What we do
Losing employer coverage
A job ending opens a Special Enrollment Period with a hard deadline. The right answer depends on your age, your income and whether you are mid-treatment — and it is rarely the option that arrives in the mail first.
What you get
Concrete things, not a conversation about a conversation.
Every one of these is included, and none of it is billed to you. Our compensation comes from the carrier you eventually choose — or from nowhere at all, if the right answer is to leave your coverage exactly as it is.
- Your exact deadline, in writing, for each available route
- The real cost of COBRA versus a subsidised Marketplace plan, side by side
- A subsidy calculation based on your projected income for the remainder of the year
- A check on whether your current doctors and treatment continue under each option
- If you are over 65: whether your coverage was creditable and what that means for Part B
- The enrollment handled, with the effective date confirmed before the old plan ends
How it runs
Step by step.
- 01
Pin down the dates
The last day of coverage, the date of the qualifying event, and the deadline on each route. These differ, and they are the constraint everything else works inside.
- 02
Price every route honestly
COBRA at the full unsubsidised premium plus administrative fee. Marketplace at the after-credit price. A spouse’s plan at the family-tier cost. Medicare if age applies. Same page, same units.
- 03
Check continuity of care
Mid-treatment, mid-deductible, or seeing a specialist you cannot easily replace changes the calculus — sometimes decisively in COBRA’s favour despite the price.
- 04
Enroll before the gap
We work backwards from the last day of your old coverage so the new plan starts the following day, with no uninsured window in between.
COBRA versus a Marketplace plan
| COBRA | ACA Marketplace | |
|---|---|---|
| Your plan and network | Identical to what you had | New plan, usually narrower network |
| Deductible progress | Carries over for the plan year | Resets from zero |
| Cost | Full premium plus up to 2% administration | After premium tax credit, often far less |
| Subsidy available | No | Yes, if income-eligible |
| Duration | Typically 18 months | Ongoing, renewed annually |
| Election window | Typically 60 days from the notice | Typically 60 days from the loss of coverage |
| Best when | Mid-treatment, or deductible nearly met | Income-eligible for a credit, or COBRA is unaffordable |
If you are 65 or older
Losing employer coverage after 65 triggers a Medicare Special Enrollment Period, and this is where the most expensive mistakes in the entire Medicare system happen. Electing COBRA instead of enrolling in Part B does not preserve your Special Enrollment Period — COBRA is generally not considered creditable coverage for Part B purposes. People who assume otherwise can end up with both a coverage gap and a lifetime Part B penalty.
If you are in this position, call before you sign the COBRA election form. This is a short conversation that prevents a permanent problem.
What to gather before the conversation
That last item changes the answer more often than the financial ones. Being mid-course with a specific team is the strongest argument for COBRA there is, and it is easy to under-weight when you are looking at two premium figures.
- The exact last day of your current coverage — not the last day of employment, which is often different
- The COBRA election notice, if it has arrived, and the date printed on it
- Your current plan’s summary of benefits, so we can compare like with like
- Your projected household income for the remainder of the calendar year
- Everyone in your tax household, and whether any of them have other coverage available
- Any treatment in progress, and the providers involved
The two ages where the rules change
If a dependant is turning 26, ageing off a parent’s plan is a qualifying event with its own Special Enrollment Period. It is worth planning a month ahead rather than treating it as a surprise.
If you are 65 or older, the picture is different again and considerably less forgiving. Electing COBRA does not preserve your Medicare Part B Special Enrollment Period, because COBRA is generally not treated as active employer coverage for that purpose. People who assume otherwise end up with a coverage gap and a lifetime Part B penalty at the same time.
Frequently asked questions
How long do I have to decide?
Typically 60 days from the loss of coverage for a Marketplace Special Enrollment Period, and typically 60 days from the COBRA election notice for COBRA. The two clocks run in parallel and start on different dates, which is why writing them down matters.
Can I elect COBRA and switch to a Marketplace plan later?
Losing COBRA because it runs out is a qualifying event. Voluntarily dropping COBRA mid-term generally is not, which means you would wait for Open Enrollment. Choose deliberately at the start rather than assuming you can change your mind in month four.
I am retiring at 63. What are my options?
Usually a Marketplace plan as a bridge to Medicare, and this is a case where the subsidy math deserves real attention — your reported income in those years directly drives the premium tax credit. We will show you what the premium looks like at different income levels so you can plan withdrawals with your tax adviser.
Coverage involved
The products this service touches.
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ACA / Marketplace health plans
An ACA Marketplace plan is individual major-medical health insurance sold under the Affordable Care Act. Carriers cannot decline you or price you on health history, every plan covers the ten essential health benefits, and households under certain income levels receive a premium tax credit that reduces the monthly cost — often substantially.
About this coverage -
Short-term medical
Short-term medical is temporary health insurance designed to bridge a coverage gap. It is medically underwritten, does not cover pre-existing conditions, and is not required to include the ACA essential health benefits. It is genuinely useful for a defined short gap and a poor substitute for comprehensive coverage over the long term.
About this coverage -
Medicare Advantage (Part C)
Medicare Advantage (Part C) is a private plan that replaces how you receive your Part A and Part B benefits. Plans usually bundle prescription drug coverage and extras like dental and vision, often carry a $0 monthly premium, and cap your annual out-of-pocket costs — but you use a provider network and pay copays at the point of care.
About this coverage
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