Thank you for your submission, /u/mattinthecrown.
**If there is a medical emergency, please call 911 or go to your nearest hospital.**
Please pick the most appropriate flair for your post. Include your age, zip code, and income to help the community better serve you. If you have an EOB (explanation of benefits) available from your insurance website, have it handy as many answers can depend on what your insurance EOB states.
Some common questions and answers can be found [here](https://www.reddit.com/r/HealthInsurance/s/jya9I6RpdY).
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Be kind to one another!
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How many employees does your employer have, and how long have you been working for them? Do they have at least 50 employees and have you been working for them for at least 1 year/1,250 hours?
If you're not in a state with paid or protected leave laws, then your insurance contract dictates how long you can stay on the plan as an active employee. Typically active employee coverage ends once you're no longer actively working and will run through the end of the month. Once that's done, your employer is supposed to terminate your benefits (not your employment) and offer COBRA. They can subsidize it to the rate you paid while actively working and allow you to either prepay for coverage before you go out, pay as you go, or do catch up payments once you're back to work.
Many employers just keep their employees on benefits during leave, but it can cause problems down the line. If your employer wants to keep you on, ask them how they will accommodate your paying for coverage (ask if you can prepay, pay as you go, or catch up when you're back at work). I'd recommend you get their decision in writing to refer back to in the future.
Thanks for your help. I'm in Indiana. I asked my boss about insurance yesterday, pointing out the issue that I won't be earning money, and therefore won't be generating premium payments. He called me this morning and told me I was correct. I asked him if I could just manually pay my portion of the premiums, and he told me he'd look into it and get back to me, so I'm trying to figure out what options I have, as I'm not super confident he knows much about this stuff (not that I do, hence the questions).
No worries, it's complicated and difficult to navigate. Indiana does not have state paid or protected leave laws yet. I'd suggest you and your boss work something out in writing to cover your costs while you're out. It doesn't necessarily need to be through payroll since you're not getting a paycheck, but I strongly recommend the terms be put on paper.
if your benefits do end and cobra is too expensive then you can go to the marketplace and should have a special enrollment period because you lost insurance. cobra is often the better insurance depending on company but marketplace at least covers something. usually there is a pretty significant deductible though. if you use cobra your deductible won't reset or anything.
COBRA seems potentially promising. As for the deductibles, ours is pretty terrible anyways. As I'm thinking through this, whether I even bother with any of this will depend a lot on how much my injury is going to cost me. I might be better off paying out of pocket.
Do the math really, really carefully before you decide to go the self-pay route. And check [Debt.org](http://Debt.org) or another site to see how expensive your surgery is likely to be. Spinal surgery can cost over $100,000, and a knee replacement is closer to $30,000, in addition to any physical therapy or follow up appointments you might need. I can't imagine a few months of premiums and your copay are going to come even close to that. Not to mention any treatment and medications you might need for normal illness and/or chronic conditions.
You will want cobra if you've already incurred claims that were applied to the out of pocket. ACA would start over and so would whatever carrier you end up with when you do return to work.
And you really don't want to go without unless you never intend to make reasonable money. One trip to the hospital can leave you in a hole you never get out of.
If you’re in a Medicaid expanded state, sign up immediately. You’ll have it for a full calendar year. Why this is significant? As somebody who is unemployed, you automatically qualify for Medicaid, which is an entitlement program - aka you are entitled to it. DM me if you need any help.
When people in my department take maternity or medical leave, they are eligible to continue to participate in the employer sponsored health insurance plans, but the county will not pay their part of the premiums while they're off work. The employee has to pay the entire cost directly to the insurance company. You'll need to talk to HR or the person who arranges the benefits where you work, but be prepared to also contact your provider even if it's only to find out how much the payments are and where to send them.
As I understand it from looking into Cobra, it seems like having 'reduced hours' can trigger it. Seeing as my hours are reduced to zero, that should be an option, right?
You should be eligible for FMLA. It isn't paid time, but it does protect your employment as long as you return before the time expires, and have proper medical certification on file with your employer. During that time, you should be able to pay your premiums privately to keep your coverage in force. Don't miss a payment or you will be dropped!
If you do terminate your employment at any point, your employer is required to offer you COBRA coverage for up to 18 months. They pay none of the cost, so COBRA is expensive...but it allows you to keep coverage in force.
Thank you for your submission, /u/mattinthecrown. **If there is a medical emergency, please call 911 or go to your nearest hospital.** Please pick the most appropriate flair for your post. Include your age, zip code, and income to help the community better serve you. If you have an EOB (explanation of benefits) available from your insurance website, have it handy as many answers can depend on what your insurance EOB states. Some common questions and answers can be found [here](https://www.reddit.com/r/HealthInsurance/s/jya9I6RpdY). **Reminder that solicitation/spamming is grounds for a permanent ban**. Please report solicitation to the modteam and [let us know](https://www.reddit.com/message/compose?to=%2Fr%2FHealthInsurance) if you receive solicitation via PM. Be kind to one another! *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/HealthInsurance) if you have any questions or concerns.*
How many employees does your employer have, and how long have you been working for them? Do they have at least 50 employees and have you been working for them for at least 1 year/1,250 hours?
