Losing Employer Coverage: Your Options

Losing a group plan starts a short clock, and the worst outcome is usually not choosing the wrong option — it is letting a deadline pass while you decide. Your coverage end date triggers a special enrollment period, typically 60 days, that lets you take a Marketplace plan outside the autumn window. COBRA has its own 60-day election window and is retroactive. That means you have a real, if brief, stretch of time to compare properly. Here is every option on the table, including the two that cost us a sale.

The alternative

Waiting it out uninsured

The default that happens when nobody makes a decision. Worth naming honestly, because it is the most common outcome and the most expensive one.

No premium to pay, which is the only thing in its favour
Full retail cost of any care, with no negotiated network pricing
A single unexpected hospital stay can run into six figures
Your special enrollment period expires while you wait, usually after 60 days
Miss it and the next Marketplace opportunity may be months away
A condition that develops in the gap becomes a pre-existing one later

What we do

Reviewing your options with an advisor

One licensed advisor lays out every route — including the ones we are not paid for — and you pick from the real picture before the deadlines close.

Every option compared, Medicaid and subsidised Marketplace plans included
Private PPO coverage available any day of the year, with no window to miss
Coverage that can start quickly rather than at the next enrollment period
Broad nationwide PPO networks, often wider than a regional group plan
A straight answer when a subsidy or Medicaid beats what we sell
Five questions and one call, not a bidding pool of agencies

Line by line

Where each one actually wins.

FactorWhat it gives youWhat it costs you

COBRA

What it gives you: Same plan, same doctors, deductible carries over
What it costs you: Full unsubsidised premium; ends after ~18 months

COBRA

Same plan, same doctors, deductible carries over

Full unsubsidised premium; ends after ~18 months

Marketplace with a subsidy

What it gives you: Can be extremely cheap; cannot decline you
What it costs you: Networks are often narrow local HMOs

Marketplace with a subsidy

Can be extremely cheap; cannot decline you

Networks are often narrow local HMOs

Medicaid, if you qualify

What it gives you: Little or no cost; full benefits
What it costs you: Income limits, and provider access varies

Medicaid, if you qualify

Little or no cost; full benefits

Income limits, and provider access varies

A spouse's employer plan

What it gives you: Group pricing, often the cheapest real option
What it costs you: Needs a qualifying event; adds to their payroll cost

A spouse's employer plan

Group pricing, often the cheapest real option

Needs a qualifying event; adds to their payroll cost

Private PPO

What it gives you: Underwritten, so not everyone qualifies
What it costs you: Lower premiums, broad networks, no enrollment window

Private PPO

Underwritten, so not everyone qualifies

Lower premiums, broad networks, no enrollment window

Short-term medical

What it gives you: Cheapest premium; fast to start
What it costs you: Excludes pre-existing conditions; capped term

Short-term medical

Cheapest premium; fast to start

Excludes pre-existing conditions; capped term

Staying uninsured

What it gives you: Nothing to pay this month
What it costs you: Unlimited downside, and the clock runs out

Edge: What it costs you

Staying uninsured

Edge: What it costs you

Nothing to pay this month

Unlimited downside, and the clock runs out

General comparison of plan types, not of any specific plan. Benefits, exclusions, networks and eligibility vary by plan, by state and by individual circumstances.

Start somewhere other than here if

A spouse or partner can add you to their employer plan
Your income for the year now puts you in the large-subsidy range
You may qualify for Medicaid in your state
You are mid-treatment and COBRA's continuity is worth the premium
You have already met most of this year's deductible

A private PPO review makes sense if

Your COBRA notice arrived and the number was the real shock
You are going independent and need coverage that is actually yours
You get little or no subsidy at your expected income
You want a national PPO instead of a narrow local network
You need coverage moving now, without waiting for a window

The verdict

Check a spouse's plan first, then check whether your new income qualifies you for a large subsidy or Medicaid — if either lands, take it, and we will tell you so. If none of those fit, the real choice is usually between an expensive COBRA premium and a privately underwritten PPO, and for a healthy applicant that comparison is rarely close. Whatever you decide, decide inside your 60 days. Five questions here is enough for a licensed advisor to walk the whole list with you on one call.

Talk it through

The right choice depends on your household.

A comparison page can show the trade-offs. Only a conversation about your state, your health history and your budget can tell you which side of it you're on. That's what the one call is for.

A licensed advisor checks what's available where you live
Exclusions and waiting periods explained before you commit
If the alternative is genuinely better for you, they'll say so

Start My Free Review

Straight answers

No small print, no hedging.

The questions people actually ask on the first call — answered here so the call can be about you instead.

What is the very first thing I should do?

Find your exact coverage end date and write it down. Every deadline you care about — the 60-day special enrollment period and the 60-day COBRA election window — runs from that date, not from your last day at work. Those two are often different, and people lose weeks assuming they are the same.

Should I check whether my spouse can add me?

Yes, before anything else. Losing your coverage is a qualifying event that lets you join their plan outside open enrollment, and group pricing is frequently the cheapest genuine option available to you. It costs us a sale to say that, and it is still the first thing to check.

My income just dropped to nothing. Does that change things?

Substantially. Subsidies are based on your expected income for the year, not last year's, so a job loss can put you in the range for a very large premium tax credit — or for Medicaid in your state. Either can beat anything we sell, and an advisor will point you there if that is where you land.

Can I take COBRA now and switch later if it is too expensive?

You can apply for private coverage at any time, and if you are approved you can drop COBRA. Because COBRA is retroactive for 60 days, the cleaner sequence is usually to compare first and elect COBRA inside the window only if you need it — that way you are not paying for two months you could have skipped.

How fast can new coverage actually start?

Private coverage can often begin within days of approval, and typically on the first of the following month. That is generally faster than a Marketplace plan, which usually starts at the beginning of the next month after you enrol. If you have a genuine same-week gap, say so on the call.

Keep comparing

vs. ACA Marketplace vs. COBRA vs. Short-Term Plans vs. Health Sharing vs. HMO

Get a straight answer

Not sure which side you land on?

Five questions, one licensed advisor, and an honest read on whether this is your better option — or whether something else is.

Pre-existing conditions covered
Apply any day of the year
Your details are never sold

Free coverage review

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