Medical bills after a car crash in California: auto insurance, health insurance and liens

The short answer

Crash-related medical bills are usually paid in layers, not by one company:

Your own coverage pays as bills arrive: your health coverage (job-based, Covered California, Medi-Cal or Medicare) and, if your auto policy has it, Medical Payments coverage ("MedPay"), which pays no matter who caused the crash.
The at-fault driver's liability insurance pays later, usually in one lump sum when your claim settles. For policies issued or renewed since January 1, 2025, the minimum is $30,000 for one injured person.
Your uninsured or underinsured motorist coverage (UM/UIM) can step in if that driver had no insurance, too little, or drove off.
Whoever paid your bills may then claim repayment from your settlement. Health plans, Medi-Cal, Medicare and hospitals can all ask, but the law limits many of these claims.

If you were hurt while working, workers' compensation pays first. This page is general information as of October 22, 2026, not legal advice.

First: care, then a few time-sensitive steps

Get help now

If anyone is hurt, call 911. Some concussion symptoms may not appear for hours or days. Get emergency care right away for danger signs such as a headache that gets worse and does not go away, repeated vomiting, seizures, weakness or numbness, slurred speech, one pupil larger than the other, confusion, passing out, or being very drowsy or hard to wake.

Once you are safe:

Show your health coverage card wherever you get care and ask each provider to bill it.
Report the crash to the DMV within 10 days on form SR-1 if anyone was hurt, even slightly, or killed, or property damage to any one person was over $1,000. An insurance agent, broker or lawyer can file it.
If the other driver drove off, uninsured motorist coverage requires that their vehicle touched you or your vehicle, that the crash was reported within 24 hours to the city police, county sheriff or California Highway Patrol, and that you give your insurer a sworn statement within 30 days after that.
Tell your own auto insurer promptly, even if you were not to blame.

Who pays, and when

Who pays	When	What it covers	Watch for
Your health coverage	As bills arrive	Covered care, minus your deductible and copays	May claim repayment from a settlement
MedPay on your auto policy	As bills arrive	Medical costs for you and your passengers, up to your limit, whoever was at fault	Optional; check limits and repayment terms
At-fault driver's liability insurance	Usually once, at settlement or judgment	Your damages, including medical bills, up to its limit	May dispute fault
Your UM/UIM coverage	After you claim against your own insurer	Your injury damages when the other driver had no or too little insurance	Two-year deadline
Workers' compensation	If you were hurt on the job	Medical care for the work injury	Tell your employer within 30 days
California Victim Compensation Board (CalVCB)	Last, after every other source	Costs from crimes such as DUI or hit-and-run	Up to $70,000 in total

What your auto policy does for your own bills

Liability coverage pays other people, not you

Liability coverage pays for injuries you cause to others, not your own or your household's. The minimums rose on January 1, 2025. Under SB 1107, a 2022 state law, policies issued or renewed on or after that date must carry at least $30,000 for injury or death of one person (up from $15,000), $60,000 for two or more people in one crash (up from $30,000) and $15,000 for property damage (up from $5,000). Another increase, to $50,000, $100,000 and $25,000, is scheduled for policies issued or renewed on or after January 1, 2035. Minimum limits can run out quickly after a serious injury.

MedPay

MedPay is optional coverage on your own policy. It pays medical expenses for you and your passengers, regardless of fault, up to the limit you chose. Depending on the policy, it may cover deductibles and copays your health coverage leaves to you. Ask your insurer whether it expects repayment from a later settlement.

Uninsured and underinsured motorist coverage (UM/UIM)

UM pays for your injuries when the at-fault driver has no insurance or cannot be identified. UIM pays when that driver's coverage is less than your own UM limits. California auto liability policies must include UM and UIM, at no less than $30,000 per person and $60,000 per crash, unless you signed a written agreement to drop or lower that coverage.

UIM pays only after the other driver's limits are used up by a settlement or judgment and you send your insurer proof.
It fills the gap, not on top. The most UIM pays is your UIM limit minus what was paid for the at-fault driver. Limits from several cars or policies cannot be added together.
Your policy may subtract MedPay already paid from a UM claim.
Two-year deadline. Within two years of the crash, you must sue the uninsured driver, reach an agreement with your insurer, or formally start arbitration (a neutral arbitrator decides disputes) by certified mail to your insurer.
Ask before you settle. The law says UM coverage does not apply if you settle with someone who may be legally responsible without your insurer's written consent. Tell your insurer in writing before signing any release.

