COBRA vs ACA Marketplace — when each is the right choice
Lost your job-based health coverage? You have a 60-day window to either elect COBRA or enroll in an ACA Marketplace plan. They're very different products. For most people, ACA is significantly cheaper. Here's how to choose.
Key takeaways
- COBRA lets you keep your exact job-based plan for up to 18-36 months — but you pay the full premium plus 2% admin fee.
- ACA Marketplace qualifies you for premium subsidies based on your new income, often making it dramatically cheaper.
- Switch: You can switch from COBRA to ACA at next Open Enrollment (or sooner if your COBRA runs out).
- The math: For most middle-income job losers, ACA is 40-70% cheaper than COBRA after subsidies.
How COBRA works
COBRA (Consolidated Omnibus Budget Reconciliation Act of 1985) lets you continue your former employer's group health plan after losing job-based coverage. Key facts:
- Same plan, same network: You keep the exact same coverage, doctors, deductibles, and prescription tiers.
- You pay the full premium: What your employer used to pay PLUS what you used to pay PLUS 2% admin fee. Often 200-400% of what you previously paid.
- Duration: Up to 18 months for most events (job loss, reduced hours). Up to 36 months for divorce, death of covered employee, or losing dependent status.
- Election deadline: 60 days from the loss-of-coverage notice OR from coverage end date — whichever is later.
How ACA Marketplace works after job loss
Losing employer coverage triggers a Special Enrollment Period (SEP) to enroll in an ACA Marketplace plan. Key facts:
- Different plans, possibly different networks: You're choosing from Marketplace plans, not your old employer plan.
- You pay your share of premium based on income: If your forecast income for the year is lower than employed income, you may qualify for premium tax credits and cost-sharing reductions.
- Duration: Indefinite — ACA plans renew annually; you can keep coverage as long as you want.
- Election deadline: 60 days from loss of coverage.
The math — a worked example
Imagine a 45-year-old earning $90,000/year who just lost her job. She's getting severance for 3 months and expects to find new work in 4-6 months. Her old job-based plan was a $600/month family premium ($200 her share, $400 employer).
COBRA option: $600/month employer premium + 2% admin = $612/month. For 6 months: $3,672. She keeps her doctors and her prescription tiers.
ACA option: Forecast income of $40,000 for the year (severance + projected unemployment + part-year new job = much less than $90K full year). At ~210% FPL, she qualifies for ~$700/month subsidy. A comparable Silver plan costing $700/month becomes ~$0/month after subsidy. For 6 months: ~$0.
Difference: ~$3,672 saved by choosing ACA. Network may be different — she'd want to verify her doctors are in the ACA plan's network before committing.
When COBRA actually wins
COBRA is the right choice when:
- You have ongoing care with specific specialists who are in your current network but not in nearby ACA plans — e.g., mid-cancer-treatment.
- You've already met your deductible for the year and have major procedures coming up — starting fresh with an ACA plan resets the deductible.
- Your new job starts in <2-3 months with new coverage starting then — the short-term continuity may not be worth switching plans.
- You have FSA money tied to the employer plan — some FSA arrangements only work with COBRA continuation.
The hybrid strategy: short-term COBRA → ACA
A common play: elect COBRA for 1-3 months to keep continuity through a known procedure or until a specialist appointment, then switch to ACA at the next opportunity (Open Enrollment if you can wait, or if your job-loss SEP is still open).
Note: Voluntarily dropping COBRA does not trigger an SEP for ACA. The original loss-of-employer-coverage SEP gives you 60 days from the original coverage-loss date — not from when COBRA ends. So if you're going to do hybrid, calculate carefully so your ACA enrollment lands within the 60-day window.
EXCEPTION: COBRA naturally running out (e.g., reaching the 18-month limit) DOES trigger an SEP.
Common questions
Is COBRA cheaper than the ACA Marketplace?
How long do I have to enroll in ACA after losing my job?
Can I switch from COBRA to the ACA Marketplace?
Does COBRA count as 'minimum essential coverage'?
Questions about your specific situation?
A licensed SilverEdge advisor can walk through your exact options in 15 minutes by phone — free, no pressure.