When someone goes on long-term disability, it usually means they’re unable to work for an extended period because of a serious injury, illness, or medical condition. One of the first questions people ask is, “Who pays my health insurance while I’m on long-term disability?”
It’s an important question — because even while you’re out of work, you still need access to medical care, prescriptions, and ongoing treatment. The good news is that you usually have several options to keep your health insurance coverage active during disability, but who pays for it depends on your job, insurance type, and disability benefits.
Let’s go over everything you need to know in plain, easy-to-read language.
Understanding Long-Term Disability Insurance
Before explaining who pays your health insurance, it’s important to understand what long-term disability (LTD) actually covers.
Long-term disability insurance replaces part of your income if you can’t work due to a medical condition. Most LTD plans pay 50% to 70% of your regular salary, depending on your policy.
There are two main types of LTD coverage:
- Employer-sponsored long-term disability insurance – Provided through your workplace as part of your employee benefits.
- Private long-term disability insurance – Purchased individually through an insurance company.
These policies help with your living expenses but don’t automatically include health insurance coverage, which means you need to make separate arrangements to keep your medical plan active.
Who Pays Health Insurance While on Long-Term Disability?
Whether your health insurance continues — and who pays for it — depends on your employer’s policies, your insurance type, and how long you’ve been away from work.
Let’s break down the common situations.
Employer Continues to Pay Health Insurance (Fully or Partially)
If you receive long-term disability through your employer, there’s a good chance your company might continue to pay for your health insurance — at least for a while.
Some employers cover the full premium for employees on disability leave, while others may pay a portion and ask you to pay the rest.
For example, your employer may continue your coverage for 6 to 12 months, and after that, you may have to take over the full premium cost yourself.
Always check your employee handbook or HR department for specific policies.
You Pay Your Own Health Insurance Premiums
In many cases, once you move from short-term to long-term disability, your employer stops paying for your health insurance premiums, even though you remain on their group plan.
You can usually keep your existing insurance by paying your share directly to the employer or insurance company.
This is common because you’re technically still an employee, just not actively working. Your LTD benefits help replace part of your income, which you can use to cover your share of the insurance cost.
Coverage Through COBRA
If your employer stops paying for your health insurance completely or you lose your job while on disability, you can continue your coverage under COBRA (the Consolidated Omnibus Budget Reconciliation Act).
COBRA allows you to keep your employer’s health plan for up to 18 or 36 months after losing your job or benefits — but you must pay the full premium yourself, plus a small administrative fee.
It can be expensive, but it ensures you don’t lose access to your doctors or ongoing treatment during a critical time.
Switching to a Spouse’s Health Insurance Plan
If you’re married, one of the easiest and most affordable ways to maintain coverage is by joining your spouse’s employer-sponsored health insurance plan.
Most employers allow you to enroll mid-year if you lose coverage due to disability or job separation — it’s considered a “qualifying life event.”
This option is often cheaper than COBRA and provides continuous coverage without interruption.
Buying Health Insurance Through the Marketplace
If your employer coverage ends and you don’t qualify for COBRA or a spouse’s plan, you can buy a new policy through the Health Insurance Marketplace (HealthCare.gov).
You might qualify for premium tax credits or subsidies based on your disability income, making your monthly premiums much lower.
The Marketplace plans must include essential health benefits like hospitalization, prescriptions, and preventive care, so it’s a good safety net if you lose employer-sponsored coverage.
Medicare for Long-Term Disability
If you’re on Social Security Disability Insurance (SSDI), you can qualify for Medicare, even if you’re under 65.
You must receive SSDI benefits for 24 months before Medicare coverage begins. After that waiting period, you’ll get access to Medicare Part A (hospital insurance) and Part B (medical insurance).
Medicare can become your primary insurance, and you can add supplemental coverage or prescription drug plans if needed.
Medicaid for Low-Income Individuals on Disability
If your long-term disability benefits don’t provide much income, you may qualify for Medicaid.
Medicaid is a federal and state-funded program that offers free or low-cost health coverage to people with limited income or resources.
Eligibility rules vary by state, but many disabled individuals qualify automatically once they start receiving SSI (Supplemental Security Income).
What Happens to Health Insurance After You Leave Your Job?
If you’re permanently unable to return to work, your employment might end after a certain period on long-term disability.
When that happens, your employer’s health plan usually ends as well. At that point, you have a few choices:
- Enroll in COBRA coverage (temporary option)
- Join your spouse’s plan
- Apply for Medicaid or Medicare
- Buy individual insurance through the Marketplace
The best choice depends on your income, health needs, and how long you expect to remain disabled.
How to Keep Health Insurance While on Long-Term Disability
To make sure you don’t lose coverage during your disability period, here are some key steps to take:
- Talk to Your HR Department Early
Find out how long your employer will continue paying for your health insurance and whether you’ll need to contribute. - Request Written Confirmation
Always get details about your benefits and coverage options in writing. This will help you avoid confusion later. - Apply for SSDI or Other Benefits Quickly
If your disability is expected to last a year or more, apply for Social Security Disability Insurance early. It can open the door to Medicare coverage later. - Compare All Options
Check costs and coverage for COBRA, Marketplace, and spousal plans to find the most affordable solution. - Don’t Let Coverage Lapse
Gaps in health insurance can cause major financial problems, especially if you’re dealing with medical treatments. Always have a backup plan ready before one policy ends.
Can You Lose Health Insurance While on Long-Term Disability?
Yes, it’s possible to lose your employer-provided health insurance if your employment officially ends or if you stop paying premiums.
However, thanks to COBRA, Medicare, and Marketplace options, you can continue coverage without interruption — as long as you act quickly and know your rights.
Final Thoughts: Who Pays Health Insurance While on Long-Term Disability?
So, who pays health insurance while on long-term disability? The answer depends on your situation.
If your employer continues to cover you, they may pay part or all of your premiums. If not, you can use COBRA, your spouse’s plan, or buy coverage through the Marketplace. For people on SSDI, Medicare eventually becomes available, and those with lower income may qualify for Medicaid.
The key is to stay proactive — communicate with your employer and insurance providers early, and make sure you don’t go without health coverage while you recover.
Protecting your health is just as important as replacing your income. With the right plan, you can stay insured, stable, and focused on getting better.