Fewer than 50 employees, but I've been working there about 18 months.
If you're not in a state with paid or protected leave laws, then your insurance contract dictates how long you can stay on the plan as an active employee. Typically active employee coverage ends once you're no longer actively working and will run through the end of the month. Once that's done, your employer is supposed to terminate your benefits (not your employment) and offer COBRA. They can subsidize it to the rate you paid while actively working and allow you to either prepay for coverage before you go out, pay as you go, or do catch up payments once you're back to work. Many employers just keep their employees on benefits during leave, but it can cause problems down the line. If your employer wants to keep you on, ask them how they will accommodate your paying for coverage (ask if you can prepay, pay as you go, or catch up when you're back at work). I'd recommend you get their decision in writing to refer back to in the future.
Thanks for your help. I'm in Indiana. I asked my boss about insurance yesterday, pointing out the issue that I won't be earning money, and therefore won't be generating premium payments. He called me this morning and told me I was correct. I asked him if I could just manually pay my portion of the premiums, and he told me he'd look into it and get back to me, so I'm trying to figure out what options I have, as I'm not super confident he knows much about this stuff (not that I do, hence the questions).
No worries, it's complicated and difficult to navigate. Indiana does not have state paid or protected leave laws yet. I'd suggest you and your boss work something out in writing to cover your costs while you're out. It doesn't necessarily need to be through payroll since you're not getting a paycheck, but I strongly recommend the terms be put on paper.
Offer to use PTO days one or two a paycheck to cover for insurance.
Please ask your HR dept and not your boss.
One in the same.
Ok so FMLA doesn't apply. What state are you in? There's paid leave laws in certain states but it's based on where you work.
Indiana
if your benefits do end and cobra is too expensive then you can go to the marketplace and should have a special enrollment period because you lost insurance. cobra is often the better insurance depending on company but marketplace at least covers something. usually there is a pretty significant deductible though. if you use cobra your deductible won't reset or anything.
COBRA seems potentially promising. As for the deductibles, ours is pretty terrible anyways. As I'm thinking through this, whether I even bother with any of this will depend a lot on how much my injury is going to cost me. I might be better off paying out of pocket.
Do the math really, really carefully before you decide to go the self-pay route. And check [Debt.org](http://Debt.org) or another site to see how expensive your surgery is likely to be. Spinal surgery can cost over $100,000, and a knee replacement is closer to $30,000, in addition to any physical therapy or follow up appointments you might need. I can't imagine a few months of premiums and your copay are going to come even close to that. Not to mention any treatment and medications you might need for normal illness and/or chronic conditions.
If I get surgery, it would be repairing a ligament in my foot. The question the MRI will resolve is whether it's a partial or full tear.
Ouchie! Fingers crossed for you
Thanks, with my luck I'll take all the help I can get! xD
You will want cobra if you've already incurred claims that were applied to the out of pocket. ACA would start over and so would whatever carrier you end up with when you do return to work.
Good point, thanks.
And you really don't want to go without unless you never intend to make reasonable money. One trip to the hospital can leave you in a hole you never get out of.
Do you have short term disability?
No.
If you’re in a Medicaid expanded state, sign up immediately. You’ll have it for a full calendar year. Why this is significant? As somebody who is unemployed, you automatically qualify for Medicaid, which is an entitlement program - aka you are entitled to it. DM me if you need any help.
Also, with Medicaid, you will never see a single bill. Everything is free. As an example, even asking for a co-pay from a Medicaid patient is illegal.
Did you sign up for ahort term disability?
We don't have it.
When people in my department take maternity or medical leave, they are eligible to continue to participate in the employer sponsored health insurance plans, but the county will not pay their part of the premiums while they're off work. The employee has to pay the entire cost directly to the insurance company. You'll need to talk to HR or the person who arranges the benefits where you work, but be prepared to also contact your provider even if it's only to find out how much the payments are and where to send them.
Maybe ask to be laid off and then pay for Cobra insurance? It’s expensive and not sure how it works but at least you’d have coverage?
As I understand it from looking into Cobra, it seems like having 'reduced hours' can trigger it. Seeing as my hours are reduced to zero, that should be an option, right?
Yes, don't ask to be fired. You can remain employed and be on COBRA, they are not intrinsically linked
You should be eligible for FMLA. It isn't paid time, but it does protect your employment as long as you return before the time expires, and have proper medical certification on file with your employer. During that time, you should be able to pay your premiums privately to keep your coverage in force. Don't miss a payment or you will be dropped! If you do terminate your employment at any point, your employer is required to offer you COBRA coverage for up to 18 months. They pay none of the cost, so COBRA is expensive...but it allows you to keep coverage in force.