Why Unlimited PIP Is the Only Real Choice for Michigan Families in 2026

Car insurance ads often emphasize how much drivers can save by choosing lower Personal Injury Protection coverage limits. What those ads rarely explain is how quickly medical costs can exceed those limits after a serious crash. In Michigan, the difference between capped and unlimited PIP coverage is not just a pricing decision. It is a financial risk decision that can affect your medical care, independence, and long-term stability after an accident. Understanding how these coverage options actually function in real injury scenarios is essential before you ever need to use them.

What Michigan PIP Coverage Options Exist in 2026?

Michigan drivers can choose from several Personal Injury Protection coverage levels, each offering a different amount of medical expense protection after a crash. These options were created after the state’s No Fault reform and allow drivers to balance monthly premiums against potential out-of-pocket risk, but once a policy is selected, that limit controls how much medical care the auto insurer must pay if a serious injury occurs. In practical terms, PIP covers accident-related treatment, rehabilitation, attendant care, prescriptions, and recovery services, and the real difference between coverage tiers is not what they pay for, but how long those benefits last before they stop.

Michigan PIP Coverage Levels Explained

How Fast a $250,000 Policy Can Run Out

Many drivers assume a $250,000 PIP limit would be more than enough after an accident. In reality, even a moderate injury can generate medical bills that approach or exceed that amount within weeks. Consider a realistic scenario involving a traumatic brain injury that requires emergency treatment, surgery, and rehabilitation. The costs below reflect typical ranges seen in serious injury cases and illustrate how quickly expenses can accumulate before long term recovery even begins.

In this scenario, the policy limit is reached before the patient has even returned home. Once that $250,000 threshold is hit, PIP medical coverage stops paying for additional treatment. Ongoing therapy, follow-up care, and long-term support must then be covered by other sources such as private health insurance or personal funds.

The Real Cost of Long Term Care After a Michigan Crash

Many drivers assume expenses end when a patient leaves the hospital. In serious injury cases, the opposite is often true. The largest financial exposure frequently begins at home, when ongoing supervision or assistance with daily living becomes necessary.

In 2026, professional attendant care for injuries such as traumatic brain injury or spinal cord trauma commonly requires agency level services. Depending on care needs, hourly rates often fall within the $27 to $36 range. At an average of $32 per hour, continuous care costs approximately $5,376 per week or about $279,552 per year.

Under Michigan law, insurers generally must reimburse no more than 56 hours per week for care provided by family members. If medical providers recommend round the clock supervision, the remaining hours typically must be filled by paid caregivers. Those additional hours are billed at market rates and count toward the policy’s PIP limit.

Example: First Year Care Costs After a Moderate Brain Injury

In this scenario, a $250,000 policy can be exhausted before the first year of recovery ends, and once that limit is reached, PIP medical benefits stop paying for additional treatment or care. In practice, long term recovery expenses are often more financially significant than the initial hospital stay, which means coverage levels that seem adequate when purchased may prove insufficient once ongoing care needs are fully calculated.

What Happens When PIP Runs Out?

When Michigan PIP benefits reach their limit, coverage does not gradually reduce. It stops. Understanding what happens next is important because the financial responsibility for care can shift quickly once that threshold is reached.

Step 1: The PIP limit is exhausted

After medical bills equal the selected coverage amount, the auto insurer is no longer required to pay additional PIP medical expenses. At that point, any ongoing treatment, therapy, or care must be paid through another source or out of pocket.

Step 2: Other insurance may step in

Health insurance, if available, may begin covering treatment. However, private health plans often have deductibles, copays, network restrictions, and limits on rehabilitation or long term care services, which can leave significant portions of care unpaid.

Step 3: Providers may bill the patient directly

If treatment is not fully covered by another insurer, the remaining balance can become the patient’s responsibility. This can include therapy, medications, medical equipment, or home care.

Step 4: A lien or reimbursement claim may arise

If another insurer pays accident-related medical bills, it may later seek repayment from any settlement or verdict obtained from the at fault driver. This process is commonly called subrogation, and it allows the insurer to recover what it paid for care.

Step 5: Financial pressure increases over time

Once PIP benefits end, ongoing recovery costs do not stop. The longer treatment continues, the greater the potential out of pocket exposure, especially when care involves therapy, medications, or daily assistance.

Why Medical Inflation Makes Capped Policies Riskier Each Year

Michigan’s No Fault system includes a medical fee schedule that limits what providers may charge auto insurers for certain services, a framework established under MCL 500.3157 and tied in many cases to Medicare based formulas or percentage caps. While designed to control costs, this system operates alongside real world medical inflation, where hospital care, rehabilitation, medications, and skilled services tend to increase in price over time due to staffing shortages, technology expenses, and demand for specialized treatment.

For capped policies, this creates a compounding risk because coverage limits remain fixed while medical costs continue to rise. A $250,000 or $500,000 policy that appears substantial today may pay for significantly less care in future years, meaning the real value of that protection declines annually as treatment expenses increase.

Who Should Strongly Consider Unlimited Coverage

Certain drivers face greater financial risk if serious injuries occur, making higher PIP limits especially important to evaluate. The following groups are more likely to experience long term consequences if coverage runs out:

Choosing a coverage level is not only about premiums. It is about how much financial exposure you are willing to assume if a catastrophic injury occurs.

Capped vs. Unlimited: The Medical Cliff in Practice

The Medical Cliff is not a legal theory. It is the point at which an insurance policy’s medical limit is reached and payments stop even though treatment is still ongoing. In practical terms, it is the moment financial responsibility shifts from the insurer to the patient. The comparison below shows how capped and unlimited PIP policies typically respond to the same serious injury scenario in 2026.

In 2026, the cost of emergency transport and initial trauma care alone can consume a substantial portion of a capped policy, meaning a significant percentage of available benefits may be used within the first days of treatment. The Medical Cliff is determined by policy limits, not injury severity. Two people with identical injuries can face completely different financial outcomes depending solely on the coverage level selected.

Quick Self Check: Are You Protected?

You can verify your coverage level in less than a minute by reviewing your auto insurance declarations page. This document lists the exact PIP medical limit you selected when your policy was issued or renewed. Follow these steps:

Check Your Coverage Before You Need It

Reviewing your coverage takes only a minute, but it can determine how medical expenses are handled after a serious accident. Checking your declarations page now allows you to understand your level of protection before you ever need to rely on it, and drivers who want a clearer picture of how these situations unfold often explore their options for legal help after a serious crash in Michigan. Many people focus on premiums when selecting a policy, yet the more important question is whether their coverage would still protect them months or years into recovery. Taking time to confirm your limits today can help prevent difficult financial decisions later.