Comparison
Private PPO vs. COBRA Coverage
COBRA keeps the exact plan you already have. What it does not keep is the employer paying for most of it.
COBRA is the same plan, the same network, the same deductible progress and the same doctors — with the entire premium moved onto you, plus up to a 2% administrative fee. People are usually shocked by the number, because the employer share was invisible until the moment it stopped.
There are situations where paying it is clearly right, and situations where it is the most expensive way to keep something you no longer need. The deciding factors are almost always mid-year deductible progress and whether you are in active treatment.
The alternative
COBRA
- Identical plan, network and benefits — nothing changes but the bill
- Deductible and out-of-pocket progress for the year carries over
- No underwriting and no waiting period
- Available for 18 months in most cases, longer in some
- You pay 100% of the premium plus up to a 2% admin fee
- Employer-group premiums are set for the group, not for you
- Election deadlines are short and easy to miss
What we work with
Private PPO coverage
- Typically a fraction of an unsubsidized COBRA premium
- Starts fresh — no carryover of this year's deductible progress
- Medically underwritten, so terms depend on health history
- Broad nationwide PPO networks
- Apply any day, so a lapse between jobs is avoidable
- You choose the deductible rather than inheriting the group's
- Not tied to the employer, so a new job does not disrupt it
| Feature | COBRA | Private PPO coverage |
|---|---|---|
| Monthly cost | Full group premium + 2% | Often far less |
| Deductible progress | Carries over | Resets |
| Underwriting | None | Yes |
| Network | Whatever the employer chose | Broad nationwide PPO |
| Duration | Usually 18 months | Ongoing |
| Existing treatment in progress | Uninterrupted | May be excluded or delayed |
| Start date control | Retroactive to coverage loss | Days, not retroactive |
| Ties to employer | Yes | No |
Monthly cost
COBRAFull group premium + 2%
Private PPO coverageOften far less
Deductible progress
COBRACarries over
Private PPO coverageResets
Underwriting
COBRANone
Private PPO coverageYes
Network
COBRAWhatever the employer chose
Private PPO coverageBroad nationwide PPO
Duration
COBRAUsually 18 months
Private PPO coverageOngoing
Existing treatment in progress
COBRAUninterrupted
Private PPO coverageMay be excluded or delayed
Start date control
COBRARetroactive to coverage loss
Private PPO coverageDays, not retroactive
Ties to employer
COBRAYes
Private PPO coverageNo
I am halfway through my deductible. Does that settle it?
Often, yes. If you have already spent $4,000 toward a $5,000 deductible and you have surgery scheduled, restarting that clock on a new plan can cost more than the COBRA premium difference for the rest of the year.
Do the arithmetic rather than the instinct: remaining COBRA premiums through December against the new plan's premiums plus the deductible you would be restarting.
Can I start COBRA and switch later?
Yes, and it is a common bridge. COBRA election is retroactive to the date coverage ended, so you can elect it to cover a gap and move to a private plan once approved.
Watch the election window. It is typically 60 days from the later of coverage loss or the notice date, and missing it is permanent.
Is COBRA worth it if I am healthy and between jobs for two months?
Usually not, if a private plan approves you. Two months of an unsubsidized family COBRA premium frequently runs past $3,000, and a private PPO for the same period typically does not.
The exception is anyone mid-treatment, pregnant, or with a condition that underwriting would exclude. Then the premium is buying continuity, which is what it is actually for.
What about the Marketplace instead?
Losing employer coverage triggers a special enrollment period, so the Marketplace is genuinely open to you for 60 days. If your new income qualifies for a subsidy — and after a job loss it often does — that is likely your best option.
Check that before anything else. An advisor who does not raise it is not doing the job.
Better off with COBRA
- You are mid-treatment or have surgery scheduled
- You have made significant deductible progress this year
- You are pregnant or planning to be within the year
- A specific doctor relationship matters more than the premium
Better off with Private PPO coverage
- You are healthy and the COBRA premium is the main problem
- You are early in the plan year with little deductible spent
- The gap between jobs is long or open-ended
- You want a national network instead of the one your old employer picked
The plain verdict
COBRA is not a bad product. It is an expensive one, and the expense buys continuity — which is worth a great deal if you are in the middle of care and very little if you are not.
Check the Marketplace first, because losing employer coverage opens a special enrollment period and a post-job-loss income often qualifies for a real subsidy. If that comes back thin and you are healthy, a private PPO is usually the cheaper bridge. A licensed advisor can run all three side by side in one call.
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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