Out-of-Pocket Expenses

If you have been injured, getting medical attention is the highest priority. This is an immediate need. Many times, the appropriate paperwork for coverage is not completed right away. Other times, the payment structure from the insurance is for reimbursement only. As a result, the at-fault insurance company does not cover your costs at the outset.

What does this mean for you? Generally, you will have to make payments before everything is sorted. This leads to out-of-pocket expenses. You will have medical expenses and more to pay for. Compensation from the at-fault insurance occurs for covered expenses. It is critical that the compensation you receive is just, especially if you paid anything out of your pocket. It is also critical to know which expenses get covered and which do not.

What are Out-of-Pocket Expenses?

What are Out-of-Pocket Expenses?

Out-of-pocket expenses are a category used to define a variety of costs related to the treatment of injuries after an accident. It is an encompassing term that goes beyond medical costs. Out-of-pocket expenses also include costs incurred to receive medical care. They may come into play after a car accident, workplace accident, or any other injury-causing event.

What is Included?

Expenses can add up quickly if you have been injured. This can cause financial issues that you don’t want to shoulder long-term. It can also lead to financial stress in the short term. To get reimbursed for your expenses, it is important to know what gets covered. 

Not everything is covered by the insurance company. You want to avoid incurring a cost you will not get reimbursed for. Insurance companies, by nature, do not want to pay out claims. 

Policies vary amongst companies. As a result, they will carefully evaluate any expense you submit. The standard for coverage is reasonable and necessary. Be sure to keep track of everything. Keep every receipt and note any money spent. 

There are two main types of out-of-pocket expenses: expenses arising from your medical treatment and transportation costs. 

Medical treatment expenses

Your medical treatment expenses include anything that you had to pay for during your treatment. This must be related to your injury arising from the accident. 

This includes things such as:

  • Medication, both prescribed and anything over-the-counter
  • Medical equipment, such as wheelchairs

The cost for lodging, if you have to travel out of town for treatment, is also covered. 

Be sure to note here that it must have been reasonable and necessary for your treatment. For example, if you get hit by a car and come away with only scratches on your arms, the insurance company would not cover an arm sling.

Transportation costs

The at-fault insurance company must also cover transportation costs to and from treatment. These are incidental expenses and can include:

  • Mileage reimbursement 
  • Rental car
  • Parking fees
  • Cab fares if you cannot drive
  • Train fares to see doctors out of town

Here it is important to note that you must be getting treatment for the accident injury. If you are going for your annual physical exam, those costs will not get covered.

How Do You Track These Expenses?

Throughout the process, proper documentation is key. There are a few tips to keep in mind to help:

  1. Keep every receipt for transportation. 
  2. Keep every receipt for medication costs.
  3. Keep every receipt for other treatment-related payments, such as co-pays.
  4. Do not throw out any documentation – such as appointment cards and prescription slips.
  5. Make a list of all of your expenses.

Be sure to keep everything together in a safe space. If you lose anything, you can contact your doctor or pharmacy to provide the necessary proof. 

Do not trust that your doctors or the insurance company will gather this information for you. Doing it yourself will ensure that nothing is missed. Once all of this is done, you can send a demand package. The demand package includes a letter asking for reimbursement and outlining the monetary amounts. 

What if there is a Dispute?

Unfortunately, disputes are not uncommon. You may get a response from the insurance company that is less than what you are owed. The insurance company will list out what they are and are not covered in your claim. The insurance company might request more information. In this case, you might need to go to your doctor to get a letter from the company. The doctor can explain the course of your treatment and why it is reasonable and necessary. 

You also may have to go to the responsible party to collect additional payment. In this case, be sure to continue to document any interaction you have with that party. If anything goes awry with payment, the documentation is there for reference. 

Contact a Personal Injury Attorney For Help 

Getting injured can be an upsetting time. The last thing that you want to worry about is having trouble with increasing out-of-pocket expenses. If you need help discussing your expenses and how to get reimbursement, contact a personal injury attorney today at (717) 231-1640.