Your three options
When you lose job-based coverage, you generally have three paths:
1. COBRA continuation
COBRA lets you keep your employer's exact same plan for up to 18 months (sometimes 36 for certain events). The catch: you pay the full premium yourself, plus a 2% administrative fee. Your employer was probably covering most of the cost before. In KFF's 2026 employer survey, employers paid about 83% of the premium for single coverage and 73% for family coverage.
That same survey put the average annual premium at $9,804 for single coverage and $28,303 for family coverage. With the 2% fee, COBRA averages about $830 a month for one person (about $10,000 a year) and about $2,400 a month for a family.
COBRA's main advantage is continuity. Same doctors, same network, same formulary. If you're in the middle of treatment or have a provider you can't switch away from, that matters.
2. ACA marketplace plan
A marketplace plan through HealthCare.gov (or your state exchange) is often significantly cheaper, especially if you qualify for a subsidy. Losing job-based coverage triggers a 60-day Special Enrollment Period, so you can sign up immediately.
If your household income for the year will be between 100% and 400% of the federal poverty level ($15,960 to $63,840 for one person for 2027 coverage), you get a premium tax credit. Above 400% FPL there is no tax credit for 2027. And if it's below 250% FPL and you pick a Silver plan, you also get cost-sharing reductions that lower your deductible and copays.
One important detail: when you estimate your income for the marketplace application, use your projected annual income for the full year, not your previous salary. If you were laid off in March and expect to earn less for the rest of the year, your subsidy could be larger than you think.
3. A spouse's or parent's plan
If your spouse has employer coverage, losing your own job triggers a special enrollment to join theirs. If you're under 26, you can go back on a parent's plan. These options may be the simplest if they're available.
COBRA vs. marketplace: a cost comparison
For most people who lost a job, the marketplace is cheaper. Enter your numbers below to see an estimate.
COBRA vs. Marketplace Calculator
Enter your COBRA premium and basic info to see how a marketplace plan with subsidies might compare.
Not sure whether COBRA or a marketplace plan saves you more? Nora can compare real plans in your area in under 2 minutes.
Timeline and deadlines
You have 60 days from your last day of employer coverage to enroll in a marketplace plan. For COBRA, you have 60 days from receiving the COBRA election notice (your employer is required to send one).
You can elect COBRA and still switch to a marketplace plan later, but be careful with timing. COBRA counts as qualifying coverage, so dropping it mid-year does not give you a new SEP for the marketplace. The SEP from your original job loss is the one you need to use.
Some people elect COBRA retroactively to cover a gap. You have 60 days to decide, and if you elect it, coverage is retroactive to your termination date. This can be useful if you had a medical event during that gap and need to file claims.
What about Medicaid?
If your income drops low enough, you may qualify for Medicaid. In states that expanded Medicaid, the threshold is about 138% FPL ($22,025 for a single person). Medicaid enrollment is open year-round with no enrollment period restrictions.
If your state did not expand Medicaid (Texas, Florida, Tennessee, and several others), there's a coverage gap: you might earn too little for marketplace subsidies but too much for traditional Medicaid. In that case, a marketplace plan at full price or COBRA may be your only options.
Do you qualify for a SEP?
Do I qualify for a Special Enrollment Period?
Check any that happened to you in the last 60 days (or that you expect in the next 60 days).
If none of these apply, you can still enroll during Open Enrollment, which runs November 1, 2026 through January 15, 2027 for 2027 coverage. Outside that window, you'll need to wait for the next Open Enrollment unless your situation changes.
Steps to take this week
- Get your COBRA election notice from your former employer or their benefits administrator. Note the premium amount and the 60-day deadline.
- Estimate your annual income for the coverage year. Include severance, unemployment benefits, freelance income, and any other earnings you expect. Unemployment benefits count as income for subsidy purposes.
- Shop for a marketplace plan. Ask Nora to find plans based on your projected income, or go directly to HealthCare.gov (or your state marketplace) to start an application.
- Compare total costs, not just premiums. Look at deductibles, copays, and whether your doctors are in-network. A plan with a slightly higher premium but much lower deductible might save you money overall.
- Enroll and pay your first premium.Coverage won't start until you pay. If you pick a plan before your job-based coverage ends, the new plan can start the 1st of the month after it ends. Otherwise, coverage starts the 1st of the month after you enroll.