PIP Health Insurance Primary FAQs for New Jersey
Choosing Health Insurance Primary means your health insurance is the primary payor for medical expenses incurred from a motor vehicle accident, for you and all family members residing at your policy address. Secondary benefits will be provided by your auto insurance under your Personal Injury Protection (PIP) plan.
Consumers can save premium dollars by choosing the Health Insurance Primary option. However, restrictions apply.
The Health Insurance Primary option impacts all resident relatives of your household who do not maintain their own auto insurance policy, including non‐drivers.
You are not eligible if you or any resident relative(s) or non‐drivers who do not maintain their own auto insurance:
- are covered under Medicare and/or Medicaid;
- have a Health Insurance Plan that will not cover auto accident injuries as the primary payor; or
- do not have health insurance coverage through a Group Health Plan (GHP).
Federal law prohibits Medicare and Medicaid from being the primary health insurer for auto accidents. Since Health Insurance Primary applies to all family members residing at your policy address, you are not eligible for Health Insurance Primary. You should choose the NJM Primary option.
Typically, if you are covered under Medicare, your Supplemental Health Insurance plan will not provide primary coverage for auto‐related injuries. We recommend contacting your Supplemental Health Insurance carrier to determine if they will provide primary coverage for auto‐related injuries.
You should not choose the Health Insurance Primary selection if you will become eligible for Medicare or Medicaid during the policy year. Similarly, other life events such as changes in employment (including retirement) and changes in health insurance may affect how auto medical expense claims are processed after an auto accident.
You will have coverage, since New Jersey law requires automobile insurers to provide PIP benefits when a health insurance company excludes coverage for auto-related injuries.
However, there may be additional costs for which you will be responsible:
- A $750 deductible may apply along with your chosen PIP deductible and the 80/20 co‐payment.
- There may also be a backdated premium charge to change the PIP Coverage to Auto Primary.
A signature is required for this change. Visit NJM.com to manage your policy or reach out to a Customer Service Representative at 1-800-232-6600 or personallines@njm.com with any questions.