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COBRA & Transition CoverageCOBRA keeps the plan you already know — at the price your employer was quietly paying most of. You have 60 days to decide, and the alternative is usually worth the hour it takes to look at.
COBRA is the option that arrives in the post. It requires no research, no application and no decision about networks, which is exactly why most people take it without comparing anything — and why so many discover the real price only when the first invoice lands.
It is a genuinely good product in specific circumstances. It is simply not the default it appears to be, and the window to choose something else is short.
Four routes. COBRA is the one that writes to you; the others you have to go and ask for.
The same plan, same network, same doctors, and your deductible progress carries over. You pay the full premium plus 2%. Strong if you are mid-treatment, near a deductible you have already paid down, or months from Medicare.
Up to 18 monthsLosing coverage opens a 60-day special enrollment period. Premium tax credits are based on this year's income — which, after a job loss, is often far lower than the figure that would have disqualified you while employed.
Often far cheaperSold directly by carriers and never listed on HealthCare.gov. No subsidy applies, but the pricing and networks are different — worth comparing if severance or a spouse's income puts you above the subsidy line.
Above 400% FPLYour loss of coverage is a qualifying event on their plan too, usually with a 30-day window that is shorter than the others. Frequently the cheapest answer available and the one most often overlooked.
Check first — 30 daysThere is no fee and no obligation, and the comparison takes about an hour of our time and fifteen minutes of yours.
Premium plus deductible plus out-of-pocket maximum, COBRA against the alternatives, in writing. Monthly premium on its own has misled more people in this decision than any other number.
Send the list of physicians and prescriptions. We verify them against each plan's network and formulary before you are asked to choose, not after.
Nothing is cancelled until the replacement is approved with a confirmed effective date. A gap in coverage during a job change is the one outcome we will not let happen.
Our compensation comes from the carrier when you enroll, at rates set by the carrier, and your information goes to this agency and nowhere else.
Your ZIP and a phone number is enough to start. We will come back with COBRA against the alternatives, costed for the full year. Response within 24 hours.
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Recurring situations from this line of work — described as patterns, not as client quotes. Verified client reviews appear further down.
A household that paid $280 a month through payroll receives a COBRA bill for $1,640 — the same plan, with the employer's share of the premium no longer being paid.
Someone is certain they earn too much for a subsidy, using the salary they no longer have. Credits are assessed on the current year's actual income, which has just fallen sharply.
A cheaper Marketplace plan in September would have reset a deductible that was almost entirely met, making the more expensive COBRA option cheaper across the remaining year.
COBRA is elected and abandoned four months in to save money. Voluntarily ending it is not a qualifying event, and the next enrollment opportunity is open enrollment.
A spouse's employer plan would have been the cheapest option available, but its special enrollment window closed at 30 days while the COBRA packet was still being considered.
Coverage is cancelled the day a new application is submitted rather than the day it is approved, opening a two-week window in which nothing is in force.
Carrier names are trademarks of their respective owners. Saintellus Health Advisory is an independent advisor.
The COBRA packet gives you a monthly figure. The Marketplace gives you a different monthly figure. Neither tells you what the year costs, and the year is what you actually pay.
A fair comparison has three lines, not one:
| What to compare | Why it changes the answer |
|---|---|
| Annual premium | COBRA is the full premium plus up to 2%. A Marketplace premium may be reduced by a credit calculated on your new income. |
| Deductible position | COBRA carries your progress this plan year. A new carrier resets it to zero, which can quietly cost more than the premium you saved. |
| Out-of-pocket maximum | The real worst case. It is the number that matters if the year goes badly, and it is the one least often quoted to you. |
Do not cancel anything first. Elect nothing and cancel nothing until a replacement plan is approved with a confirmed effective date in writing. COBRA's 60-day election window is retroactive, which means you can take the time to compare properly without being uninsured while you do it.
It genuinely often is, and an advisor who tells you otherwise in every case is selling rather than advising. COBRA wins when:
If you are early in the plan year, have no treatment under way, and your income for this calendar year has dropped because you stopped earning — that combination is where the Marketplace tends to win by a wide margin. The credit is calculated on what you will earn this year, not on the salary you were on when you were told you earned too much to qualify. A great many people are told that once, believe it permanently, and never check again after their circumstances change.
The one genuinely time-critical item is a spouse's employer plan. That window is often 30 days rather than 60, which means it closes while you are still thinking about the other two. If your partner has coverage available, check that first.
Have it compared before the window closes Send your ZIP, your household and roughly what you now expect to earn this year. We will come back with COBRA priced against the alternatives across the full year — premium, deductible and worst case — so the decision is arithmetic rather than a guess.You have 60 days from the later of the date your coverage ended or the date your COBRA election notice was sent. Election is retroactive to the day coverage ended, so if you elect on day 55 you are still covered for anything that happened in between. That retroactivity is genuinely useful: if you are healthy and weighing alternatives, you are not uninsured while you decide, though you would owe the back premiums to activate it.
Because what you were paying was only your share. Employers typically cover around 70 to 80 percent of the premium, and that contribution stops with employment. COBRA charges the full premium plus an administration fee of up to 2%. The plan has not changed and the price has not risen — you are simply seeing the whole of it for the first time.
No. Premium tax credits apply to Marketplace plans only and cannot be used toward COBRA. This is the main reason the Marketplace often wins the comparison: after a job loss your income for the year is frequently much lower than it was, and that lower figure is what the credit is calculated on.
Yes, but only at open enrollment or with a new qualifying event. Exhausting COBRA at the end of its term is itself a qualifying event and opens a special enrollment period. Choosing to drop COBRA part-way through, or being dropped for non-payment, is not — you would be waiting until the next open enrollment. It is worth knowing that before you elect.
It carries over on COBRA, because it is the same plan and the same plan year. It does not carry over to a new plan with a different carrier, which starts you at zero. If you have had significant medical spending this year, that reset can easily outweigh a lower monthly premium — which is why the comparison has to be run across the full year.
It is a strong candidate, because COBRA's 18 months will reach Medicare if you are past roughly 63 and a half, and the plan and network stay identical throughout. Below that age it will run out before Medicare starts and you will be arranging a second plan anyway. Either way, COBRA does not protect you from the Part B late-enrollment penalty — only coverage from current employment does.
Not on a Marketplace or ACA-compliant private plan. Pre-existing conditions cannot be used to deny you coverage or to raise your premium. Short-term medical plans are the exception — they are medically underwritten, can decline you and can exclude conditions you already have, which is why they are only appropriate for a genuine short gap.
Not if it is sequenced properly, and this is the part worth handing to somebody else. Nothing gets cancelled until the replacement is approved with a confirmed effective date in writing. COBRA's retroactive election window is also a safety net while a Marketplace application is processing.
Saintellus Health Advisory is an independent insurance agency licensed in 31+ states. Plan availability, pricing and eligibility vary by state, county, age and household. This page is general education and is not medical, tax or legal advice.
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