After employer health coverage ends, compare three routes: a Marketplace plan, COBRA continuation, and Medicaid or CHIP if eligible. Start by confirming deadlines and effective dates, then compare your household’s estimated total costs, doctors and prescriptions—not just the monthly premium. Losing job-based coverage generally opens a 60-day Marketplace Special Enrollment Period, but your exact eligibility, costs, and start date depend on your circumstances.
Start with your deadlines and coverage dates
Write down the date your employer plan ends, the deadline to elect COBRA, and when replacement coverage could begin. A Marketplace plan generally can begin on the first day of the month after job-based coverage ends, so it may not start the same day. HealthCare.gov says the Marketplace application window after losing job-based insurance is 60 days. Check your eligibility notice for the exact deadline, effective date, and any documents required to prove the loss of coverage. HealthCare.gov explains the rules for losing job-based insurance.
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Compare the coverage routes
Marketplace coverage
Leaving a job and losing its health plan generally qualifies you for a Special Enrollment Period, regardless of why you left. The Marketplace application can determine whether you qualify for premium tax credits, extra cost-sharing savings, Medicaid, or CHIP. Savings depend on estimated income for the full calendar year and your tax household; include income earned before your job ended, and update the application if your circumstances change.
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1Fix the driver behind crashes, sound loss and screen glitches2Repair Windows errors before they cause bigger problems3Scan for outdated or missing drivers - takes under a minuteAn offer of coverage through a spouse or another employer can affect premium tax credit eligibility. If that offer is considered affordable and meets minimum standards, you may not qualify for a tax credit even if you decline the coverage. Apply and use the Marketplace’s eligibility determination rather than assuming unemployment by itself guarantees a subsidy. HealthCare.gov’s job-based coverage guidance covers the application route and timing; its lower-cost coverage guidance explains savings screening.
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COBRA continuation
COBRA may allow eligible people to keep their employer plan temporarily after a qualifying event. HealthCare.gov describes 18 months as the typical continuation period, though the duration can vary with the event and circumstances. The former employee usually pays the full premium, including the amount the employer previously contributed, plus a small administrative fee. Ask the employer or plan administrator for your actual premium, election deadline, duration, and which family members can continue coverage. HealthCare.gov’s COBRA guidance explains continuation and switching rules.
Keeping the same plan may preserve familiar benefits and access to its network, but compare its full price with Marketplace offers and any Medicaid or CHIP eligibility. You can generally switch from COBRA to a Marketplace plan during Open Enrollment. Outside Open Enrollment, a Special Enrollment Period can apply when COBRA runs out or is no longer available, including when an employer stops contributing or a subsidy ends. Voluntarily ending COBRA early or simply stopping premium payments generally does not create a new Special Enrollment Period. Confirm eligibility and the replacement plan’s start date before ending COBRA.
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Medicaid and CHIP
Applications for Medicaid and CHIP are available year-round. The Marketplace can screen your household for these programs as part of an application, but eligibility rules depend on your state and household. Use the Marketplace or your state agency to get an actual eligibility determination. HealthCare.gov’s savings guidance describes the screening process.
Build a household-specific cost comparison
For each available route, compare costs over the months you expect to need coverage. A useful estimate is premiums for those months plus likely deductibles, copayments, and coinsurance. Since care needs can be uncertain, calculate low-, medium-, and high-use scenarios rather than treating one estimate as certain. Marketplace total-cost estimates are estimates; actual spending depends on the care and services used.
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- Premium: Compare the full COBRA premium with Marketplace premiums after any estimated savings.
- Deductible and cost sharing: Check what you pay before coverage begins and your copayments or coinsurance for likely services.
- Out-of-pocket maximum: For the 2026 plan year, the federal Marketplace ceiling is $10,600 for an individual or $21,200 for a family, according to CMS and HealthCare.gov. This is a ceiling, not a promise that every plan uses that amount; check the actual plan limit and applicable year. The maximum generally limits costs for covered, in-network care after applicable deductibles and cost sharing. It does not include premiums, uncovered services, out-of-network care, or amounts above the allowed charge.
Use the Marketplace’s plan details and the plan’s Summary of Benefits and Coverage (SBC) to compare benefits and costs. The SBC includes standardized examples for diabetes care and childbirth and is available for individual and job-based plans. HealthCare.gov explains plan total costs, and its SBC guidance explains how to use that document.
Check whether the plan covers the care you use
Before choosing, verify your doctors, hospitals, pharmacies, and important prescription drugs against the plan’s current provider directory and drug list. Networks and formularies are specific to each plan and can change. Check the drug’s formulary tier and any prescription deductible or cost sharing, not only whether the drug appears on a list.
Network rules also affect access and cost. HMO and EPO plans generally restrict non-emergency care to network providers; PPO and POS plans have different out-of-network and referral rules. Confirm those rules in the plan documents. HealthCare.gov’s plan-type overview describes common differences.
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Use metal levels as a cost-sharing clue, not a quality rating
Bronze, Silver, Gold, and Platinum describe how costs are shared between the plan and member. They are not ratings of care quality, and plans within the same category can differ in network, benefits, and cost sharing. Compare the actual plan details rather than choosing by metal level alone. HealthCare.gov explains Marketplace plan categories.
Side-by-side checklist
| What to compare | Questions to answer |
|---|---|
| Eligibility and timing | Do you qualify for a Special Enrollment Period or public coverage? What are the election and application deadlines, start and end dates, and proof requirements? |
| Total household cost | What will premiums, likely deductible, copayments, and coinsurance cost over the expected coverage period? What is the plan’s out-of-pocket maximum? |
| Care continuity | Are your current doctors, hospitals, pharmacies, and specialists in network? |
| Medicines | Are your prescriptions covered, at what formulary tier, and subject to what deductible or cost sharing? |
| Benefits and rules | What does the SBC show for relevant care? Are referrals required, and what services are covered? |
| Flexibility | How long can COBRA continue, and what events permit a switch? What service area and network limits apply to a Marketplace plan? |
What to do next
- Confirm the loss date and COBRA details. Get the employer’s coverage end date and COBRA notice, including premium, election deadline, and covered family members.
- Apply through the Marketplace promptly. Enter the tax household and estimated income for the full calendar year, including income before job loss. Review the eligibility notice for savings, Medicaid or CHIP screening, deadlines, effective date, and document requests.
- Compare actual plan options. Check total costs, network, prescriptions, benefits, and the SBC; compare Marketplace coverage with the quoted COBRA price.
- Confirm the transition before ending existing coverage. Verify the new plan’s effective date and any required enrollment steps so you do not assume coverage begins earlier than it does.
Marketplace dates, premiums, provider networks, drug formularies, and state Medicaid rules can change. HealthCare.gov’s guidance retrieved October 4, 2026, notes that 2027 Open Enrollment starts November 1; check current Marketplace results and your actual plan notices before acting.
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