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PIP vs. MedPay in Texas: A Decision Guide to Choosing (or Stacking) Your Coverage

By Accident Atlas Editorial Team · Reviewed by Phil Ayres · Updated July 13, 2026 · 7 min read

Quick Answer: How Texas PIP and MedPay Compare

Texas law requires every auto liability insurer to include Personal Injury Protection (PIP) in a policy unless the policyholder rejects it in writing (Tex. Ins. Code § 1952.152). Medical Payments coverage (MedPay), by contrast, is not a state-mandated coverage — it shows up only as an optional first-party add-on for medical bills, per the Texas Department of Insurance (TDI) Automobile Insurance Guide.

OPIC describes PIP as covering medical bills plus 80% of lost wages, while MedPay is described only as paying "some of the medical bills," with no wage-loss component mentioned. — and both can be used alongside a UM/UIM claim if the at-fault driver is uninsured or underinsured.

What Texas Law Actually Requires: PIP Is Opt-Out, Not Optional by Default

Many drivers assume PIP is something they have to actively choose. Under Texas law, it's the opposite: insurers may not issue an auto liability policy without including PIP unless the required written rejection process is followed (Tex. Ins. Code § 1952.152). PIP benefits are defined as "all reasonable expenses" arising from an accident and incurred within three years of the accident date (Tex. Ins. Code § 1952.151).

The statute sets a ceiling on the required amount, not a floor: insurers are not required to provide more than $2,500 in aggregate PIP benefits per person (Tex. Ins. Code § 1952.153), but nothing stops you from purchasing higher limits. This PIP requirement is entirely separate from the mandatory 30/60/25 liability minimums for bodily injury and property damage that every Texas driver must also carry, per the Texas Department of Insurance (TDI) Automobile Insurance Guide.

PIP vs. MedPay Side-by-Side: What Each Actually Pays For

Both coverages can be filed under your own policy to get medical bills paid while a liability or UM/UIM claim is pending or in dispute, according to OPIC. Neither coverage substitutes for liability coverage — Texas still separately requires 30/60/25 liability limits under the TDI Automobile Insurance Guide.

Who Qualifies for PIP Benefits

PIP coverage extends to the named insured, members of the insured's household, any authorized operator, and any passenger — including a guest occupant — of the insured vehicle (Tex. Ins. Code § 1952.151). To qualify, the expenses must arise from the accident and be incurred no later than the third anniversary of the accident date.

If No Insurer Will Cover You: The TAIPA Fallback

Drivers who are turned down by two insurance companies can still obtain basic coverage through the Texas Automobile Insurance Plan Association (TAIPA), per the TDI Automobile Insurance Guide. TAIPA sells liability, PIP, and UM/UIM coverage, but it does not sell collision, comprehensive, or liability limits higher than state law requires. TAIPA coverage also costs more than coverage obtained through standard insurers, and it charges more still if you've had tickets or accidents.

Special Situations That Change Your Coverage Calculus

Rideshare driving: a personal auto insurer may exclude coverage for losses that occur while the driver is logged into a transportation network company's (TNC) digital network or engaged in a prearranged ride (Tex. Ins. Code § 1954.151). That exclusion can apply to liability coverage, PIP, MedPay, UM/UIM, and physical damage coverage alike — meaning your personal PIP or MedPay may simply not respond during app-on periods. Between rides — logged on but not yet matched with a passenger — the TNC's own policy layer must independently provide at least $50,000 per person and $100,000 per incident in bodily injury liability coverage, separate from your personal PIP or MedPay (Tex. Ins. Code § 1954.052).

Government vehicles: if a governmental employee's negligent operation of a motor vehicle caused the crash, the governmental unit can be held liable under the Texas Tort Claims Act, separate from any PIP or MedPay claim you file (Tex. Civ. Prac. & Rem. Code § 101.021). A similar liability framework extends to certain crashes caused by state prison inmates operating vehicles under the direction of the Department of Criminal Justice (Tex. Civ. Prac. & Rem. Code § 101.029).

Death from injury: a personal injury claim does not end because the injured person dies. It survives and passes to the heirs, legal representatives, or estate of the injured person, in addition to any separate wrongful-death claim (Tex. Civ. Prac. & Rem. Code § 71.021).

Decision Criteria: Choosing Between PIP and MedPay

If wage replacement matters to you, the source material shows only PIP explicitly covers 80% of lost wages — factor this in before opting for MedPay alone. Because insurers are not required to provide more than $2,500 in aggregate PIP benefits per person (Tex. Ins. Code § 1952.153), ask your insurer about purchasing higher PIP limits if you want more first-party protection.

If you're considering rejecting PIP in favor of MedPay or another arrangement, remember that Texas law only allows an insurer to omit PIP when the policyholder affirmatively rejects it in writing (Tex. Ins. Code § 1952.152) — confirm exactly how your insurer documents that rejection so you don't lose the coverage by accident. Finally, think about how PIP or MedPay interacts with UM/UIM: file a UM/UIM claim under your own policy if the at-fault driver lacks enough insurance, and use PIP or MedPay simultaneously to get medical bills paid while that claim works its way through (OPIC).

Next Steps and Deadlines After a Texas Crash

File PIP/MedPay and UM/UIM claims under your own policy promptly to start getting medical bills — and, for PIP, lost wages — paid while other claims are resolved (OPIC). Beyond first-party claims, several statutory deadlines apply to any Texas motor-vehicle case:

Note that the notice deadline for claims involving a governmental unit is far shorter — six months — than the general two-year lawsuit deadline. Consider speaking with an attorney who handles auto accident cases, especially when the other driver is uninsured or underinsured, or when a governmental unit may be involved (OPIC).