How does COBRA work, how much does it cost, and how do I get health insurance after losing my job?

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What to do
The evidence
AI answer checked
Common questions

The short answer. COBRA is a federal law that generally lets you keep your former employer's group health plan after you lose your job, if the employer had 20 or more employees in the prior year (US Department of Labor). It usually lasts up to 18 months (US Department of Labor). You usually pay the full premium, up to 102% of the plan's cost, unless your employer agrees to pay some or all of it as part of your separation, meaning the terms on which you leave the job (US Department of Labor).

You have 60 days to enroll in COBRA, counted from the day you lose coverage or the day you get the election notice (the notice of your right to choose COBRA), whichever is later (US Department of Labor). You also have 60 days after losing job-based coverage to enroll in a Marketplace plan, an individual health plan you sign up for through HealthCare.gov (HealthCare.gov). A Marketplace plan may cost less than COBRA, especially if you qualify for savings based on your income (HealthCare.gov).

If you are eligible for Medicaid or CHIP, you can enroll any time, and coverage can start immediately (HealthCare.gov).

What to do next (our advice)

Write down both 60-day deadlines. The Marketplace one counts from the day your coverage ends (HealthCare.gov). The COBRA one counts from that day or the day you get the notice, whichever is later (US Department of Labor). Don't wait for the COBRA notice before you look at Marketplace plans. The CMS Understanding COBRA job aid allows up to 44 days for it. If your coverage ended the day your job did and the notice takes the full 44 days, you could have only 16 of your 60 Marketplace days left (our arithmetic). If a plan at a spouse's job could cover you, ask its administrator today what your deadline is. CMS's COBRA page for state and local government plans gives 30 days from losing coverage, which is shorter than the 60 days for COBRA.
Compare on three things before you choose: the monthly price after any income-based savings, whether your doctors are in the plan's network, and how much of this year's deductible you have already paid (more under the questions below).
Check whether you qualify for Medicaid or CHIP, and wait for the answer before ending COBRA. HealthCare.gov says you can enroll in them any time, and to wait for a final decision on your eligibility before you end COBRA.
When you apply for Marketplace savings, estimate your household income for the year you want coverage, including unemployment pay. Update the estimate if your income changes. HealthCare.gov says a poor estimate could mean paying money back at tax time.
If you are negotiating severance, ask whether your employer will pay part of the COBRA premium. The US Department of Labor says employers can agree to cover some or all of it as part of your separation (see what COBRA costs, below).
If it has been under 60 days since you lost job-based coverage, you can still switch from COBRA to a Marketplace plan. After that, don't drop COBRA outside Open Enrollment (the yearly sign-up period, November 1 to January 15) expecting to switch. HealthCare.gov says that if you leave COBRA before 18 months, by dropping it or by choosing to stop paying, that does not open a Special Enrollment Period (a chance to buy a Marketplace plan outside Open Enrollment). HealthCare.gov also says to always check your coverage start date before you end COBRA.
If you are 65 or older, or about to turn 65, sign up for Medicare without waiting for COBRA to end, and first call your State Health Insurance Assistance Program (shiphelp.org). Medicare.gov says COBRA does not extend your limited time to sign up for Medicare. Medicare.gov also says that if you had COBRA first, it will probably end once you sign up. The CMS Understanding COBRA presentation says that where a person loses COBRA because of Medicare, their spouse and children still may be eligible for COBRA. So ask about cover for your spouse and children too.

What the evidence says

Who can get COBRA

COBRA generally requires group health plans of employers with 20 or more employees in the prior year to offer continuation coverage, a temporary extension of your health coverage (US Department of Labor). If your employer's plan is subject to COBRA and you were covered by it, resignation, layoff and discharge other than for gross misconduct are among the qualifying events (CMS Understanding COBRA job aid, May 2026).

Some states have their own "mini-COBRA" laws: they require insurers that cover employers with fewer than 20 employees to let you keep coverage for a limited time (Medicare.gov). Medicare.gov says to check with your state insurance commissioner's office.
In New York, an employee of an employer with fewer than 20 employees may keep group health coverage for up to 36 months under the state's own mini-COBRA law, regardless of the reason coverage ended (New York Department of Financial Services circular letter, 2009).

