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Losing Employer Coverage: Your Options

Four routes, two clocks, and one mistake that costs people the most. Here is the order to think about it in.

Two people in aprons in their woodworking shop
The short version

When group coverage ends, two clocks start at once: 60 days to elect COBRA, and 60 days of special enrollment on the marketplace. Both are easy to miss while you are dealing with everything else a job change brings.

There are four realistic routes, and the right one depends on your health, your household income, and how long you need the coverage to last.

At a glance

Window to act

COBRA or a spouse's plan
60 days (COBRA)
Bright Health Savings
60 days (marketplace) / any day (private)

At a glance

Health questions

COBRA or a spouse's plan
None
Bright Health Savings
None on marketplace; yes on private

At a glance

Keeps your doctors

COBRA or a spouse's plan
Exactly (COBRA)
Bright Health Savings
Often, on a broad PPO

At a glance

Deductible already paid

COBRA or a spouse's plan
Carries over on COBRA
Bright Health Savings
Resets
The alternative

COBRA or a spouse's plan

The two continuity routes: keep your existing group plan at full cost, or join a spouse's employer plan through their special enrollment period.

Where it wins

  • Guaranteed — no health questions on either route.
  • COBRA keeps your exact network, doctors and accumulated deductible.
  • A spouse's plan is usually the cheapest option of all, because their employer subsidises it.
  • Both cover pre-existing conditions with no interruption.

Where it costs you

  • COBRA costs the full group premium plus up to 2% — usually a shock.
  • COBRA runs out after roughly 18 months regardless.
  • A spouse's plan has its own 30-day-ish special enrollment window after the loss.
  • Neither is available if you do not qualify — and that window closes quickly.
What we do

Marketplace or private PPO coverage

The two open-market routes: a subsidised ACA plan through your special enrollment period, or a medically underwritten PPO available any day.

Where it wins

  • Losing job-based coverage opens a 60-day marketplace special enrollment period.
  • If your income has dropped, a subsidy may now make a marketplace plan very cheap.
  • A private PPO is available any day of the year, with no window to miss.
  • A private PPO has no 18-month cliff and typically uses a broad nationwide network.

Where it costs you

  • The marketplace window is 60 days, and missing it means waiting for open enrollment.
  • A private PPO requires underwriting, so acceptance is not guaranteed.
  • Your deductible resets on either route.
Row by row

The differences that actually change your bill.

Window to act
COBRA or a spouse's plan60 days (COBRA)
Bright Health Savings60 days (marketplace) / any day (private)
Health questions
COBRA or a spouse's planNone
Bright Health SavingsNone on marketplace; yes on private
Keeps your doctors
COBRA or a spouse's planExactly (COBRA)
Bright Health SavingsOften, on a broad PPO
Deductible already paid
COBRA or a spouse's planCarries over on COBRA
Bright Health SavingsResets
Typical cost
COBRA or a spouse's planFull group premium
Bright Health SavingsSubsidy-dependent, or underwritten
How long it lasts
COBRA or a spouse's planUp to 18 months
Bright Health SavingsOngoing
If income has dropped
COBRA or a spouse's planNo effect
Bright Health SavingsSubsidies may become substantial
Mid-treatment
COBRA or a spouse's planUsually the safer route
Bright Health SavingsRiskier on the private route

Actual premiums, deductibles, networks and benefits vary by age, location, health history and the plan selected.

The questions people ask

Answered properly, not in one line.

What should I do in the first week?

Write down two dates: the day your coverage actually ends, and the day 60 days after it. Then check whether a spouse's plan can take you, because that is usually the cheapest outcome and it has the shortest window.

Only after those two are settled is it worth comparing COBRA against the open market.

My income dropped. Does that change the marketplace math?

Enormously. Premium tax credits are based on your projected income for the year, not last year's. A mid-year job loss frequently moves a household into subsidy territory for the first time.

Run the numbers on healthcare.gov before assuming the marketplace is unaffordable — the figure from two years ago is not the figure today.

Can I avoid a gap in coverage entirely?

Usually. COBRA is retroactive to the day your group coverage ended, so even electing it late in the 60 days closes the gap. Marketplace and private plans generally start on the first of a following month, so applying before your last day is what avoids the gap.

The scenario to avoid is going uncovered for a month and having something happen in it.

What if I have a pre-existing condition?

Then continuity is worth paying for. COBRA or a spouse's plan covers it with no interruption, and a marketplace plan covers it from day one by law.

A private PPO may still be an option depending on the condition and the carrier, but this is exactly the case where an advisor should be checking before you apply rather than after.

Nobody at my old employer explained any of this. Is that normal?

Unfortunately yes. The COBRA election notice is a legal document mailed to you, not an explanation, and no one is obliged to walk you through the alternatives.

That is most of what an advisor does on this call: lay the four routes side by side with your actual numbers on them.

COBRA or a spouse's plan is better for you if

A spouse's plan can take you, you are mid-treatment, you have spent meaningfully toward this year's deductible, or you need only a short bridge to a new job's benefits.

Marketplace or private PPO coverage is better for you if

Your income has dropped enough to unlock a subsidy, or you are in reasonable health and need coverage that lasts beyond 18 months without the full group premium.

The verdict

Check a spouse's plan first, then run the marketplace subsidy numbers with your new income, then compare COBRA against a private PPO on price. Do all three inside the first two weeks — the routes that are guaranteed are also the ones with the shortest clocks, and a missed window is the only genuinely irreversible mistake here.

Put your numbers on it

Five questions. A real answer for your household.

A licensed advisor takes what is on this page and works it out against your state, your household and your health history — including telling you when the option we do not sell is the right one.

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