If you were driving without insurance

Under Civil Code section 3333.4, you generally cannot recover pain-and-suffering damages if you owned an uninsured vehicle in the crash, were driving without the insurance the law requires, or were convicted of DUI for that crash. (Uninsured owners hit by a driver convicted of DUI are an exception.) You can still recover economic losses such as medical bills.

Your health coverage pays first, and may want money back

Health coverage generally pays for covered crash-related care under its usual rules, but plan documents often include a "subrogation" or "reimbursement" section that lets the plan claim repayment if you recover money from whoever caused your injury.

State-regulated plans, including Covered California plans

If your plan is licensed by the California Department of Managed Health Care or Department of Insurance and its contract gives it a repayment right, Civil Code section 3040 limits the claim:

No more than what the plan actually paid your providers, plus reasonable costs of making the claim. (A different formula applies to care paid through fixed monthly payments to a medical group.)
No more than one-third of your settlement or judgment if you hired a lawyer, or one-half if you did not.
Reduced by a fair share of your lawyer's fees and costs.
Reduced by your percentage of fault, if a judge, jury or arbitrator finds you partly at fault.

Plans your employer pays for itself

Some employers "self-fund" their health plans: the employer pays claims, and an insurance company may only administer them. These plans fall under a federal law called ERISA, and California's limits generally do not apply. The U.S. Supreme Court has held that the plan's written repayment terms control; if the plan says nothing about lawyer's fees, a fair-share reduction applies. Ask your benefits office whether the plan is self-funded, and request the plan document.

Medi-Cal

Give every provider your Medi-Cal Benefits Identification Card so they can bill Medi-Cal. They have up to one year from the date of service to do so.
Notify the state within 30 days. If you make a claim or file a lawsuit against whoever caused the crash, you or your lawyer must tell the Department of Health Care Services (DHCS) Personal Injury Program in writing within 30 days. Telling your county worker is not enough.
Medi-Cal can be repaid from your recovery, including, DHCS says, your own UM, UIM or MedPay payments. A settlement is not final until DHCS has had a reasonable chance to assert its claim.
The law limits DHCS's share. It can take only the part of a recovery that pays for medical care, and a court can decide disputes about that part. If you paid a lawyer, its claim is cut by 25% for fees, plus a share of costs, and it can never exceed what you keep after fees and costs. To request a reduction, send DHCS your settlement papers with fees and itemized costs. The amount is due at settlement; DHCS does not offer payment plans.
Uninsured when the crash happened? Ask the hospital about applying for Medi-Cal, which can now pay unpaid bills from up to three months before you apply if you were eligible then. For applications dated on or after January 1, 2027, DHCS says a 2025 federal law shortens that to one month for the expansion adult group (generally ages 19 to 64, without a disability) and two months for others. See Medi-Cal in plain language.

Medicare and Medicare Advantage

Auto and liability insurance pay first. MedPay pays before Medicare, and so does liability insurance, which Medicare says includes uninsured and underinsured motorist coverage.
Providers try the auto insurer first. Once told about a claim, they must try to get that insurer to pay. If it does not pay promptly (usually within 120 days), Medicare may make a "conditional payment" that must be repaid from any settlement.
Report the crash to Medicare's Benefits Coordination & Recovery Center. After a settlement, report its date and amount and the lawyer's fees and costs you paid, which Medicare takes into account. You can dispute unrelated charges, ask about a waiver or appeal, and owe interest if you pay a repayment demand late.
Medicare Advantage plans can also claim repayment, and federal rules say a state law cannot take that right away.

Hospital liens: what they can and cannot reach

A lien is a legal claim against money. California's Hospital Lien Act lets a hospital that treated your crash injuries claim part of what you recover from whoever caused them, within limits:

It covers only the hospital's reasonable and necessary charges for those injuries.
It does not apply to work injuries covered by workers' compensation.
It works only if the hospital delivers written notice, or sends it by registered mail, to the person responsible and their insurer before they pay you.
It can reach no more than half of what is due under the settlement or judgment, after any earlier liens are paid.
If an insurer pays you despite a valid notice, the hospital can sue that insurer within one year.

