What Happens to Your Health Insurance During FMLA Leave?
Taking leave under the Family and Medical Leave Act (FMLA) can be stressful enough without worrying about losing your health insurance. Whether you’re taking time off for your own serious health condition, caring for a family member, or welcoming a new child, understanding how your benefits work can help you avoid costly surprises.
The good news is that, in most cases, your employer must continue your group health insurance while you’re on approved FMLA leave. However, that doesn’t necessarily mean your coverage is completely free or that every benefit stays exactly the same.
Here’s what employees need to know about what happens to your health insurance during FMLA leave, including who pays the premiums, when coverage could end, and what happens when you return to work.
Please visit our Pay & Benefits Hub for more articles about health insurance, paid time off, leave laws, and employee benefits.
Table of Contents
Quick Answer
If you’re taking approved FMLA leave, your employer generally must continue your group health insurance coverage under the same terms as if you were still working. That means your employer continues paying its usual share of the premiums, while you’re still responsible for your normal employee contribution.
If you fail to pay your required premiums or do not return to work after your leave (under certain circumstances), your employer may have additional rights regarding your coverage and premium costs.
How Health Insurance Works During FMLA Leave
The FMLA requires covered employers to maintain an employee’s group health insurance throughout qualifying leave.
This means:
- Your medical insurance continues.
- Your employer continues paying its normal portion.
- You remain responsible for your regular employee contribution.
- Coverage generally cannot be reduced simply because you’re on FMLA leave.
In other words, your health insurance should work just as it did before your leave began.
Do You Have to Keep Paying Your Health Insurance Premiums?
Yes.
Although your employer continues paying its usual share, you’re still responsible for your portion of the premium.
How you pay depends on your situation.
If You’re Receiving a Paycheck
If you’re using:
- Paid vacation
- Paid sick leave
- PTO
- Paid parental leave (when running concurrently with FMLA)
Your insurance premiums are usually deducted from your paycheck just like normal.
If You’re Not Receiving Paychecks
If your FMLA leave is unpaid, there may not be a paycheck from which to deduct your insurance premiums.
Employers often require employees to:
- Mail monthly payments
- Pay online
- Pay in advance
- Catch up on deductions after returning to work (if both sides agree)
Your employer should explain the payment process before your leave begins.
Can Your Employer Cancel Your Health Insurance?
Generally, no—not simply because you’re on FMLA leave.
However, your employer may terminate coverage if:
- You fail to pay your required premiums after receiving proper notice.
- Your FMLA leave ends and you don’t return to work.
- Your employment ends for reasons unrelated to the leave.
Employers must follow specific notice requirements before ending coverage for missed premium payments.
What Happens if You Miss Premium Payments?
If you don’t make your required premium payments, your employer doesn’t have to continue paying indefinitely.
Typically, employers must:
- Notify you that your payment is overdue.
- Give you a grace period before terminating coverage.
- Inform you if your insurance will end because of nonpayment.
If you pay within the required timeframe, your coverage generally continues without interruption.
Does Dental, Vision, or Other Insurance Continue?
Usually, yes.
If your employer offers:
- Dental insurance
- Vision insurance
- Prescription drug coverage
- Mental health benefits
These benefits generally continue if they’re part of the same group health plan maintained during FMLA leave.
However, benefits that aren’t considered group health plans—such as life insurance, disability insurance, or retirement contributions—may follow different employer policies.
What Happens When You Return to Work?
When you return from FMLA leave, your health insurance should continue exactly as it did before your leave.
Your employer generally cannot:
- Make you wait through a new eligibility period
- Require a new medical exam
- Exclude pre-existing conditions because of the leave
Your coverage should resume seamlessly if it remained active throughout your leave.
What if You Decide Not to Return?
If you choose not to return to work after FMLA leave, your employer may be allowed to recover the employer-paid portion of your health insurance premiums during your leave.
However, this generally does not apply if you can’t return because of:
- A continuing serious health condition
- Circumstances beyond your control
- Other situations protected under the FMLA
Each situation is different, so it’s important to understand your employer’s policies before making a decision.
Can You Lose Other Benefits During FMLA?
Possibly.
The FMLA specifically protects group health insurance, but other benefits may operate differently.
Examples include:
- Bonuses tied to attendance
- Retirement plan contributions
- Life insurance
- Disability insurance
- Paid leave accruals (depending on employer policy)
Employers generally must treat employees on FMLA leave the same as employees taking other comparable unpaid leaves.
Tips Before Starting FMLA Leave
Before your leave begins:
- Ask how you’ll pay your insurance premiums.
- Verify which benefits continue during leave.
- Keep copies of payment confirmations.
- Notify HR immediately if your address changes.
- Read all notices from your employer carefully.
- Ask questions if anything about your benefits is unclear.
Planning ahead can prevent accidental coverage lapses.
Frequently Asked Questions
Does my employer have to keep my health insurance during FMLA leave?
Yes. Covered employers must generally maintain your group health insurance under the same conditions that would apply if you were actively working.
Do I still pay my insurance premiums during FMLA?
Yes. You’re typically responsible for your normal employee share of the premium, while your employer continues paying its usual portion.
Can my employer cancel my insurance if I’m on unpaid FMLA?
Not simply because your leave is unpaid. However, coverage may end if you fail to make required premium payments after receiving proper notice.
What happens if I don’t return to work after FMLA?
Your employer may be able to recover the employer-paid portion of your health insurance premiums unless your failure to return falls within one of the FMLA’s recognized exceptions.
Does FMLA cover dental and vision insurance?
If dental and vision benefits are part of your employer’s group health plan, they generally continue during approved FMLA leave.
The Bottom Line
One of the most important protections provided by the FMLA is the continuation of your employer-sponsored health insurance while you’re on qualifying leave. Although you’ll usually need to keep paying your share of the premiums, your employer generally must continue its contribution and maintain your coverage under the same terms that applied before your leave.
Before your leave starts, review your employer’s benefits information, understand how premium payments will be handled, and stay current on any required payments. Taking a few minutes to prepare can help ensure your health insurance remains in place while you focus on your health or your family.
Related Articles
Continue learning about your rights while taking medical leave:
- Do You Accrue PTO While on FMLA? Your Rights and What You Can Do
- Can You Be Fired While on FMLA Leave?
- Can Your Employer Deny FMLA Leave?
- What Qualifies as a Serious Health Condition Under FMLA?
- How Long Does FMLA Last? Understanding the 12-Week Rule
- Can You Use PTO and FMLA at the Same Time?
- What Happens to Your Job When FMLA Ends?
You can also explore our Pay & Benefits Hub for more articles about health insurance, paid time off, leave laws, and employee benefits.
Disclaimer (Please read)
Disclaimer: This article is for informational purposes only and should not be considered legal advice. Employment laws can vary based on your specific circumstances, employer policies, collective bargaining agreements, and state laws. If you have questions about your rights under the Family and Medical Leave Act (FMLA), consult your human resources department, the U.S. Department of Labor, or a qualified employment attorney. Please read our Terms and Conditions.
Article: What Happens to your Health Insurance During FMLA Leave?
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