COBRA insurance and how to get coverage: Losing employer health coverage is stressful — especially if you’re in the middle of treatment or trying to avoid gaps in care. COBRA (the Consolidated Omnibus Budget Reconciliation Act) can let eligible workers and their families keep their group health plan temporarily after a qualifying event. This guide explains what COBRA is, who qualifies, how long it lasts, what it costs, exactly how to enroll, smart alternatives to compare, and a printable checklist you can use right away.
What is COBRA — in one sentence
COBRA lets eligible employees and family members continue the same employer-sponsored health coverage for a limited time after certain life events (job loss, reduced hours, divorce, etc.), so you don’t lose access to your doctors and benefits immediately. (USAGov)
Who must offer COBRA and who’s covered
- Which employers: COBRA generally applies to private-sector group health plans sponsored by employers that had 20 or more employees in the prior year, and it also applies to many state and local government plans. The federal government and most church plans are treated differently. (DOL)
- Who’s a “qualified beneficiary”: the covered employee, their spouse/former spouse, and dependent children who were covered under the group plan on the day before the qualifying event. Each qualified beneficiary has an independent right to elect continuation coverage. (DOL)
If you’re unsure whether your employer’s plan is covered, check with HR or the plan administrator — they must tell you your rights under COBRA.
What counts as a qualifying event — common triggers
Typical qualifying events include:
- Voluntary or involuntary termination of employment (unless fired for gross misconduct)
- Reduction in hours that causes loss of coverage
- Divorce or legal separation from a covered employee (if it causes loss of coverage)
- Death of the covered employee
- A child losing dependent status under the plan’s rules
- Employee becomes entitled to Medicare (in some cases this is a qualifying event that affects dependents). (DOL)
Different events affect how long COBRA must be offered (see next section).
How long does COBRA last?
- 18 months is the typical maximum period for loss of coverage due to termination or reduced hours.
- 36 months may apply following other qualifying events (death, divorce, a child losing dependent status) or if a second qualifying event occurs during an initial 18-month period. In some disability cases an additional extension is possible (special rules can increase the cost for those extra months). (DOL, Centers for Medicare & Medicaid Services)
Because duration depends on the type of qualifying event and whether second events occur, confirm the exact end date with the plan administrator.
How much does COBRA cost?
COBRA lets you keep the same plan, but you generally pay a higher share of the premium because your employer usually stops subsidizing it. By law a plan may charge up to 102% of the plan’s total premium (employee + employer share) to cover costs and a small administrative fee; for certain disability-based extensions that rate can rise (statutory exceptions allow up to 150% for that extended period). That’s why COBRA is often more expensive than the premium you paid while employed. (DOL, Centers for Medicare & Medicaid Services)
Tip: ask HR for an itemized premium amount: the full COBRA premium, any administrative fee, and exact payment due dates.
Your timeline: notices, election period, and payments — what to expect
- Notice from employer/plan: After a qualifying event, the plan administrator must provide an election notice. The plan typically must give you at least 60 days to decide whether to elect COBRA coverage; that 60-day period begins from the later of the date the election notice is provided or the date you would otherwise lose coverage. Plans must also follow notice timing rules when employers notify the plan of events. (DOL)
- When coverage starts: If you elect COBRA and pay required premiums, coverage is generally retroactive to the date your coverage ended — so medical bills during that interim may be covered once you pay owed premiums. (DOL)
- Payment windows: Plans often allow a short period (e.g., 45 days from election) to make the initial COBRA payment; later payments follow monthly deadlines. If you miss payments, coverage can be terminated. (Timing can vary by plan, so read the election notice carefully.) (SHRM)
Step-by-step: How to get COBRA coverage (practical)
- Notify & confirm the qualifying event. If your employer or HR notifies the plan as required, you should receive a COBRA election notice. If you don’t receive notice within a few weeks of the event, contact HR or the plan administrator — you have rights if they fail to notify you. (chard-snyder.com)
- Read the election notice immediately. It lists the plan name, premium amount, how long coverage lasts, deadlines, and how to elect. The clock to elect typically starts on the date the notice is provided or the date coverage would otherwise end (whichever is later). (DOL)
- Weigh the cost vs. alternatives. Compare the full COBRA premium (including that up-to-102% figure) to Marketplace plans, spouse/partner coverage, Medicaid, or short-term options. In many cases Marketplace plans with premium tax credits are cheaper — especially if you’re eligible for subsidies. Healthcare.gov explains how COBRA fits with other options. (HealthCare.gov)
- Elect COBRA in writing within the election window. Follow the instructions in the notice exactly — sign and return the election form or use the plan’s online/electronically provided method if allowed. Keep copies and confirmation numbers. (DOL)
- Make your initial premium payment on time. Ask how to pay (check, online portal, ACH) and when the first payment must arrive. If you delay election but then elect within the 60-day window, your coverage is typically retroactive — but you’ll still owe premium back to the date coverage ended. (SHRM)
Smart alternatives (don’t assume COBRA is the only answer)
- Spouse/partner’s employer plan: Often the fastest and less expensive route (special enrollment due to loss of other coverage).
