Do you have to pay for health insurance while on workers’ comp? (2024 Expert Answers)
Do you have to pay for health insurance while on workers comp? With health insurance costing single payers an average of $456, most Americans can’t afford to lose their coverage after an injury. Many states protect employees on workers’ comp, but you’ll have to check local laws to be sure.
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Eric Stauffer
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Eric Stauffer is an insurance agent and banker-turned-consumer advocate. His priority is educating individuals and families about the different types of insurance coverage. He is passionate about helping consumers find the best coverage for their budgets and personal needs. Eric is the CEO of C Street Media, a full-service marketing firm and the co-founder of ProperCents.com, a financial educat...
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UPDATED: Nov 28, 2024
It’s all about you. We want to help you make the right legal decisions.
We strive to help you make confident insurance and legal decisions. Finding trusted and reliable insurance quotes and legal advice should be easy. This doesn’t influence our content. Our opinions are our own.
Editorial Guidelines: We are a free online resource for anyone interested in learning more about legal topics and insurance. Our goal is to be an objective, third-party resource for everything legal and insurance related. We update our site regularly, and all content is reviewed by experts.
UPDATED: Nov 28, 2024
It’s all about you. We want to help you make the right legal decisions.
We strive to help you make confident insurance and legal decisions. Finding trusted and reliable insurance quotes and legal advice should be easy. This doesn’t influence our content. Our opinions are our own.
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Getting injured on the job is hard enough, but do you have to pay for health insurance while on workers comp? In most states, workers’ comp does cover health insurance to an extent.
However, you’ll likely have to continue paying your health insurance payments. Additionally, your employer might not have to pay for your health insurance premiums, depending on state law.
So, can employers cancel your health insurance while on workers’ compensation? Explore this complicated issue below. If you don’t want to rely on your employer’s coverage, enter your ZIP code into our free comparison tool to see health insurance rates in your area.
- Workers’ compensation laws vary by state
- Many employers continue to offer health insurance when you’re on workers’ comp
- You’ll probably have to pay your portion of your premiums to keep your coverage
Understanding Workers’ Compensation vs. Health Insurance
Workers comp benefits apply to any worker who suffers a qualifying work injury. They guarantee that the worker’s health insurance (which includes medical bills and disability benefits) will be paid by his employer’s workers’ compensation insurance. Calculating lost wages is also part of workers’ compensation, so you don’t miss out on your paychecks.
However, the “medical bills” requirement applies only to medical bills relating to the injury, so you may still need your health insurance if you have a family who is covered under the policy or if you need routine care while on workers comp.
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While most state laws require employers to carry workers’ compensation insurance, they don’t always have to pay for your health insurance.
If your employer isn’t obligated to pay, then you may also be able to take advantage of COBRA provisions that allow you to continue to keep your existing health insurance coverage while on workers’ comp if you pay the full premiums (i.e., you get the same coverage at the same discounted group rate as before, but now you’re picking up the whole bill for the premiums instead of your employer paying some).
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Understanding COBRA
Getting workers’ comp health insurance payments isn’t your only way to ensure continued coverage. Unless you’ve been fired for gross misconduct, you’ll probably qualify for COBRA coverage for at least 18 months after losing your health insurance benefit.
Most employees qualify for COBRA coverage, including those who were injured on the job. However, navigating COBRA coverage and workers’ compensation can be difficult, as you can see with this Reddit user’s experience.
Almost year on worker comp
byu/Inevitable-Match-758 inWorkersComp
If you find yourself in a similar situation as this Reddit user and are asking yourself, “Does my employer have to pay my health insurance while on workers’ comp?”, getting help may be your best bet. That’s particularly true if you find yourself in a unique situation, like wondering what happens to COBRA coverage when your ex-employer goes out of business. These laws can be difficult to understand, but having help in your corner is never a bad thing.
Family and Medical Leave Act and Workers’ Compensation
There can be significant variation in workers’ compensation benefits by state, but there are more legal protections in place to help you keep your health insurance. The Family and Medical Leave Act (FMLA) may be able to help while you are out on extended medical leave under certain circumstances. Factors such as company size, employee tenure, and annual hours worked will determine what, if any, benefits are available.
The FMLA offers coverage up to 12 weeks. Unfortunately, you can be fired for taking additional absence time after running out of FMLA time, so employees facing long-term disability should plan ahead.
Private Health Insurance Rates
Aside from living expenses like a mortgage or rent and car payments, health insurance is often one of a person’s biggest expenses. Many Americans decide to purchase private coverage instead of accepting what their workplaces offer to avoid unnecessary drama, like issues with whether an employer can change insurance policies without giving the employees any notice.
However, private insurance can be expensive. To get an idea of how much the average American pays for health insurance, check the rates below.