Gap: our checked sources give the terms of a state continuation law for small employers in New York only. Ask your state insurance commissioner's office what your state's law gives you.

How long you have to decide, and what you owe when you do

You don't have to decide on the first day. If you elect COBRA within the election period and pay the first premium within 45 days of electing, it generally reaches back to the day your coverage ended (CMS Understanding COBRA job aid, May 2026). You still owe the premiums for that earlier time (CMS presentation, Transitioning from Employer-Sponsored Coverage to Other Health Coverage, June 2020).

An employer subject to COBRA must tell its plan administrator (whoever runs the plan) within 30 days after your job ends (CMS Understanding COBRA job aid).
The administrator must then tell you about your COBRA rights within 14 days of that notification (CMS Understanding COBRA job aid).
If your employer is also the plan administrator and sends COBRA notices itself, it has the whole 44-day period to send the notice (CMS Understanding COBRA job aid).
If your group coverage has ended and no notice comes, ask your employer's benefits administrator or group health plan about your COBRA rights (Medicare.gov).
After your first payment, later premiums count as on time if paid by the due date or within a grace period of 30 days after it, or a longer period under the plan (CMS COBRA page, written for state and local government plans).

Gap: our checked sources state this grace period for state and local government plans only. Ask your plan administrator what yours is.

How long COBRA lasts, and what can end it

COBRA coverage usually lasts up to 18 months (US Department of Labor COBRA page).
Certain life events can extend COBRA to 36 months (US Department of Labor COBRA page).
Your spouse and children may enroll in COBRA even if you, the former employee, do not (US Department of Labor COBRA page).
A qualified beneficiary is, in general, an employee, spouse or dependent child who was covered by the plan the day before the qualifying event (the life events that let you elect COBRA) (CMS Understanding COBRA job aid, May 2026).
If a qualified beneficiary in your family is disabled and meets certain criteria, you are eligible for an 11-month disability extension, for a total of 29 months (CMS Understanding COBRA job aid, May 2026).
COBRA may end earlier if you do not pay premiums on a timely basis, or if the employer stops maintaining any group health plan (CMS Understanding COBRA job aid).
If the other coverage meets the rule's conditions, a plan may end your COBRA on the date you first become covered by another group health plan after electing COBRA, even if that coverage is less valuable (Treasury COBRA rules).
One of the conditions for ending it this way is that you are actually covered by the other plan, rather than merely eligible for it (Treasury COBRA rules).

What COBRA costs

The rules set a ceiling, not a price: your former employer's plan quotes your actual cost.

People on COBRA may be required to pay the whole premium, up to 102% of the plan's cost (US Department of Labor).
The full premium cannot be more than 102% of the premium for similarly situated people who have not had a qualifying event (such as losing their job), or 150% during a disability extension (CMS Understanding COBRA job aid, May 2026).
On the 102% rule, a plan whose full premium is $800 a month could charge up to $816 a month for COBRA; this is arithmetic on the rule, not a typical price.
Some employers pay part of the premium, and practice varies (2014 RiseSmart survey, reported by SHRM):
- In that 2014 RiseSmart survey of over 250 US HR professionals, 70% of surveyed companies had a standard COBRA policy for all employees in a reduction in force (a layoff).
- Among those companies in the 2014 RiseSmart survey, 29% of respondents reported paying premiums directly to the insurer.
If you have a health savings account (HSA), its funds may pay for health care continuation coverage, such as COBRA, and for health coverage while you receive unemployment compensation (IRS Publication 969, 2025).

Gap: we have no checked figure for a typical monthly COBRA premium. The price that counts is the one your former employer's plan quotes for your plan and the people it covers.

Other health insurance after a job loss

You do not have to enroll in COBRA, and you can compare its cost with Marketplace plans before you decide (HealthCare.gov).

