Life is unpredictable, and unforeseen events can affect physical and financial well-being. One such scenario many individuals may face is losing health insurance while collecting workers’ compensation. This challenging situation balances managing medical expenses, maintaining health insurance, and recovering from injury.
Workers’ compensation is designed to provide financial assistance and medical benefits to employees who suffer job-related injuries or illnesses. However, it is important to understand that workers’ compensation does not replace health insurance. They both cover different aspects of an individual’s healthcare needs.
Consider these scenarios:
- Paying your premiums: If you leave work due to a work-related illness or injury, discuss with your employer how your insurance premiums will be paid. This is, of course, assuming your employer pays at least part of your insurance. Generally, however your premiums are paid, they should remain the same. Some companies, particularly smaller businesses, do not pay for their employees’ health insurance or pay a partial amount, leaving the employee to pay for the rest. As workers’ compensation benefits cover all medical expenses related to your work injury, your health insurance will cover other medical expenses.
- Loss of job while injured: Unfortunately, you can lose your job while out, even if you have a workers’ compensation case. Should this happen, your employer-provided health insurance will also end, but your workers’ compensation benefits covering your work-related injury should continue.
- COBRA benefits: The Consolidated Omnibus Budget Reconciliation Act (COBRA) allows individuals who lose their job-based health insurance to continue coverage for a limited time. However, COBRA can be expensive, as individuals are often responsible for the full premium plus a 2% administrative fee. Your health plan administrator must give you 60 days to accept this coverage.
- Public health insurance programs: Depending on your situation, you may be eligible for public health insurance programs such as Medicaid or the Affordable Care Act (ACA) marketplace. These options can provide coverage during recovery, but eligibility criteria vary by state and individual circumstances.
- Illegally terminated: Your employer cannot terminate your employment illegally. If you suspect this, you should speak with an experienced lawyer right away and discuss your rights and what you can do.
- Immediate notification: If you anticipate losing your health insurance, promptly notify your workers’ compensation adjuster. Timely communication ensures that necessary arrangements can be made to address your medical needs.
- Advocacy and legal assistance: If you encounter challenges obtaining healthcare coverage, consider seeking legal advice. An attorney with experience in workers’ compensation and insurance law can advocate for your rights and guide you through the process.
Losing health insurance while collecting workers’ compensation can be a daunting experience, but it is important to recognize that solutions exist. By proactively addressing the issue, exploring available options, and seeking assistance when needed, individuals can navigate this challenging intersection and ensure that their health needs are met during recovery.
Our West Chester Workers’ Compensation Lawyers at Wusinich, Sweeney & Ryan, LLC Advocate for Injured Workers Collecting Benefits
If you have been injured at work, you will likely face many questions with few answers. You will need the help of an experienced lawyer. Our West Chester workers’ compensation lawyers at Wusinich, Sweeney & Ryan, LLC are here to assist. Call 610-594-1600 or fill out our online form for a free consultation. Located in Exton, Pennsylvania, we serve clients in Downingtown, West Chester, Exton, Coatesville, Phoenixville, Malvern, Lyndell, Wagontown, Uwchlan Township, Parkesburg, Chester Springs, Lancaster County, Reading, and Morgantown.
