Plain-English Guide

Losing your job's health insurance? Here are your real options.

Leaving a job — by choice or not — usually means your health coverage ends with it. You have four realistic paths, and the right one depends on your health, your budget, and your timeline. Here's each one, honestly.

By Brian Fuller, licensed health & life agent (31 states) · Fuller Built Insurance, Tampa, FL

First: your two deadlines

COBRA: you generally have 60 days from your election notice (or the day coverage ends) to sign up.
ACA Marketplace: losing employer coverage triggers a 60-day Special Enrollment Period — you don't have to wait for open enrollment.

Private plans can usually be applied for any time of year, but don't coast uninsured while you decide — one ER visit can undo years of savings.

Option 1: COBRA — keep your exact plan, at full price

COBRA lets you keep the same plan, doctors, and deductible progress you already have, typically for up to 18 months (up to 36 in some cases). The catch is the price: you now pay the entire premium — including the large share your employer was covering — plus up to a 2% admin fee. Family COBRA premiums of $1,500–$2,500+/month are common.

COBRA makes sense when: you're mid-treatment, you've already hit your deductible this year, or you have conditions that other options won't cover.

Option 2: ACA Marketplace (Healthcare.gov)

Marketplace plans cover pre-existing conditions, cover the ACA's essential benefits, and — depending on your income — can come with meaningful subsidies. If your income will be low this year (common right after leaving a job), a subsidized ACA plan can be very affordable.

Watch for: narrow local networks (many Marketplace plans are HMOs), high deductibles on the cheaper tiers, and premiums that rise sharply if your income rebounds.

Option 3: Private PPO plans (what we specialize in)

Private (off-Marketplace) plans are medically underwritten — the carrier reviews your health before approving you. That cuts both ways, and an honest broker will say so plainly:

If you're relatively healthy: private PPO plans often cost meaningfully less than COBRA, with broad nationwide PPO networks, no referral requirements, and year-round enrollment.
If you have significant pre-existing conditions: you can be declined, or the condition can be excluded. In that case COBRA or an ACA plan is usually the better answer — and we'll tell you that instead of selling you the wrong thing.

Option 4: Short-term medical — the stopgap

Short-term plans are cheap and fast to start, but they're thin: they typically exclude pre-existing conditions and much more. Think of them as a bridge for a known, short gap — not a plan to live on.

The 30-second decision framework

Mid-treatment or major pre-existing conditions → COBRA (or ACA at the 60-day window).
Low income this year → get your ACA subsidy quote first.
Healthy, want your doctors and a national network → compare private PPO quotes against your COBRA rate; the savings are often significant.
Short, known gap (new job starts soon) → short-term can bridge it.

This guide is general information, not legal or tax advice — your situation may differ, which is exactly why a quick conversation beats guessing.

Want the comparison done for you — free?

Tell us your situation and we'll compare your COBRA rate against private PPO and Marketplace options across multiple carriers, in plain English. If COBRA is your best move, we'll say so.

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Common questions

How long do I have to decide after losing employer coverage? +

You generally have 60 days to elect COBRA after your coverage ends or you receive your election notice, and losing employer coverage also opens a 60-day Special Enrollment Period for ACA Marketplace plans. Private plans can typically be applied for at any time of year — but don't wait; going uninsured even briefly is a risk.

Why is COBRA so expensive? +

With COBRA you keep your exact employer plan, but you now pay the full premium yourself — the share you paid before PLUS the share your employer was quietly covering — plus up to a 2% administrative fee. That's why COBRA often costs several hundred to over a thousand dollars a month more than people expect.

Is a private PPO plan better than COBRA or an ACA plan? +

It depends on your health and budget. Private PPO plans are medically underwritten — if you're relatively healthy, they can offer broad nationwide networks and lower monthly costs than COBRA. But they can decline applicants or exclude pre-existing conditions. If you have significant ongoing conditions, COBRA or an ACA plan (which must cover pre-existing conditions) is often the safer choice. An honest broker will tell you which side of that line you're on.

What happens if I just go without coverage for a few months? +

There's no longer a federal tax penalty for being uninsured, but one accident or diagnosis while uninsured can be financially devastating, and some options get harder to qualify for after a gap. If cost is the concern, compare all four options first — there's usually a way to stay covered for less than COBRA.