If you are eligible for Medicaid or CHIP, you can enroll any time (HealthCare.gov). HealthCare.gov says to wait for a final decision on your eligibility before ending COBRA.
To minimize gaps in coverage, you can apply and enroll in a Marketplace plan up to 60 days before you lose coverage, for coverage starting the first of the month after your employer coverage ends (CMS Understanding COBRA presentation).
In a CMS worked example (Transitioning from Employer-Sponsored Coverage to Other Health Coverage, June 2020), someone who chooses a Marketplace plan after their employer coverage has ended, under the Special Enrollment Period for that loss, has coverage beginning the first day of the month after they choose the plan.
If you are eligible for COBRA but have not signed up, you may still qualify for Marketplace savings, if otherwise eligible (CMS Understanding COBRA presentation).
If you have elected COBRA, you may qualify for Marketplace savings if you end COBRA by the time your Marketplace plan would start (CMS Understanding COBRA presentation).
Marketplace savings are based on your expected household income for the year you want coverage, not last year's income (HealthCare.gov).
The income to count for Marketplace savings includes all unemployment compensation you get from your state (HealthCare.gov).
On average, Marketplace enrollees had access through their plan's network to 40% of the doctors near their home, with considerable variation around that average (KFF analysis; the page we read gives no year for this figure).

Joining a spouse's employer plan

You may be able to join a plan from your spouse's employer without waiting for an open enrollment period (this is called special enrollment), if you ask within 30 days of losing your health coverage (CMS COBRA page, written for state and local government plans).
If you elect COBRA, special enrollment is also available after your COBRA is exhausted (CMS COBRA page, written for state and local government plans).
A group health plan must allow an employee at least 30 days to request enrollment, for the employee or a dependent, after other coverage is lost through events that include termination of employment or reduced hours (federal rule 26 CFR 54.9801-6).

Gap: our checked sources don't cover a partner's plan, or say how these rules apply to your own case. That plan's administrator has the answer.

Can I leave COBRA for a Marketplace plan?

Whether you can leave COBRA for a Marketplace plan depends on when and why.

Within 60 days of losing job-based coverage: yes. You can switch from COBRA to a Marketplace plan while it is still within 60 days of losing your job-based coverage (HealthCare.gov). Someone who elects COBRA and then decides to end it may still use that 60-day window to enroll in a Marketplace plan (CMS Understanding COBRA presentation).
During Open Enrollment: yes, for any reason. Marketplace Open Enrollment runs November 1 to January 15 (HealthCare.gov dates page, read November 2026). If you enroll by December 15, coverage starts January 1, and if you enroll December 16 through January 15, it starts February 1, as long as you pay your first premium (HealthCare.gov dates page).
After those 60 days and outside Open Enrollment: only in certain cases. You can switch if your COBRA is running out, or if you must pay the full cost because your former employer stops contributing or you lose a government subsidy (HealthCare.gov). You can also switch if you have another life change, such as getting married, a new baby or dependent, moving, or losing health coverage (HealthCare.gov).
If you leave COBRA before 18 months, dropping it by choice or choosing to stop paying the premiums does not qualify you for a Special Enrollment Period, a chance to buy a Marketplace plan outside Open Enrollment (HealthCare.gov).
If you choose to end COBRA early, you would wait until the next Open Enrollment, unless you have another life change (HealthCare.gov).
When COBRA expires or is no longer available, you have 60 days to enroll in a Marketplace plan (HealthCare.gov).
Switching in the middle of the year can mean starting your deductible again. A new Marketplace plan starts your deductible and out-of-pocket payments again from zero, while on COBRA what you have paid in the plan year carries over (blog post on insuredandmore.com).
If your COBRA plan follows the calendar year, its deductible and out-of-pocket costs reset to $0 on January 1 (healthinsurance.org). In that case, switching to a new individual plan on January 1 loses nothing already applied to your deductible and out-of-pocket costs (healthinsurance.org). As healthinsurance.org points out, some employer plans don't follow the calendar year; it advises checking the details of your plan.

