PLMAhard
A Massachusetts insured with private group health insurance is injured as a passenger in her friend's MA-registered auto and incurs $9,000 in covered medical expenses. Under c. 90 §34A PIP coordination, how is the medical-expense layer typically allocated between PIP and her health plan?
AHer private health plan must pay the entire $9,000 as primary from the first dollar, because group health coverage fully displaces all PIP medical benefits under c. 90 §34A coordination rules.
BPIP pays the full $8,000 cap regardless of her private health insurance
CThe friend's insurer pays $9,000 in BI liability without involving PIP at all
PIP pays the first $2,000; her health plan then becomes primary for the next layer of medical expenses; PIP may still pay deductibles/co-insurance up to its $8,000 cap
Why this is the answer
Massachusetts PIP coordinates with private health insurance in a specific sequence. PIP pays the first $2,000 of medical expenses without regard to other coverage. Above $2,000, an insured's private health plan becomes primary for medical bills, and PIP fills in deductibles, co-pays, and co-insurance up to the $8,000 PIP aggregate.
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