If your health plan already paid. In 2005, the California Supreme Court held that a hospital that accepted a health plan's payment as payment in full, leaving the patient owing nothing, could not then use a hospital lien to collect the rest of its full charges. Hospitals can keep that right through their contracts with plans, so ask the hospital in writing what you still owe and why.

Treatment "on a lien." Some providers offer to wait for payment until your case settles. First ask whether you will owe the full bill if the claim fails or settles low, what rate they charge, and whether they can bill your health coverage instead. In a 2018 California appeals case, an insured man who chose lien-based care outside his plan faced full billed charges and confirmed he was personally responsible for all the costs of his surgery.

Example (fictional)

Example (fictional): Rafael is rear-ended at a red light in Modesto and needs emergency care and physical therapy.

His job-based HMO, licensed by the Department of Managed Health Care, pays his providers $9,000. His $5,000 of MedPay covers the $1,500 he owes in deductible and copays.
He hires a lawyer for a one-third contingency fee. The other driver has the minimum $30,000 of liability coverage, and that insurer pays all of it.
His plan contract gives it a repayment right. Under section 3040, its claim cannot exceed the $9,000 it paid or one-third of $30,000 ($10,000), so it starts at $9,000. The law then reduces it by a share of his lawyer's fees; if that share matches his one-third fee, the plan receives $6,000.
His losses exceed $30,000, and he carries $100,000 of UM/UIM coverage. Because the other driver's limit was paid in full, he can claim up to $100,000 − $30,000 = $70,000 in UIM benefits within the two-year deadline.

Records to keep

Police report number; the other driver's name, insurer and policy number; witness contacts
Photos of the vehicles, the scene and your injuries
Your declarations page showing MedPay and UM/UIM limits, and any UM waiver you signed
Every health coverage card used and every Explanation of Benefits
An itemized bill from each provider, including the ambulance, emergency doctors, imaging and therapy
Copies of your SR-1, notices you sent DHCS or Medicare, and every lien notice you receive
Claim numbers, adjuster names and a dated call log
Prescription costs, mileage to appointments and missed work

Why one emergency visit generates several bills explains who sends what. How to read an itemized hospital bill covers billing errors, California's ground ambulance limits and hospital financial assistance. Do not sign a settlement or release until you know every lien amount.

When to talk to a lawyer or legal aid

Many claims settle without a lawyer, but get advice early if:

You were seriously hurt, or your losses may exceed the other driver's limits.
Fault is disputed, or the other driver was uninsured or drove off.
A government agency, vehicle or road may be involved; a written claim to a public entity is generally due within six months.
Medi-Cal, Medicare or an employer plan is claiming repayment, or there is more than one lien.
An insurer is pressing you to sign a release quickly.

Deadlines. The general deadline to sue for a personal injury in California is two years, as is the UM deadline. Different deadlines can apply to children and in other situations, so ask early.

Paying a lawyer. Injury lawyers usually take a percentage of the recovery (a contingency fee). California requires that agreement to be in writing, state the percentage, explain how costs affect your share, and say the fee is not set by law and can be negotiated. Ask who will negotiate the liens.

Where to find help:

Certified Lawyer Referral Services listed by the State Bar of California offer a free or reduced-fee first consultation.
LawHelpCA, from the Legal Aid Association of California, lists legal aid by city, county or ZIP code.
California Department of Insurance: 1-800-927-4357 (TTY 1-800-482-4833) if an insurer delays or denies. Insurers generally must accept or deny a claim within 40 calendar days of receiving proof, or explain in writing why they need more time.
Medi-Cal Personal Injury Program: (916) 445-9891. Medi-Cal eligibility questions: (800) 541-5555.
Medicare Benefits Coordination & Recovery Center: 1-855-798-2627 (TTY 1-855-797-2627).
CalVCB: 800-777-9229. Applications are generally due within seven years of the crime, with some exceptions.
Division of Workers' Compensation: 1-800-736-7401.