- Health Insurance Marketplace (ACA): You may qualify for premium tax credits or cost-sharing reductions that can make Marketplace plans substantially cheaper than COBRA. Losing employer coverage typically triggers a Special Enrollment Period to enroll in Marketplace coverage. (HealthCare.gov)
- Medicaid: If your income meets state thresholds, Medicaid may be free or very low cost.
- Short-term plans: Not ideal for people with ongoing medical needs because they often exclude pre-existing conditions and don’t cover essential benefits.
Compare network providers, prescription coverage, and out-of-pocket costs — not just monthly premium — before you decide.
If your employer didn’t give you the notice — what to do
If you don’t get a COBRA election notice:
- Ask HR/plan administrator immediately for a copy.
- If you don’t get a satisfactory response, file a written request for COBRA information and keep records (emails, dates, names).
- Contact the Department of Labor’s EBSA (Employee Benefits Security Administration) for assistance — they can help enforce notice and election rules. (DOL)
Quick checklist — use this now
- Ask HR: “Did the plan administrator receive notice of my qualifying event?”
- Look for your COBRA election notice — you must get at least 60 days to decide. (DOL)
- Get the exact full premium amount (COBRA can be up to 102% of plan cost). (DOL)
- Compare COBRA vs. Marketplace vs. spouse plan vs. Medicaid (costs, network, prescriptions). (HealthCare.gov)
- Elect COBRA in writing and make the first payment by the deadline. Keep confirmation and receipts. (SHRM)
Where to get authoritative help (clickable official links)
- USA.gov — Learn about COBRA insurance and how to get coverage.
https://www.usa.gov/cobra-health-insurance. (USAGov) - U.S. Department of Labor (EBSA) — COBRA Continuation Coverage and model notices.
https://www.dol.gov/agencies/ebsa/laws-and-regulations/laws/cobra. (DOL) - DOL FAQ / Employee’s Guide to COBRA — clear Q&A and rules on premiums, elections, and timelines.
https://www.dol.gov/sites/dolgov/files/EBSA/about-ebsa/our-activities/resource-center/faqs/cobra-continuation-health-coverage.pdf. (DOL) - CMS / CCIIO — COBRA fact sheet (premium rules and extensions).
https://www.cms.gov/cciio/programs-and-initiatives/other-insurance-protections/cobra_fact_sheet. (Centers for Medicare & Medicaid Services) - HealthCare.gov — If you’ve lost job-based coverage, compare Marketplace options and check whether you qualify for subsidies.
https://www.healthcare.gov/unemployed/cobra-coverage/. (HealthCare.gov)
Final thought
COBRA can be a lifesaver for continuity of care — but it can also be expensive. Don’t rush: use your 60-day election window to compare costs, confirm deadlines, and choose the option that keeps your care affordable and uninterrupted.
Disclaimer: This article is informational and not legal or financial advice. Rules, premium amounts, and deadlines may change — verify specifics with your plan administrator, the U.S. Department of Labor, or the official government pages linked above before you act. All images used in this article are royalty‑free or licensed for commercial use and are provided here for illustrative purposes.