Guide
Losing employer coverage: your options.
You have four real paths and a 60-day window. Here they are in the order most people should consider them.
Losing job-based coverage is a qualifying life event. It opens a special enrollment period of roughly 60 days from the date coverage ends, and it makes COBRA available to you retroactively. Both clocks are short and both are easy to lose track of during a job change.
Work through the options in this order. It is deliberately the order that costs you the least first, not the order that earns a broker the most.
The alternative
Staying on COBRA
- Nothing about your coverage changes — same plan, same doctors
- Deductible progress for the year carries over
- No underwriting and no gap in coverage
- You pay the full group premium plus up to 2%
- Typically limited to 18 months
- Election deadlines are short and missing one is permanent
What we work with
Moving to private PPO coverage
- Usually a fraction of an unsubsidized COBRA premium
- Apply immediately — no waiting for an enrollment window
- Broad nationwide PPO networks
- Not tied to any employer going forward
- Deductible progress resets
- Medically underwritten, so terms depend on health history
| Feature | Staying on COBRA | Moving to private PPO coverage |
|---|---|---|
| ACA Marketplace with subsidy | Often the cheapest option post-job-loss | Check this first |
| Spouse's employer plan | Job loss opens a special enrollment for it | Check this second |
| Medicaid / CHIP | Income-based; no enrollment window | Check if income dropped |
| COBRA | Full group premium + 2% | Best if mid-treatment |
| Private PPO | Underwritten, year-round | Best if healthy and the gap is open-ended |
| Short-term plan | Cheapest, thinnest | Only for a short, defined gap |
| Time pressure | ~60 days for SEP and COBRA election | Private coverage has no window |
ACA Marketplace with subsidy
Staying on COBRAOften the cheapest option post-job-loss
Moving to private PPO coverageCheck this first
Spouse's employer plan
Staying on COBRAJob loss opens a special enrollment for it
Moving to private PPO coverageCheck this second
Medicaid / CHIP
Staying on COBRAIncome-based; no enrollment window
Moving to private PPO coverageCheck if income dropped
COBRA
Staying on COBRAFull group premium + 2%
Moving to private PPO coverageBest if mid-treatment
Private PPO
Staying on COBRAUnderwritten, year-round
Moving to private PPO coverageBest if healthy and the gap is open-ended
Short-term plan
Staying on COBRACheapest, thinnest
Moving to private PPO coverageOnly for a short, defined gap
Time pressure
Staying on COBRA~60 days for SEP and COBRA election
Moving to private PPO coveragePrivate coverage has no window
What should I do in the first week?
Find the exact date coverage ends — not your last day of work, the date on the plan. Both the special enrollment period and the COBRA election window run from it.
Then check the Marketplace with your new expected income. After a job loss that number is often much lower than last year's, and the subsidy that produces is frequently the best deal available to you.
My spouse has employer coverage. Can I join mid-year?
Yes. Losing your own coverage is a qualifying event for their plan too, and most employers allow a 30-day window — shorter than the Marketplace's 60.
It is usually the simplest answer when it exists. Ask for the cost of adding you before assuming it is expensive; the difference between employee-only and employee-plus-spouse is often smaller than expected.
What if my income dropped to nearly nothing?
Check Medicaid eligibility. It uses current monthly income rather than annual, has no enrollment window, and in expansion states covers adults up to 138% of the federal poverty level.
If your household qualifies, take it. It is better coverage than anything in this comparison and it costs you nothing.
I am healthy and none of the above applies. Now what?
That is the case private PPO coverage is built for: no subsidy, no spouse plan, no Medicaid, and a COBRA premium that is hard to justify for a healthy person.
Apply before COBRA lapses rather than after, so an approval decision arrives while you still have the fallback available.
How long does private coverage take to start?
Underwriting is typically days rather than weeks, and coverage can often begin the first of the following month or sooner depending on the carrier.
Keep COBRA electable in the background until you have a written approval. Never drop a fallback on the strength of a verbal yes.
Better off with Staying on COBRA
- You are in active treatment or have surgery scheduled
- You are pregnant or planning to be within the year
- You have substantial deductible progress this year
- The gap is short and continuity is worth the premium
Better off with Moving to private PPO coverage
- The Marketplace subsidy came back small or zero
- There is no spouse plan and no Medicaid eligibility
- You are healthy and the COBRA premium is the problem
- The gap is open-ended and you want coverage that is not tied to a job
The plain verdict
Check in this order: Marketplace subsidy, spouse's plan, Medicaid, then COBRA against private coverage. Three of those four cost less than anything we sell, and an advisor who skips past them is not advising.
If you reach the end of that list still needing coverage, a private PPO is usually the answer — and the 60-day clock is the reason to work through it this week rather than next month.
No pressure, ever
Find out which one actually fits your household.
A licensed advisor will tell you when the option on the left of this page is the better buy. That happens more often than you would expect from a brokerage website.
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