Sources

Insurance Requirements — California Department of Motor Vehicles, accessed October 22, 2026.
Bulletin 2023-1: Increase in Private Passenger Motor Vehicle Financial Responsibility Requirements — Senate Bill 1107 — California Department of Insurance, January 30, 2023.
Vehicle Code section 16056 — California Legislature, as reproduced by California.Public.Law, accessed October 22, 2026.
Auto Insurance (consumer guide, Form 901) — California Department of Insurance, February 2025.
Insurance Code section 11580.2 — California Legislature, as reproduced by California.Public.Law, accessed October 22, 2026.
Civil Code section 3333.4 — California Legislature, as reproduced by California.Public.Law, accessed October 22, 2026.
Vehicle Code section 16000 — California Legislature, as reproduced by California.Public.Law, accessed October 22, 2026.
Civil Code section 3040 — California Legislature, as reproduced by California.Public.Law, accessed October 22, 2026.
FMC Corp. v. Holliday, 498 U.S. 52 (1990) — Supreme Court of the United States, as reproduced by the Legal Information Institute, Cornell Law School.
US Airways, Inc. v. McCutchen, 569 U.S. 88 (2013) — Supreme Court of the United States, as reproduced by the Legal Information Institute, Cornell Law School.
The Personal Injury Lien Process — California Department of Health Care Services, accessed October 22, 2026.
Personal Injury Frequently Asked Questions — California Department of Health Care Services, accessed October 22, 2026.
Welfare and Institutions Code section 14124.73 — California Legislature, as reproduced by California.Public.Law, accessed October 22, 2026.
Welfare and Institutions Code section 14124.76 — California Legislature, as reproduced by California.Public.Law, accessed October 22, 2026.
Welfare and Institutions Code section 14124.72 — California Legislature, as reproduced by California.Public.Law, accessed October 22, 2026.
Welfare and Institutions Code section 14124.78 — California Legislature, as reproduced by California.Public.Law, accessed October 22, 2026.
H.R. 1 Implementation (proposed trailer bill fact sheet) — California Department of Health Care Services, May 2026.
How Medicare Works with Other Insurance (CMS Product No. 02179) — Centers for Medicare & Medicaid Services, February 2026.
Medicare's Recovery Process — Centers for Medicare & Medicaid Services, page last modified June 11, 2026.
42 CFR 422.108, Medicare secondary payer (MSP) procedures — Electronic Code of Federal Regulations, current as of October 20, 2026.
Civil Code section 3045.1 — California Legislature, as reproduced by California.Public.Law, accessed October 22, 2026.
Civil Code section 3045.3 — California Legislature, as reproduced by California.Public.Law, accessed October 22, 2026.
Civil Code section 3045.4 — California Legislature, as reproduced by California.Public.Law, accessed October 22, 2026.
Civil Code section 3045.5 — California Legislature, as reproduced by California.Public.Law, accessed October 22, 2026.
Parnell v. Adventist Health System/West (2005) 35 Cal.4th 595 — Supreme Court of California, as reproduced by SCOCAL, Stanford Law School.
Pebley v. Santa Clara Organics, LLC (2018) 22 Cal.App.5th 1266 — California Court of Appeal, Second Appellate District, filed May 8, 2018.
Signs and Symptoms of Mild TBI and Concussion — Centers for Disease Control and Prevention, last reviewed September 15, 2025.
I was injured at work — California Division of Workers' Compensation, January 2025.
Who Is Eligible — California Victim Compensation Board, accessed October 22, 2026.
What Is Covered — California Victim Compensation Board, accessed October 22, 2026.
Code of Civil Procedure section 335.1 — California Legislature, as reproduced by California.Public.Law, accessed October 22, 2026.
Government Code section 911.2 — California Legislature, as reproduced by California.Public.Law, accessed October 22, 2026.
Business and Professions Code section 6147 — California Legislature, as reproduced by California.Public.Law, accessed October 22, 2026.
Cal. Code Regs. tit. 10, § 2695.7 (Fair Claims Settlement Practices Regulations) — California Department of Insurance, as reproduced by the Legal Information Institute, Cornell Law School, accessed October 22, 2026.
Find a Lawyer Referral Service — State Bar of California, accessed October 22, 2026.
LawHelpCA — Legal Aid Association of California, accessed October 22, 2026.
Report of Traffic Accident Occurring in California (SR-1) — California Department of Motor Vehicles, accessed October 22, 2026.
All County Welfare Directors Letter No. 26-07: Policy Changes to Retroactive Medi-Cal Coverage Periods — California Department of Health Care Services, March 12, 2026.