This explains Michigan’s general rules. It can’t decide your eligibility or promise payment; your policy or plan decides that.
Why this exists
Many patients wait longer or pay more than they need to because nobody explained which coverage applies. A car accident, a work injury and everyday back pain are paid in three different ways in Michigan, with different rules for referrals and visit limits. This tool shows the usual lane in under a minute.
Who pays after a car accident in Michigan?
Your own auto insurer pays for reasonably necessary medical care through personal injury protection (PIP), no matter who caused the crash. How much it pays depends on the PIP medical level on your policy. There is no preset number of visits. Give your insurer written notice within one year. See our no-fault treatment guide.
Who pays for a work injury?
Your employer’s workers’ compensation insurer, usually with nothing owed by you for approved care. Report the injury to your employer first and get the claim number. In Michigan, your employer can choose the provider for the first 28 days of care.
Are there visit limits?
Auto no-fault and workers’ comp have no preset visit count; care has to be necessary and related to the injury. Original Medicare has no hard cap on physical therapy, but above a yearly amount the therapist documents that care is still necessary. Health plans and Medicare Advantage plans often limit therapy visits each year or need approval first. We check your plan.
Do I need a referral?
Not after a car accident, and not with original Medicare or most PPO plans. HMO plans and most Medicaid health plans need a referral from your primary care doctor to see a specialist. Michigan lets you start physical therapy without a prescription for up to 21 days or 10 visits, though your plan may want one to pay.
Do you take Medicare and Medicaid?
Yes. We accept Medicare, Medicare Advantage, Michigan Medicaid and many commercial plans. Some treatments, such as PRP and shockwave therapy, are usually self-pay under health plans, and we tell you the price in writing before treatment. If you’re uninsured or not using insurance, you have the right to a Good Faith Estimate. See insurance accepted.
Attorneys, physicians and employers
You’re welcome to share this page with clients, patients and employees. To send a patient to us, use the referral form; for records, the records request form.
Sources
- MCL 500.3107, personal protection insurance benefits
- Michigan DIFS, Choosing PIP medical coverage
- MCL 500.3145, time limits for PIP claims
- MCL 418.315, workers' compensation medical care
- MCL 333.17820, physical therapy without a prescription
- Medicare.gov, physical therapy services
- CMS, your right to a Good Faith Estimate
