Losing or leaving a job means making a quick decision about health insurance. For most people under 65, the choice comes down to keeping your employer’s plan through COBRA or buying a plan through the ACA Marketplace. The right answer depends on your costs, your health care needs, and the timing.
Side-by-side comparison
| COBRA | Marketplace plan | |
|---|---|---|
| What it is | The same employer plan you had, continued after you leave | An individual or family ACA plan you choose |
| Monthly cost | Usually the full premium plus up to 2% | Varies; may be lowered by income-based tax credits |
| Doctors & network | No change | Depends on the plan you pick |
| Deductible progress | Carries over for the plan year | Starts over with the new plan |
| How long | Usually up to 18 months | As long as you keep enrolling |
| Pre-existing conditions | Covered | Covered |
When COBRA tends to make sense
- You’ve already met much of your deductible or out-of-pocket maximum this year.
- You’re in the middle of treatment and want to keep the same doctors.
- You only need a short bridge, such as until a new job’s coverage starts.
- Your former employer is helping pay the COBRA premium as part of a severance package.
When a Marketplace plan tends to make sense
- Your income for the year will be lower after leaving your job, which may qualify you for tax credits.
- The full COBRA premium is more than you can comfortably afford.
- You need coverage for longer than COBRA lasts.
- A Marketplace plan includes your doctors at a lower total cost.
Tip on income: Marketplace tax credits are based on your expected income for the whole calendar year. If you leave a job partway through the year, your annual income may be lower than you think. For 2026, tax credits are generally limited to households earning up to 400% of the federal poverty level. If your income is very low, you may qualify for Medicaid, depending on your state.
The deadline that matters most
Losing job-based coverage generally opens a 60-day special enrollment period for Marketplace coverage. You can choose a Marketplace plan during this window even if you’re offered COBRA.
Timing matters after that. If you enroll in COBRA and later drop it voluntarily or stop paying premiums, that generally doesn’t qualify you for a new special enrollment period, so you may have to wait until open enrollment to switch. When your COBRA coverage runs out on its own, you typically do qualify.
You also usually have time to decide on COBRA itself, often 60 days from your election notice, and coverage can apply back to the date your job coverage ended once you elect and pay.
How to decide
- Get your COBRA notice and note the monthly premium and deadlines.
- Estimate your household income for the full year.
- Price Marketplace plans at HealthCare.gov or your state’s exchange, or have a licensed agent compare them for you.
- Compare total costs: premiums plus the deductible and out-of-pocket costs you’re likely to face.
- Check your doctors and prescriptions in any new plan.
Retiring early rather than changing jobs? See our guide to health insurance for early retirees.
Please note: LocalQuotes.online is not an insurance company, agency, or broker and is not affiliated with HealthCare.gov or any government agency. We connect you with licensed agents and marketing partners who may contact you about plans. Not all plans are available in all states, and plan details vary. We may be compensated by the agents and partners we connect you with. This page is general information, not insurance, legal, or tax advice.