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After job-based health insurance ends, compare three routes: a Marketplace plan, COBRA continuation, and Medicaid or CHIP if you may qualify. Losing employer coverage generally opens a 60-day Marketplace enrollment window. Before deciding, compare the start and end dates, your likely total yearly costs, and whether each option covers your doctors and prescriptions.
Start with your coverage dates and enrollment window
Write down the last day of your current employer plan and the date any replacement coverage could begin. A Marketplace plan generally starts on the first day of the month after job-based coverage ends, rather than on the same day. HealthCare.gov says you have 60 days after losing job-based coverage to apply for a Marketplace Special Enrollment Period; your eligibility notice will confirm dates and any documents needed to prove the loss. HealthCare.gov: If you lose job-based health insurance.
Also note any COBRA election and payment deadlines in the notice from your former employer. Verify the effective dates of a new policy before letting existing coverage end, so you understand whether there will be a gap.
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| Option | What it may offer | What to check |
|---|---|---|
| Marketplace plan | A Special Enrollment Period after loss of job-based coverage; possible premium tax credits and extra cost-sharing savings. | Application deadline, effective date, required proof, estimated full-year household income, plan network, and drug coverage. |
| COBRA continuation | Continuation of the employer plan for an eligible person after a qualifying event. HealthCare.gov describes 18 months as typical. | Actual premium, administrative fee, election and payment deadlines, covered family members, eligibility, and continuation period. |
| Medicaid or CHIP | Applications are accepted year-round, and the Marketplace can screen for eligibility. | State-specific rules and household eligibility; apply through the Marketplace or the relevant state agency. |
Marketplace coverage and financial help
When you apply, include estimated income for the entire calendar year—not just income after your job ended—and the members of your tax household. Income earned earlier in the year can affect eligibility for premium tax credits and other savings. Update the Marketplace if your circumstances change. The application can also screen for Medicaid or CHIP. See HealthCare.gov: Find out if you can save on Marketplace coverage.
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An offer of health coverage through a spouse’s job or another employer can affect eligibility for Marketplace premium tax credits. If the offer is considered affordable and meets minimum standards, you may not qualify for those credits even if you decline the offer. Ask the Marketplace to determine your eligibility rather than assuming that unemployment by itself qualifies you for a subsidy. HealthCare.gov explains how job-based coverage offers affect Marketplace eligibility.
COBRA continuation
COBRA may let an eligible person keep the employer plan temporarily after a qualifying event. The former employee generally pays the full premium, including the amount the employer previously contributed, plus a small administrative fee. The 18-month period is typical guidance, not a guarantee for every event or circumstance. Ask the employer for the actual cost, eligibility, continuation period, and which family members can elect coverage. HealthCare.gov: COBRA coverage.
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Keeping the same plan may make it easier to retain familiar benefits and network access, 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—for example, if 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 your eligibility and the new plan’s effective date before ending COBRA.
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Estimate the full cost, not just the premium
For each plan, consider the premium across the months you expect to have coverage, plus likely deductibles, copayments, and coinsurance. Make low-, medium-, and high-use estimates if you are uncertain about how much care you will need. Marketplace cost estimates can help with comparison, but they are estimates: actual spending depends on the services you use and the plan’s rules. HealthCare.gov: Estimate your total costs for the year.
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Check the out-of-pocket maximum and what it leaves out. It caps spending on covered in-network care after applicable deductibles and cost-sharing amounts. It does not include premiums, uncovered services, out-of-network care, or amounts above the allowed charge. For the 2026 plan year, the federal Marketplace ceiling is $10,600 for an individual and $21,200 for a family; that is a ceiling, not a promise that every plan has that maximum. Confirm the limit for the specific plan and coverage year. HealthCare.gov: Out-of-pocket maximum.
Check doctors, prescriptions, and plan rules
- Doctors and facilities: Check whether the doctors, hospitals, pharmacies, and specialists you rely on are in the plan’s current network directory.
- Prescription drugs: Look up each important medication in the plan’s current drug list, including its tier and any prescription deductible or cost-sharing rules.
- Network type: HMO and EPO plans generally limit non-emergency care to in-network providers. PPO and POS plans have different out-of-network and referral rules, so check the specific plan rather than relying on the label alone.
- Benefits: Read the Summary of Benefits and Coverage (SBC), which supports side-by-side comparisons of covered services and costs and includes examples for diabetes care and childbirth. SBCs are available for individual and job-based plans. CMS: Summary of Benefits and Coverage resources.
- Metal level: Bronze, Silver, Gold, and Platinum describe how costs are shared between the plan and member; they are not ratings of care quality. Plans within the same metal level can differ in network, plan type, and other details. HealthCare.gov: Plan categories.
Use this checklist to make the decision
- List who needs coverage and when. Record the current plan’s end date, the likely start date for replacement coverage, and COBRA deadlines.
- Get real prices. Compare the full COBRA premium with Marketplace prices after any estimated savings. Submit a Marketplace application to check Medicaid or CHIP eligibility.
- Compare likely annual spending. Add premiums and estimated cost sharing under plausible care-use scenarios; check the out-of-pocket maximum and its exclusions.
- Verify access. Check current provider directories, prescription drug lists, and each plan’s referral and out-of-network rules.
- Read the SBC and confirm dates. Use the benefit examples to compare coverage, then verify the final eligibility decision and effective date before changing or ending coverage.
Because premiums, networks, drug lists, and local program rules vary and can change, use current Marketplace results, the actual COBRA notice, and your state Medicaid or CHIP determination. General federal guidance cannot identify the best plan without your location and household details.
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