Lost your job? Here are your health insurance options, ranked

Option 1: A marketplace plan, usually the winner

Losing employer coverage is a qualifying life event, which unlocks a Special Enrollment Period on the ACA marketplace. Here's the part most people miss: marketplace subsidies are based on your current income, and about 9 in 10 marketplace enrollees qualify for a subsidy per CMS enrollment data. If your income just dropped because you're between jobs, you may qualify for far more help than you'd expect, many people in this situation end up paying a fraction of what COBRA costs, sometimes very little at all, for a real major-medical plan.

Option 2: COBRA, same plan, full price

COBRA lets you keep the exact plan you had, which sounds comforting. The catch: your employer was quietly paying most of the premium, and now you pay all of it, plus an admin fee. That's routinely several hundred to over a thousand dollars a month for coverage that used to feel affordable. For scale, KFF's 2024 employer benefits survey puts the average total premium at about $9,000 a year for single coverage and over $25,000 for family coverage, and COBRA hands you that full bill plus an admin fee of up to 2 percent.

When COBRA genuinely makes sense: you're mid-treatment with doctors you can't switch, or you've already hit your deductible and out-of-pocket max for the year. In those cases, keeping the same plan can be worth the price. One useful quirk, you get 60 days to elect COBRA and it's retroactive to the day you lost coverage, so it can act as a free safety net while you decide.

Option 3: A spouse's employer plan

Your job loss is also a qualifying event for your spouse's plan. Their employer typically allows about 30 days to add you. If that plan is well subsidized, it's often the cheapest path of all, check it before anything else.

What about short-term plans?

In many states, short-term medical plans can bridge a brief gap for less money. They're real coverage for accidents and new illness, but they're not ACA plans: pre-existing conditions generally aren't covered, and benefits are capped. For a known, short gap they can be a smart tool. As your ongoing coverage, they're usually the wrong fit. This is exactly the kind of trade-off worth a ten-minute conversation.

Bottom line

Check a spouse's plan first if you have one. Then compare a subsidized marketplace plan against COBRA, with your new income, the marketplace usually wins by a wide margin. And move inside the 60-day window. I'm Carson Hornish, an independent broker licensed in 24 states (NPN 21581721), this comparison is exactly what I do, and it costs you nothing.