Lost Your Job? Keep Health Coverage Without Overpaying
Four routes stay open after job-based coverage ends. They differ in cost, deadline and what they protect — and the most expensive one is the one most people default to.
The short answer
Losing job-based coverage opens a 60-day Special Enrollment Period. COBRA keeps the same plan but costs 102% of the full premium. Medicaid is free or nearly free and accepts applications year-round. Compare the marketplace plan with its tax credit against COBRA before the window closes — after that, the choice is made for you.
The full cost, not just your payroll deduction.
Enter income and coverage dates to see your four options.
Medicaid
Check with the agencyTexas has not expanded Medicaid to adults at 138% FPL. Parents may still qualify at a much lower income level, and children usually have a higher limit — apply and let the agency decide.
Medicaid accepts applications year-round. Savings and a lump-sum severance can affect the determination.
Texas income limitsMarketplace plan (Special Enrollment)
Check eligibilityLosing job-based coverage opens a 60-day Special Enrollment Period. Premium tax credits apply between 100% and 400% FPL in 2026 — the enhanced credits expired after 2025-12-31, so the 400% cliff is back.
The 60-day clock starts the day coverage ends, not the last day of work.
Estimate the subsidyCOBRA
You may keep the same plan for up to 18 months by paying 102% of the full premium.
Enter the plan's total premium to see your monthly COBRA cost.
You usually have 60 days to elect. You can drop COBRA later and move to a marketplace plan at open enrollment — but not whenever you like.
Short-term or limited plan
Short-term plans can be cheaper and can start quickly, but they are not required to cover pre-existing conditions, maternity care or prescriptions, and they do not satisfy the individual coverage requirement. Treat them as a bridge only when the other three are closed to you.
A gap of less than three months may be cheaper than a full year of a limited plan.
This is an arithmetic check against federal rules, not an eligibility determination. The state Medicaid agency and the marketplace make the final decision — apply and let them decide, even if the result here says you are over the line.
The four options side by side
| Option | What it costs | When to enroll | What it keeps | What it gives up |
|---|---|---|---|---|
| Medicaid | Free or near-free | Year-round | Full coverage, retroactive bills in many cases | Provider network is narrower than a commercial plan |
| Marketplace plan | Premium minus tax credit | 60 days from coverage end | ACA-compliant benefits, subsidy possible | Network and plan change; deductible restarts |
| COBRA | 102% of the full premium | 60 days to elect, up to 18 months | Same plan, same doctors, same deductible | Much higher monthly cost; no subsidy |
| Short-term plan | Low monthly premium | Anytime | Fast start, low sticker price | Pre-existing conditions, maternity, prescriptions |
COBRA duration can extend beyond 18 months under state continuation laws. The 18-month figure is the federal minimum.
The COBRA arithmetic
COBRA does not preserve your payroll deduction. It preserves the plan, and you pay the employer's share too. If the plan costs $800 a month in total and $250 came out of your paycheck, COBRA costs about $816 — not $250.
- • 102% of the total premium, including the 2% fee.
- • 60 days to elect; the plan can lapse in the meantime.
- • Up to 18 months for most qualifying events.
- • No premium tax credit and no income-based discount.
The 2026 subsidy rule
Premium tax credits apply from 100% to 400% of the federal poverty level. The enhanced credits that removed the cliff expired on 2025-12-31, so for 2026 coverage one dollar over the line can remove the entire credit.
Below 100% FPL in an expansion state, Medicaid is the route. Below 100% in a non-expansion state, there may be no subsidized marketplace path at all.
Where to apply
Marketplace
HealthCare.gov, or your state's marketplace if it runs its own. The application checks both the subsidy and Medicaid in one pass.
healthcare.govMedicaid / CHIP
Apply through your state Medicaid agency or HealthCare.gov. Children often qualify at a higher income than adults.
medicaid.govCOBRA
Elect through your former employer's plan administrator using the notice you receive. Do not let the election deadline pass while comparing.
dol.govCommon questions
How long after losing a job can I sign up for health insurance?＋
Losing job-based coverage opens a 60-day Special Enrollment Period on HealthCare.gov or the state marketplace. The 60 days start on the coverage end date, not the last day of work. If you miss it, the next opportunity is usually open enrollment unless another qualifying event occurs.
Is COBRA more expensive than a marketplace plan?＋
Usually, yes — COBRA costs 102% of the plan's full premium, including the share your employer used to pay. A marketplace plan can cost less once a premium tax credit is applied, especially at income between 100% and 400% of the federal poverty level. COBRA can still win if you need a specific doctor, are mid-treatment, or the subsidy is small.
Can I get Medicaid after losing a job?＋
Yes, if your income falls under the state's Medicaid limit for your household. In expansion states the adult limit is 138% of the federal poverty level. Medicaid accepts applications year-round, and a job loss is a common trigger. In non-expansion states, adults without dependent children may have no pathway at any income.
Do I have to take COBRA if my employer offers it?＋
No. COBRA is an option, not an obligation. You generally have 60 days to elect it, and you can choose a marketplace plan instead. Electing COBRA and then dropping it later does not reopen the 60-day marketplace window.
Can I drop COBRA and switch to a marketplace plan later?＋
Only at open enrollment or after another qualifying event. Dropping COBRA for cost reasons is not itself a qualifying event. That is why the comparison should happen before the 60-day window closes.
Is a short-term health plan a real substitute?＋
No. Short-term plans are not required to cover pre-existing conditions, maternity care or prescription drugs, and they may rescind coverage. They can bridge a gap of a few weeks, but they are not equivalent coverage.
Sources
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By Alyssa Xu, Founder & Editor.
Reviewed by Gavin YE, Technical Director, ClearRules Labs.
Page last reviewed 2026-10-20