess, exclusions, and whether it pays providers directly. MedPay can still help with small, immediate bills, but it can also duplicate cover.
Where should I look to confirm I accepted or declined these covers? Check the rental agreement line items and the total charges before signing. Look for labels like PIP, MedPay, Medical Payments, Personal Accident, or similar wording in the optional products section.
