General information, not legal advice. This guide explains California law in general terms. It isn't advice about your situation, and laws and deadlines can change. Check the official sources linked on this page.
Who pays medical bills after a car accident in California?
California is an at-fault state, but the at-fault driver's insurer usually doesn't pay doctors as the bills arrive. In the meantime, your own coverage pays, and those payers may want to be repaid from any recovery. Here's who pays first and what California law says about repayment.
Short answer: Early on, your health insurance and your own MedPay usually pay. The at-fault driver's liability insurance pays later, through a settlement or judgment. Hospitals, health plans, Medi-Cal and Medicare may claim repayment from that money. California caps many of those claims (Civ. Code §3040, §3045.4).
Who pays, in order
- Your health insurance. The California Department of Insurance's auto insurance guide says health insurance usually pays for your immediate medical care. It then typically tries to get the money back from the auto insurance involved (subrogation). Give your hospital and doctors your health plan card.
- Your MedPay, if you have it. It pays regardless of fault, up to your limit. See the MedPay guide.
- The at-fault driver's liability insurance. It covers what its driver is legally responsible for, up to the policy limits. California's minimum limits are $30,000 per person and $60,000 per accident for injuries, for policies issued or renewed on or after January 1, 2025 (VC §16056). This is usually paid in a settlement or judgment, not bill by bill.
- Your uninsured/underinsured motorist coverage, if the other driver had no insurance, too little, or drove off. See the UM/UIM guide.
If you were hurt while working, workers' compensation may apply. This guide doesn't cover workers' comp.
Medi-Cal
If Medi-Cal paid for your care, the state can recover those costs from your injury settlement. That includes first-party coverage like MedPay and UM/UIM, according to the DHCS personal injury FAQ.
Welfare and Institutions Code §14124.73 requires written notice to DHCS within 30 days of filing a claim or lawsuit against a liable party. The notice must include the injury date, your Medi-Cal ID number, and the liable party's and insurer's information. DHCS has an online form for reporting a personal injury case.
Medicare
If Medicare paid for crash-related care that liability or no-fault insurance should cover, Medicare can recover those "conditional payments." CMS asks Medicare beneficiaries in an auto accident or liability case to contact its Benefits Coordination & Recovery Center (BCRC) (CMS reporting page).
Hospital liens
California's Hospital Lien Act lets a hospital that provided emergency and ongoing care claim part of your recovery from the person who caused your injuries:
- What the lien covers: the hospital's reasonable and necessary charges for treating you. It doesn't apply to workers' compensation claims (Civ. Code §3045.1).
- Notice: the lien binds the liable party and its insurer only if the hospital sends them written notice, by registered mail, before the money is paid (§3045.3).
- The cap: the lien can't be more than 50% of what you recover, after any prior liens are paid (§3045.4).
Health plan liens
Civil Code §3040 limits liens by many health plans and insurers on a third-party recovery:
- The lien can't be more than what the plan actually paid your providers, plus reasonable costs of perfecting it. For capitated care, the cap is 80% of the usual and customary charge.
- It's capped at one-third of your recovery if you hired a lawyer, or one-half if you didn't.
- If a final judgment or award includes a finding that you were partly at fault, the lien is reduced by the same percentage. It's also reduced in proportion to your reasonable attorney fees and costs (the "common fund" rule).
- It doesn't apply to workers' compensation, Medi-Cal, or hospital liens. Under §3040(h), it doesn't make a lien enforceable where federal law preempts state law, which can be true for some self-funded employer plans.
Ask any plan claiming a lien for an itemized list of what it paid, and compare it with your crash-related treatment.
Practical steps
- Keep every bill, explanation of benefits, and receipt.
- Ask providers to bill your health insurance rather than send bills to collections while your claim is open.
- Track your deadlines: the statute of limitations guide explains the two-year rule, and the government claims guide the 6-month rule.
Common questions
Does the at-fault driver's insurance pay my medical bills right away?
Usually not as the bills come in. The at-fault driver's liability insurance covers what its driver is legally responsible for, which is normally resolved through a claim settlement or a court judgment. In the meantime, your health insurance or your own MedPay coverage can pay for care.
Should I use my health insurance after a car accident?
You can. The California Department of Insurance says your health insurance usually pays for your immediate medical care and may then try to recover that money from the auto insurance involved (subrogation). Give your providers your health insurance information.
Can a hospital put a lien on my car accident settlement in California?
Yes. Civil Code §3045.1 gives a hospital that treated you a lien on your recovery from the person responsible, for its reasonable and necessary charges. Under §3045.4 the lien can't be more than 50% of what you recover, after certain prior liens. The lien only binds the payer if the hospital sent the written notice required by §3045.3 before the money was paid.
How much can my health insurance take from my settlement?
Civil Code §3040 limits many health plan and insurer liens. The lien can't be more than the amount actually paid for your care, plus certain costs. It's also capped at one-third of your recovery if you had a lawyer, or one-half if you didn't, and it shares proportionally in your attorney fees. If a judgment finds you partly at fault, it's reduced by the same percentage. It doesn't apply to Medi-Cal, workers' compensation, or hospital liens, and federal law can override it for some employer plans.
I have Medi-Cal. What do I need to do after a car accident?
Tell the Department of Health Care Services. Welfare and Institutions Code §14124.73 requires a Medi-Cal beneficiary who brings a claim or lawsuit against a liable party to give DHCS written notice within 30 days of filing. DHCS's personal injury FAQ explains how to report online and how DHCS recovers what Medi-Cal paid.
Sources
The sources this guide cites. We check the guide against these sources before publishing and each time we review it.
- California Civil Code §3040, limits on health plan liens (California Legislative Information)
- California Civil Code §3045.4, hospital lien limit (California Legislative Information)
- Automobile Insurance consumer guide (California Department of Insurance)
- California Vehicle Code §16056, minimum liability insurance limits (California Legislative Information)
- Personal Injury FAQ for Medi-Cal members (Department of Health Care Services)
- California Welfare and Institutions Code §14124.73, telling Medi-Cal about an injury claim (California Legislative Information)
- Liability, No-Fault and Workers' Compensation Reporting (Centers for Medicare & Medicaid Services)
- California Civil Code §3045.1, hospital liens (California Legislative Information)
- California Civil Code §3045.3, notice a hospital must give (California Legislative Information)
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