Medical leave: Will I still receive health care coverage while I’m gone?

It’s not a situation any of us ever wants to consider, but the reality is, at some point you may need to take sick leave from your job, whether for injury or serious illness. If the time ever comes, it’s helpful to have a good understanding of how the process works.

Under the federal Family and Medical Leave Act (FMLA), your employer must allow you the ability to take extended, unpaid time off (up to 12 full work weeks) for qualified medical and family issues, and cannot terminate your position during the leave.

Assuming you received employer health benefits before your leave, FMLA ensures employees on medical leave still receive group health insurance benefits, including employer contributions to premiums.

Now here’s where it gets tricky….

FMLA only requires employers to follow these provisions for 12 work weeks, which means if you require additional time off beyond that, you may be at risk of losing your health care coverage.

At that time, you will need to connect with your employer to discuss the status of your future with the company. And you will want to consider alternative options of health care coverage, such as Medicaid in the case of a disability.

Of course, there is fine print to the FMLA – not everyone is eligible. Workers who are not able to receive FMLA benefits include:

  • Employees of businesses with less than 50 employees
  • Part-time employees, or any employee who has worked fewer than 1,250 hours in the 12 months preceding the medical leave
  • Elected officials

The law also does not apply in certain situations that some may think would qualify as a medical or family issue. These situations include:

  • Caring for seriously ill elderly relatives (other than parents)
  • Caring for seriously ill pets
  • Recovering from a short-term, common illness
  • Caring for a family member with a short-term, common illness

To learn more about medical leave, ask questions, and see answers, visit Health Insurance Central.

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