Health insurance after a layoff

• 102%Most a plan can charge: the full premium plus a 2% admin fee
• $793Average single plan per month at 102%, vs about $120 from your paycheck
• $2,294Average family plan per month at 102%, vs about $571 from your paycheck
• 60 daysTo elect, counted from your notice or your coverage end date, whichever is later
• 45 daysTo make your first payment after you elect
• 30 daysGrace period on every payment after that
• 18 moStandard length after a layoff - 29 with a Social Security disability finding

• Federal COBRA covers private employers with 20 or more employees, plus state and local governments. Federal and church plans aren't included.
• Smaller employer? Many states have a 'mini-COBRA' law. Your state insurance department knows which rules apply.
• Elect late in your 60 days and coverage still reaches back to the day your plan ended, once you pay premiums back to that date.
• Each person on the plan gets their own choice. Your spouse or kids can keep COBRA while you pick something else.
• If Social Security finds someone on the plan disabled within the first 60 days of COBRA, the whole family can stay 29 months. Months 19-29 can cost up to 150%.
• Your spouse and kids can stay up to 36 months if a second event, like a divorce, happens during your 18 months.
• No marketplace tax credits while you're on COBRA. Dropping it on purpose doesn't open a marketplace window - using up all your months does.
• Some severance agreements pay part or all of your COBRA premiums for a set number of months.

Sources:DOL: Employee's Guide to COBRADOL: COBRA FAQsKFF: 2025 Employer Health Benefits Survey

COBRA is your old plan with the same card and the same doctors - your employer's share just lands on your bill now. It matters most if you're mid-treatment or have already met your deductible. The catch: the average single plan runs about $793 a month, and family plans run about $2,294.

If the catch is a dealbreaker: A marketplace plan picked in the same 60 days is priced on this year's income and can cost far less in a lower-income year.

• 60 daysTo pick a plan, before or after your job-based coverage ends
• 1stPick before your plan ends and coverage starts the 1st of the month after it ends - no gap
• 400%2026 income cap for tax credits: $62,600 for 1 person, $128,600 for 4
• 9.96%Most you pay for the benchmark silver plan, as a share of income, from 300% to 400% of poverty
• 2.10%Your share of income for that plan at the low end, under 133% of poverty
• $0Tax credit $1 over the cap - the whole credit disappears

• Tax credits are based on your household income for all of 2026, including pay before your last day, severance, and unemployment.
• Starting with 2026, if your income comes in higher than your estimate, you repay the full extra credit at tax time. The old repayment caps are gone.
• Report income changes during the year, like a new job, and your monthly credit adjusts.
• Below 100% of the poverty level ($15,650 for 1 person) there's no tax credit. In most states, that income points to Medicaid instead.
• If your income looks low enough for Medicaid, HealthCare.gov sends your application to your state.
• Silver plans come with lower deductibles and copays for incomes up to 250% of the poverty level.
• New plan, new network, and a deductible that starts back at $0.
• Miss the 60 days and you wait for open enrollment, which starts November 1. Dropping COBRA on purpose doesn't reopen the window.

Sources:HealthCare.gov: Special enrollment45 CFR 155.420IRS: Premium tax credit eligibilityIRS Rev. Proc. 2025-25IRS: One Big Beautiful Bill provisions

A plan you buy on HealthCare.gov or your state's site, with tax credits based on what you'll earn this year - not what you earned last year. In a year with a layoff in it, that can mean a much lower bill than COBRA. The catch: new doctors and a fresh deductible, and $1 over $62,600 (for 1 person) means no credit at all.

If the catch is a dealbreaker: If a doctor or hospital you can't give up isn't in any marketplace network, COBRA keeps them for up to 18 months.

• 138%Income limit for adults in states that expanded Medicaid
• $1,835Monthly income limit for 1 person in 2026
• $3,795Monthly income limit for a family of 4 in 2026
• 41States, counting DC, that cover adults this way - 10 don't
• 3 moHow far back coverage can reach today, in many states
• 1 moReach-back for expansion adults who apply from January 1, 2027 (2 months for others)
• 80 hrsMonthly work, school, or volunteering many adults show from January 1, 2027

• Medicaid looks at your current monthly income, so a month with no paycheck can qualify even after a high-earning year.
• Unemployment checks count as income, and severance can push a month over the limit.
• In the 10 states that didn't expand (including Texas and Florida), most adults without kids don't qualify on low income alone.
• There's no enrollment window. Apply through your state Medicaid agency or HealthCare.gov any month of the year.
• From January 1, 2027, most states have to ask adults 19-64 in the expansion group for 80 hours a month of work, school, or volunteering, or $580 a month in earnings. New applicants show it for at least 1 month before they apply.
• Parents of kids under 14, pregnant people, and medically frail adults are exempt. States can grant short-term exceptions in counties with high unemployment.
• Kids can qualify for Medicaid or CHIP at higher family incomes than adults.
• Which doctors you can see depends on who takes your state's Medicaid plans.

Sources:HealthCare.gov: Medicaid and CHIPHHS: 2026 poverty guidelinesKFF: Medicaid expansion statusCMS: Community engagement rule

Free or very low-cost coverage from your state, based on what you earn this month. If severance is spent and unemployment is small, it can be the cheapest coverage there is. The catch: every state sets its own rules, 10 states leave most adults without kids out, and new work rules arrive in 2027.

If the catch is a dealbreaker: If severance or unemployment puts you over the monthly limit, the marketplace prices on yearly income, so a low-income year can still mean a low bill.

• 30 daysMinimum window from the day your coverage ends - some plans allow more
• 1stCoverage starts by the 1st of the month after the plan gets the request
• $6,850Average yearly paycheck cost of family coverage in 2025
• $1,440Average yearly paycheck cost of single coverage, for comparison
• 18 moTake COBRA and use all 18 months, and a new 30-day window opens

• Losing job-based coverage lets a spouse add you and your kids outside open enrollment, under federal HIPAA rules.
• The 30 days count from the day your coverage ends, not from the day a COBRA notice arrives.
• Federal special enrollment covers spouses and dependents, not domestic partners. Some plans cover partners anyway - the plan's summary plan description says.
• Plans can ask for proof of the date your old coverage ended.
• Using up all your COBRA months opens a new window on this plan. Dropping COBRA early doesn't.
• If adding you to a plan that meets federal minimum value rules costs 9.96% of household income or less, you generally can't get marketplace tax credits in 2026.
• Their employer pays part of the premium, which is why this route often costs less than COBRA.

Sources:DOL: HIPAA29 CFR 2590.701-6KFF: 2025 Employer Health Benefits Survey

Joining your spouse's job-based plan outside open enrollment, because you lost yours. Their employer pays part of the premium, so it often costs less than paying for COBRA yourself. The catch: the window can be just 30 days from your last day of coverage, and domestic partners only get in if the plan allows it.

If the catch is a dealbreaker: Missed the 30 days, or the plan doesn't cover partners? COBRA and the marketplace both give you 60 days.