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Losing your job means losing your health insurance, usually at the end of the month you leave. You have three realistic options: COBRA, a marketplace plan, or Medicaid. They differ wildly in cost, and the right one depends almost entirely on your income right now and how long you expect to be without employer coverage.
COBRA: keep your old plan, pay the full price
COBRA lets you stay on your former employer’s plan, typically for up to 18 months. The catch is the price. As an employee you paid part of the premium and your employer paid the rest. Under COBRA you pay both shares plus a 2 percent administrative fee, up to 102 percent of the total premium. That is why COBRA feels brutally expensive: it is the same plan at roughly three to five times what came out of your paycheck.
COBRA has two real advantages. Nothing changes: same doctors, same network, same deductible progress. And you get 60 days to elect it, retroactively. That means you can wait, stay uninsured for a few weeks, and only elect COBRA if something expensive happens, with coverage backdated to when you lost the old plan. It is a strange but legal way to use COBRA as catastrophic backup. See what COBRA is and when it is worth it for the full rules.
Marketplace: usually cheaper, with a deadline
Losing job-based coverage triggers a special enrollment period: 60 days from the loss of coverage to buy a marketplace plan. This is the option most people should price first. Premium tax credits are based on your current annual income, and if your income just dropped, the credits can be large. A family that earned too much for help in January can qualify easily in July after a layoff.
The tradeoff is starting over: new network, new deductible, new drug list. If you are mid-treatment with specific doctors, check whether they are in any marketplace plan’s network before you switch. If your income has dropped to near zero, check Medicaid first, because marketplace credits assume you will earn enough to file taxes.
Medicaid: the best deal if you qualify
Medicaid has no enrollment window and essentially no premium. In expansion states, adults earning up to 138 percent of the federal poverty level generally qualify, and a newly unemployed person with no income usually does. Apply through your state Medicaid agency or healthcare.gov; coverage can start quickly and retroactively in some states. In non-expansion states, childless adults generally cannot get Medicaid regardless of income, which pushes you back to the marketplace.
How the three compare
| COBRA | Marketplace | Medicaid | |
|---|---|---|---|
| Typical cost | Full premium + 2% | Subsidized based on income | Little to none |
| How long you get | 60 days to decide | 60 days from coverage loss | Anytime |
| Keep your doctors? | Yes | Maybe | Maybe |
| Deductible progress | Kept | Resets | Resets |
| Best for | Short gaps, ongoing treatment | Most unemployed workers | Very low income |
The move most people should make
Price all three in the first week. Apply for Medicaid if your income is near zero, get marketplace quotes with your realistic annual income, and keep the COBRA election paperwork as your 60-day backup. Do not let the 60 days expire while you think about it: after the special enrollment window closes, the marketplace is shut until the next open enrollment unless another qualifying event happens.
One more option for very short gaps: short-term health insurance can cover a month or two between jobs, but it excludes pre-existing conditions and is a bridge, not a replacement. And if you are comparing raw prices first, 2026 monthly premium averages will ground your expectations.
