Who Pays for Health Insurance While on Long-Term Disability?

If you find yourself unable to work for a long time because of a disability, you might wonder who will pay for your health insurance. It’s important to understand your options so you can stay covered and manage your health care costs.

Understanding Long-Term Disability

Long-term disability (LTD) insurance helps you get a portion of your salary if a medical condition stops you from working for an extended period. But LTD insurance usually does not cover health insurance premiums directly. Let’s explore what options you might have for keeping your health insurance.

Employer-Provided Benefits

If you have health insurance through your job, the first thing to check is whether your employer will continue to cover your health insurance while you are on disability. Some employers might maintain your insurance for a certain time as part of your disability benefits. It’s crucial to ask your HR department about how long your insurance will last and what portion of the premium you might need to pay.

COBRA

The Consolidated Omnibus Budget Reconciliation Act (COBRA) gives employees in eligible companies the right to keep their group health insurance after leaving their job or reducing their work hours, including when going on disability. Under COBRA, you can keep your insurance for up to 18 months, but you will have to pay the full premium yourself, which can be quite expensive as it includes both your part and any part your employer used to pay.

Government Programs

  • Medicare: If you are on Social Security Disability Insurance (SSDI) for 24 months, you are automatically eligible for Medicare, regardless of your age. Medicare can help cover your medical expenses, though it might not cover everything, so you may still need additional insurance.
  • Medicaid: If your income is low while you are disabled, you might qualify for Medicaid. Medicaid programs vary by state but generally offer comprehensive health coverage for people with limited income.

Individual Health Insurance Plans

You can also buy health insurance through the Health Insurance Marketplace. Depending on your income and family size, you might qualify for subsidies that reduce the cost of premiums. This can be a good option if COBRA is too expensive and you are not yet eligible for Medicare.

Disability Insurance Policies

Some disability insurance policies include options for paying your health insurance premiums. It’s essential to read the details of your policy or talk to your insurance provider to understand what is covered.

Table: Disability Insurance Policy Features

FeatureDescription
Type of CoverageShort-Term Disability (STD), Long-Term Disability (LTD)
Benefit DurationSTD: Up to 2 years, LTD: Up to retirement age
Waiting PeriodSTD: 0-14 days, LTD: 90-180 days
Coverage PercentageTypically 50-70% of salary
Premium CostVaries based on age, occupation, and coverage amount
Taxability of BenefitsTax-free if paid with after-tax dollars, taxable if not
Policy ExclusionsPre-existing conditions, specific illnesses, injuries
Optional RidersCost-of-living adjustments, future purchase options

Using Online Health Portals

For those using specific health networks, online health portals like My Centura Health can be invaluable. You can access your medical records and health information by visiting www-mycenturahealth.us. If you need to manage your appointments or communicate with your healthcare providers, simply use the Login Mycenturahealth feature for secure access.

Planning Ahead

If you think you might be out of work due to a disability soon, start planning now. Check what your current health insurance covers and understand your options. Talking to a benefits coordinator or a financial advisor can also help you make informed decisions.

Summary

When you’re dealing with a long-term disability, keeping your health insurance is crucial for your health and financial well-being. By understanding your options, such as employer benefits, COBRA, Medicare, Medicaid, or individual plans, you can find a solution that best fits your needs. Always double-check with your employer, insurance provider, or a professional advisor to make sure you have accurate and up-to-date information.

Taking the time to explore these options can ensure that you stay covered during challenging times.

Tips:

  • Communicate Early and Often: As soon as you know you’ll be on long-term disability, talk to your HR department or insurance provider about how your health insurance coverage will be affected.
  • Explore All Options: Consider all sources of health insurance coverage, including COBRA, Medicare, Medicaid, and individual insurance plans from the marketplace.
  • Evaluate Costs and Benefits: Compare the costs and coverage of each option. Look for any subsidies or assistance programs that could make premiums more affordable.

FAQs

Q1: Can I keep my employer health insurance if I go on long-term disability?

A: Possibly, depending on your employer’s policy. You may continue receiving benefits under your current plan for a limited time, or you might need to switch to COBRA to extend your coverage.

Q2: What happens to my health insurance if I’m on disability for more than 18 months?

A: If you’re on Social Security Disability Insurance (SSDI), you’ll be eligible for Medicare after 24 months. If COBRA expires before then, you may need to look into individual plans or state Medicaid as interim coverage.

Q3: Are there any insurance plans that help pay health premiums while I’m on disability?

A: Some private disability insurance policies may offer riders that assist with health insurance premiums. Check your policy details or contact your insurance agent to see if this option is available to you.