Average Health Insurance Costs by Age| Age | Monthly Rate |
|---|---|
| Age:18 | $200 |
| Age:25 | $250 |
| Age:35 | $300 |
| Age:45 | $400 |
| Age:55 | $600 |
As you can see, private health insurance can be expensive. If you find yourself wondering, “Does my employer have to pay my health insurance while on workers’ compensation?” it’s a good idea to speak with your company’s HR department. Figuring out private health insurance and workers’ compensation coverage is tricky, so it’s best to get help.
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Get Help With Workers’ Compensation and Health Insurance Today
Deciding what to do when after a workplace injury can be challenging, especially if you have questions about who pays health insurance premiums while on workers’ compensation.
If you’ve got questions about workers’s compensation and health insurance, or you feel like your company isn’t upholding its responsibilities, you can find legal advice here. Simply enter your ZIP code to find qualified legal advice in your area.
Frequently Asked Questions
How does workers’ compensation work?
Workers’ compensation provides benefits like medical care, wage replacement, and rehabilitation to employees injured or ill due to their job, funded by employer-paid insurance.
However, workers’ compensation and health insurance laws vary by state. For example, health insurance while on workers’ comp in New York likely follows different guidelines compared to laws in Georgia.
What does workers’ compensation cover?
Workers’ compensation typically covers medical expenses, lost wages, rehabilitation services, and death benefits for work-related injuries or illnesses. If you’re wondering, “Can I lose my health insurance while on workers’ compensation?” The answer is – sometimes.
However, there are exceptions. For example, the coming-and-going rule in workers’ compensation declares that you can’t make a claim on your commute to work from your personal residence.
Can my employer cancel my health insurance while on workers’ comp?
Unfortunately, an employer can cancel your health insurance while on workers’ compensation in certain cases. Federal laws like COBRA may apply, but employers can potentially terminate health insurance if you’re no longer working and no applicable state or employer policy is preventing it.
How does workers’ comp pay?
Does workers’ comp pay my health insurance? Workers’ compensation usually pays medical providers directly for health care services. For wage replacement, workers’ compensation payments are sent to injured workers periodically. However, laws vary by situation. For example, workers’ compensation laws regarding long-term disabilities and illnesses may be different than short-term injuries.
Can I use my own insurance instead of workers’ compensation?
Workers’ compensation is the primary payer for work-related injuries. Using private insurance could result in denied claims or reimbursement requirements. Although workers’ compensation claims may take longer, you should probably skip trying to use your own insurance.
Who pays for your health insurance while on workers’ compensation in Florida?
If you’ve been injured in Florida, you’re probably wondering, “Does workers’ comp pay for my health insurance in Florida?” While companies aren’t legally required to pay for your health insurance, most continue payments for employees with a health insurance benefit. Many times, companies deduct the payments you would normally make from your workers’ comp payments so your coverage continues uninterrupted.
Who pays your health insurance while on workers’ compensation in Illinois?
Many injured employees wonder, “Who pays for my health insurance while on workers’ comp in Illinois?” after a workplace accident. In Illinois, state law requires employers to continue paying for health insurance premiums. However, you’ll likely be required to pay for your portion of your premium.
Can I lose my health insurance while on workers’ comp in Illinois?
Yes, you can lose your health insurance while on workers’ comp in Illinois. However, employers are not allowed to cancel your insurance out of spite for your injury. If you feel like your insurance was unfairly terminated, enter your ZIP code to find legal advice.
Can my employer cancel my health insurance while on disability?
Employers may cancel health insurance during disability if employment benefits policies allow it, but COBRA often gives the option to continue coverage at your expense.
Disability insurance is different than workers’ compensation. If you want to add disability benefits to your financial protection plan, most major insurance companies sell disability insurance.
Does my employer have to pay my health insurance while on workers’ comp?
One of the most pressing questions people have after a workplace injury is, “Who pays health insurance when on workers’ comp?” Employers are not obligated under workers’ compensation laws to pay for health insurance premiums unless required by a separate agreement or policy.
Who pays for my health insurance while on workers’ compensation in California?
Wondering who pays your health insurance while on workers’ compensation in California? In California, employers can pay for your health insurance if you were already receiving that benefit, but companies aren’t required to. If you do lose your health insurance, the California State Disability Insurance (SDI) program may be able to help.
Find the right lawyer for your legal issue.
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Eric Stauffer
Licensed Insurance Agent
Eric Stauffer is an insurance agent and banker-turned-consumer advocate. His priority is educating individuals and families about the different types of insurance coverage. He is passionate about helping consumers find the best coverage for their budgets and personal needs. Eric is the CEO of C Street Media, a full-service marketing firm and the co-founder of ProperCents.com, a financial educat...
Licensed Insurance Agent
Editorial Guidelines: We are a free online resource for anyone interested in learning more about legal topics and insurance. Our goal is to be an objective, third-party resource for everything legal and insurance related. We update our site regularly, and all content is reviewed by experts.