If you are 65 or older, or about to turn 65

Don't wait until COBRA ends to sign up for Medicare Part B (Medical Insurance), because COBRA does not extend your limited time to sign up for Medicare (Medicare.gov).

If you are on COBRA and turning 65.

If you have COBRA and have not signed up for Medicare, you should sign up when you turn 65 to avoid gaps in coverage and a monthly Part B late enrollment penalty (Medicare.gov).
You are generally first eligible to sign up for Part A and Part B starting 3 months before you turn 65 and ending 3 months after the month you turn 65 (Medicare.gov).
If you have COBRA and are eligible for Medicare but not enrolled, COBRA may pay only a small part of your costs (Medicare.gov). Medicare.gov says to ask your COBRA plan what percent it pays. Certain plans may pay as if Medicare paid first, even if you are not enrolled in Medicare (CMS Understanding COBRA presentation).

If you are past 65 and just lost job-based insurance.

If you or your spouse kept working past 65 and you had health insurance from that job, you have up to 8 months to sign up for Part B without a penalty (Medicare.gov).
Those 8 months run from when you stop working, or from when you lose that insurance if that happens first, whether or not you choose COBRA (Medicare.gov).
If you miss the 8-month period, you have to wait until January 1 to March 31 to sign up, with coverage starting the month after you sign up (Medicare.gov). Medicare.gov says this may cause a gap in coverage and a lifetime Part B late enrollment penalty.

For either case.

You generally won't pay a Part B penalty if you qualify for a Special Enrollment Period or enroll in a Medicare Savings Program (Medicare.gov).
Otherwise, the Part B penalty is an extra 10% for each year you could have signed up but didn't, added to your monthly premium, usually for as long as you have Part B (Medicare.gov).
If you had COBRA first, your COBRA will probably end once you sign up for Medicare (Medicare.gov).
Where a person loses COBRA because of Medicare, their spouse and children still may be eligible for COBRA (CMS Understanding COBRA presentation).
For free, one-on-one help deciding about COBRA and Part B, Medicare.gov points people to their State Health Insurance Assistance Program (SHIP, at shiphelp.org).

A figure from an AI answer, checked: "$750-$850/month for single coverage"

We can't confirm any typical figure. When we asked AI assistants how much COBRA costs in October 2026, one answer gave single-coverage figures ranging from "$400 to $700 a month per person" to "$750-$850/month for single coverage". The rules we checked set a ceiling, not a price.

Questions people also ask

Is COBRA better than the Marketplace?

It depends on your plan and your income. HealthCare.gov says Marketplace plans may cost less than COBRA, especially if you qualify for income-based savings. The CMS Understanding COBRA presentation says COBRA generally keeps you in exactly the same plan, with the same network of doctors and hospitals and the same deductible. Compare the monthly price after any income-based savings, whether your doctors are in the plan's network, and how much of this year's deductible you have already paid.

Is COBRA coverage retroactive?

Generally yes. The CMS Understanding COBRA job aid (May 2026) says COBRA generally begins retroactively on the date your employer coverage ended, as long as you elect within the election period and pay the first premium within 45 days of electing. The June 2020 CMS presentation says you are still responsible for paying the premiums for retroactive COBRA coverage.

Am I covered by COBRA if I quit?

Generally yes, if the plan is subject to COBRA. A CMS job aid, Understanding COBRA, lists voluntary or involuntary termination, including resignation, discharge (except for gross misconduct) and layoff, among the qualifying events (the life events that let you elect COBRA).

Can I deduct COBRA health insurance premiums if I am self-employed?

Gap: our checked sources don't say how COBRA itself counts for this deduction. What IRS Form 7206 instructions (2025) do say is that the self-employed health insurance deduction is not allowed for any month you were eligible for an employer-subsidized health plan, including a spouse's, even if you did not enroll.

How we checked this: this page is the output of a rigorous research pipeline run with AI tools: every factual sentence rests on a finding checked against the source's own words, and a person approved the page before it went up. How we check our facts. Updated November 12, 2026. This page is general information, not legal, tax or financial advice.