In the US, where coverage usually comes with the job
I lost my job. What happens to my health insurance?
COBRA keeps the same plan — at the full price
COBRA lets you stay on your employer’s health plan, usually for up to 18 months, with the same doctors and the same deductible you have already been paying toward. The catch is cost: you pay the whole premium your employer used to share, plus a small fee. You generally have 60 days to decide, and if you elect it, coverage reaches back to the day the old coverage ended — which makes it a safety net while you compare.
The Marketplace is often far cheaper when income drops
Losing job-based coverage is a qualifying event, so you can buy a plan on HealthCare.gov or your state’s marketplace outside the usual enrollment season — generally within 60 days of losing coverage. Help with the premium is based on what you expect to earn for the year, so if your income falls, the help rises. Many people pay a fraction of the COBRA price for a comparable plan.
Medicaid, if your income now qualifies
Medicaid is free or very low-cost coverage based on income, and the limits depend on your state. You can apply at any time of year, not just in an enrollment window. If your household income has dropped sharply, check it before paying for anything else.
Do not let it lapse without deciding
The real risk is a gap — weeks with no coverage because the decision got put off. Use the COBRA window as your backstop, price a Marketplace plan and check Medicaid in the same week, then choose. Write down the deadline on your COBRA notice; it is the date everything else hangs on.
Ask what else ends with the job
Dental, vision, life insurance and any health savings account behave differently. A health savings account is yours to keep; a flexible spending account often is not, so spend what is in it before the last day if you can.
Questions people ask next
Is COBRA worth it?
It can be if you are mid-treatment, have met your deductible this year, or will start a new job with coverage soon. Otherwise a Marketplace plan is often much cheaper. The retroactive election means you can hold COBRA as a backup while you compare.
How long do I have to sign up on the Marketplace?
Generally 60 days from losing your job-based coverage. Check the date on HealthCare.gov or your state’s marketplace now rather than near the end.
Can I get help paying for a Marketplace plan?
Yes — it is based on your expected income for the year. A lower income usually means more help, which is why the price after a layoff can be much lower than people expect.
What if I start a new job soon?
Ask the new employer when its coverage starts. If there is a short gap, COBRA’s retroactive window can cover it without paying for months you never use.
Run it against your own numbers
Everything above is the shape of the decision. What it cannot do is use your figures. You narrow four ways out to the one that fits you, then turn it into three moves in the order they work — free, and yours to keep.
Show me which wayFree. No card, and no account to begin.
This is general information about how these decisions work, not financial, legal or tax advice. Check the numbers against your own situation before you act.